Improving access and retention on opioid agonist therapy in Ukraine.

Author: Tetiana Fomenko, Anna Meteliuk, Lynn Madden, Samy Galvez, Scott Farnum, Iryna Pykalo, Myroslava Filippovych, Zahedul Islam, Frederick Altice

Theme: Models of Care Year: 2023

Background: Ukraine leads in Europe in terms of HIV prevalence, and one of the main drivers of HIV transmission is injecting drug use. Opioid agonist treatment (OAT) is the worldwide recognized therapy for people who inject drugs (PWID) and evidence-based HIV, HCV and TB prevention. The beginning of Russia’s large-scale war against Ukraine led to changes in all spheres of life, including access to services and changes in the needs of consumers of these services. There is the need in evidence-based approaches to improve the quality of OAT services.

Description of model of care/intervention: The Network for the Improvement of Addiction Treatment (NIATx) is an evidence-based approach of process improvement that helps healthcare providers to improve services, learn innovation strategies and remove the barriers within existing financial and administrative resources. The team of four local coaches had monthly online meetings with Chief Narcologists for counceling on how to change the policies and procedures for better admission and retention on OAT. There were 5 learning sessions with international team from the USA during this year.

Effectiveness: The number of OAT patients countrywide increased from 17,232 in February 2022 to 20,063 in February 2023 and the percentage of take-home dosing due to the war response constitutes 88.5%. Both OAT and ART receive 29.7% of clients (N=5,958), which constitutes 97% of all HIV-positive patients. During this period the number of HCV-positive clients has changed from 56% to 52%. Among internally displaced patients, there was no interruption in treatment and 99% stayed in the program.

Conclusion and next steps: The NIATx intervention in Ukraine contributed to access and retention in addiction treatment. It’s the useful tool to identify and overcome the structural and organizational barriers for service improvement. The next step is to continue increasing the number of patients in Ukraine and review existing interventions and services for PWID due to the war in Ukraine.

We have no conflicts of interest to disclose.

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