Lost Opportunities And Potential Of HCV Test And Treatment Among People Who Inject Drugs In Ukraine

Author: Saliuk T, Sazonova Y, Cheshun O

Theme: Epidemiology & Public Health Research Year: 2018

Background: Ukraine is facing one of the fastest growing HCV epidemics among people who inject drugs in Europe with stable HCV prevalence around 60%. Harm reduction program to prevent new HIV cases and other blood-borne infections among PWIDs are implemented in Ukraine since 2000. Recently, programmatic focus of harm reduction activities was shifted to the finding of new HIV cases in this population and linkage to care. However, HCV test and treat approach was not a priority. Approach: We used unique client code database which track services provided to PWIDs during 2013-2017in order to measure HCV testing uptake and results. To estimate the potential of reaching the PWIDs trough prevention services in different regions we estimated the number of HCV cases among PWIDs used HCV prevalence data and size of this population from integrated bio-behavior study done in 2013. Outcomes: From 2013 to 2017 harm reduction programs covered 435144 unique clients among them only 173551 (40%) were tested for HCV. During five years 38243 unique client were found with HCV (22%). According to the estimates, about 230000 PWID had HCV in 2013 Ukraine (including Crimea), what suggest that prevention services were able to identify only 17% of cases. Regional destitution of HCV cases shows that 75 percent of estimated cases are located in core 15 cities. The coverage of HCV testing in these cities varies from 3% in Simferopol (Crimea) to 34% in Kiev. Conclusions: Coverage of PWID by HCV testing and yield of HCV positive results is very low. The potential of harm reduction services implemented by NGOs is sufficiently underutilized and can be improved by focusing at selected cities and proper target setting. With reduction of price for HCV treatment the role of NGOs is crucial in eliminating HCV in this population. Due to the lower stigma towards HCV in comparison to HIV, offering the HCV test at first place may be used as the mean of building the trust for further medical interventions including HCV and HIV treatment. Disclosure of Interest Statement: The authors report no conflicts of interest.

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