"Overall, our findings confirm that significant gaps exist in the HIV treatment cascade among PWID in Ukraine. Only 58% of the estimated population of PWID living with HIV are aware of their status.
"Compared to reports from other countries, the proportion of PWID aware of their HIV status was comparable to Mexico [48], but lower than in Central Asia or other European countries [7, 49].
"We found a substantial 30% gap between HIV status awareness and ART initiation.
"There is a paucity of published data on ART coverage among PWID globally, and the figures vary considerably across countries. According to the European Center for Disease Prevention and Control (ECDC) [49], UNAIDS [7] reports, and published reviews [8, 48], there is a stark difference between higher- and lower/middle-income countries (LMIC) in reaching 90-90-90 target among PWID. Compared to other LMIC globally and within the Eastern Europe and Central Asia (EECA) region, the 70% ART coverage among PWID who were aware of their HIV- positive status that we have found in this study is higher than the average. This also indicates that the gap between the number of diagnosed PWID and the number of treated patients is relatively smaller in Ukraine.
"The final cascade indicator, viral load suppression (VLS), was achieved in approximately 74% of those PWID who reported being on ART. Additionally, 4.8% of HIV positive PWID with self-reported non-use of ART had been virally suppressed according to the lab results (4.5% among clients of harm reduction programs and 5.4% among non-clients). It might be attributed to the stage of the HIV-infection, interrupted ART uptake or misclassification of ART uptake due to the self-reported nature of data [50].
"From the available data sources, we may conclude that the level of viral load suppression in Ukrainian PWID is modestly higher than among their peers in other LMIC, but lags far behind higher income countries, (88% among those treated in Western Europe) [7, 48]."
Sazonova, Y., Kulchynska, R., Sereda, Y., Azarskova, M., Novak, Y., Saliuk, T., Kornilova, M., Liulchuk, M., Vitek, C., & Dumchev, K. (2020). HIV treatment cascade among people who inject drugs in Ukraine. PloS one, 15(12), e0244572. doi.org/10.1371/journal.pone.0244572
