Opioid Agonist Treatment and Improved Outcomes at Each Stage of the HIV Treatment Cascade in People Who Inject Drugs in Ukraine

The HIV treatment cascade is an effective tool to track progress and gaps in the HIV response among key populations. People who inject drugs (PWID) remain the most affected key population in Ukraine with HIV prevalence of 22% in 2015. We performed secondary analysis of the 2017 Integrated Bio-Behavioral Surveillance (IBBS) survey data to construct the HIV treatment cascade for PWID and identify correlates of each indicator achievement. The biggest gap in the cascade was found in the first “90”, HIV status awareness: only 58% [95% CI: 56%-61%] of HIV-positive PWID reported being aware of their HIV-positive status. Almost 70% [67%-72%] of all HIV-infected PWID who were aware of their status reported that they currently received antiretroviral therapy (ART). Almost three quarters (74% [71%-77%]) of all HIV-infected PWID on ART were virally suppressed. Access to harm reduction services in the past 12 months and lifetime receipt of opioid agonist treatment (OAT) had the strongest association with HIV status awareness. Additionally, OAT patients who were aware of HIV-positive status had 1.7 [1.2–2.3] times the odds of receiving ART. Being on ART for the last 6 months or longer increased odds to be virally suppressed; in contrast, missed recent doses of ART significantly decreased the odds of suppression. The HIV treatment cascade analysis for PWID in Ukraine revealed substantial gaps at each step and identified factors contributing to achievement of the outcomes. More intensive harm reduction outreach along with targeted case finding could help to fill the HIV awareness gap among PWID in Ukraine. Scale up of OAT and community-level linkage to care and ART adherence interventions are viable strategies to improve ART coverage and viral suppression among PWID.

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HIV treatment cascade in MSM, people who inject drugs, and sex workers

Current Opinion in HIV and AIDS ◽

10.1097/coh.0000000000000200 ◽

2015 ◽

Vol 10 (6) ◽

pp. 420-429 ◽

Cited By ~ 73

Author(s):

Kathryn Risher ◽

Kenneth H. Mayer ◽

Chris Beyrer

Keyword(s):

Sex Workers ◽

People Who Inject Drugs ◽

Hiv Treatment ◽

Treatment Cascade ◽

Hiv Treatment Cascade

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Understanding why people who inject drugs in Indonesia are disengaged from HIV testing and treatment: gaps in the HIV treatment cascade

Journal of Substance Use ◽

10.1080/14659891.2020.1723722 ◽

2020 ◽

Vol 25 (4) ◽

pp. 398-404

Author(s):

Luh Putu Lila Wulandari ◽

I Made Adimantara ◽

Ni Made Sri Nopiyani ◽

Ni Wayan Septarini

Keyword(s):

Hiv Testing ◽

People Who Inject Drugs ◽

Hiv Treatment ◽

Treatment Cascade ◽

Treatment Gaps ◽

Hiv Treatment Cascade

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Engaging the ‘Missing Men’ in the HIV Treatment Cascade: Creating a Tailored Intervention to Improve Men’s Uptake of HIV Care Services in Rural South Africa: A Study Protocol

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073709 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3709

Author(s):

Oluwafemi Adeagbo ◽

Kammila Naidoo

Keyword(s):

South Africa ◽

Health Outcomes ◽

Hiv Treatment ◽

Hiv Care ◽

Treatment Cascade ◽

Hiv Care Cascade ◽

Care Services ◽

The Social ◽

Hiv Treatment Cascade ◽

Male Specific

Men, especially young men, have been consistently missing from the HIV care cascade, leading to poor health outcomes in men and ongoing transmission of HIV in young women in South Africa. Although these men may not be missing for the same reasons across the cascade and may need different interventions, early work has shown similar trends in men’s low uptake of HIV care services and suggested that the social costs of testing and accessing care are extremely high for men, particularly in South Africa. Interventions and data collection have hitherto, by and large, focused on men in relation to HIV prevention in women and have not approached the problem through the male lens. Using the participatory method, the overall aim of this study is to improve health outcomes in men and women through formative work to co-create male-specific interventions in an HIV-hyper endemic setting in rural KwaZulu-Natal, South Africa.

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