Bridging the Gaps: Ukraine
Bridging the Gaps: Ukraine
Bridging the Gaps is alliance of nine international organisations and networks and more than 80 local and regional organisations, working towards the end of the AIDS epidemic among key populations.
Supported by global and regional level work, Bridging the Gaps works with over 80 partner organisations in 15 countries in three regions:
• Sub-Sahara Africa: Botswana, Kenya, Mozambique, South Africa, Tanzania, Uganda, and Zimbabwe.
• South East Asia: Indonesia, Myanmar, Nepal, Vietnam.
• Eastern Europe and Central Asia: Georgia, Kyrgyzstan, Tajikistan and Ukraine.
In Ukraine, the programme works with, and for the health and human rights of, sex workers, LGBT people and people who use drugs, including those living with HIV.
Mikolayiv, Kiev, Kherson, Odessa, Chernivtsi, Kirovograd, Kharkiv, Poltava
Bridging the Gaps partners in Ukraine work towards ending AIDS among key populations through (1) a strengthened civil society that holds government to account; (2) increased fulfilment of human rights of key populations; and (3) increased SRHR and fewer infections.
People who use drugs, sex workers and LGBT people
The HIV epidemic observed in Ukraine is the second largest HIV epidemic among Eastern European and Central Asian countries1. Although the epidemic has continued to expand among the general population, to a large extent due to the growing role of sexual transmission, HIV is still considered to be concentrated in key affected populations such as people who inject drugs (PWID), sex workers (SW) and men who have sex with men (MSM). The last five years have seen increasing feminisation of the epidemic among the general public: in 2014 the share of women totalled 44.2% among new HIV cases and it continues to grow. There has been a gradual decrease in the number of newly registered HIV cases among PWID. One third of PWID are women whose injecting and sexual practices include provision of sex work and using drugs after a male partner with the same syringe, as well as experience of violence. Among PWUD as a key population affected by HIV, one under-researched sub-group is people using non-injecting drugs. Among all sex workers, 27.7% use drugs and HIV prevalence among them is three times higher. A behaviour surveillance survey conducted among clients of sex workers in five cities of Ukraine shows high risk of HIV transmission (7.4% of clients of sex workers are HIV-positive2) and low level of HIV awareness, making them an important under-covered target group for prevention services. During the last 10 years, the number of people receiving ART multiplied by 22, from 3,058 in 2005 to 66,409 in 2014 and 60,753 as of 1st January 2016. The share of ART medications procured by the public budget multiplied by 13, from 6% to 78%. Opioid substitution therapy (OST) programmes have expanded from 160 clients in 2006 to 8,512 clients, of whom 41.7% are HIV positive, as of January 2016. The legislative base for HIV response and human rights protection is well developed and diverse; the challenge is the lack of implementation.
The HIV/AIDS epidemic in Ukraine has been growing since the early 1990s among key
populations. The HIV epidemic observed in Ukraine is the second largest HIV epidemic among Eastern European and Central Asian countries. During the last five years, progress in HIV response and a decreasing HIV rate among several key populations has been achieved with technical and financial support from international donors. However, HIV prevalence is estimated at 7% among sex workers. Since 2009, the Ukrainian state took financial responsibility for ART but not for the comprehensive country HIV response. In early 2014 Ukraine was hit by socio-economic and political crisis with the occupation and annexation of the Crimea.
The ongoing war in Eastern Ukraine has caused many people to leave non-Ukraine controlled territories amid high violence, crises in access to food and accommodation, and massive human rights violations. It has become hard or almost impossible for key populations to access health services. War and waves of internally displaced people (IDPs) have led to shortages in domestic funding, and pushed HIV response down to the lowest priority for state and local governments.