Accompaniment and support for receiving pre-exposure HIV prevention (PrEP)

The project aims is to help reduce the spread of HIV among MSM by introducing PrEP as part of a combined prevention and care program in Ukraine.

Project description:

In 2022, the project envisaged and planned to expand the number of PrEP courses, expand the project team, hire additional social workers and hire an additional project assistant for coordinated work and implementation of planned indicators. The work took place from 1^st of January to 24^th of February, 2022 in 5 regions of Ukraine: Kyiv, Kyiv region (the cities of Bucha and Irpin), Chernihiv, Kharkiv. Dnipro

Planned regions of activity in 2022

In the first half of 2022, in connection with the state of war in Ukraine and hostilities in the cities of Kharkiv, Chernihiv and the cities of Bucha and Irpin of the Kyiv region, as well as the proximity of the city of Dnipro and Kyiv to the regions where hostilities were taking place, work became difficult, life social workers were exposed to great risk, and clients migrated en masse to other regions (the first waves of migration took place to the western regions of Ukraine). During the operation of the project in the first and second half of the year, the organization periodically applied for statistical data to the company “HORNET LLC” (it owns an application for dating MSM and has the ability to track the activity and movement of MSM).

The obtained data reflected the continued migration of clients between regions and provided an opportunity to adjust the program and “follow the client”.

The obtained data proved that a large proportion of the organization’s current and potential clients who lived in the cities of Kyiv, Kharkiv, Chernihiv and the cities of the Kyiv region migrated to the western regions of Ukraine, namely: Lviv region, Chernivtsi region, Ivano-Frankivsk region, Transcarpatioan region, Ternopil region, Volyn region. In connection with the significant migration of potential clients to the western regions of Ukraine and the difficulty of working in the regions where hostilities took place, the organization requested and received permission from the Public Health Alliance to start pilot work in the regions where the potential clients migrated. Along with the start of the pilot activity, the project indicators were redistributed and the gradual launch of the project lines began in the regions where the clients moved.

Project team, with the assistance of the Public Health Alliance, and using the potential of the project «Prevention HIV program in Western Ukraine during the emergency situation in Ukraine among evacuated MSM including the support for ALLIANCE.GLOBAL employees and clients who displaced to west part of Ukraine», meetings were held with the heads of health care institutions and memoranda on interaction and cooperation were signed between ALLIANCE.GLOBAL and

1. “Lviv Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center” of the Lviv Regional Council, a communal non-commercial enterprise in Lviv;
2. REGIONAL COMMUNAL NON-COMMERCIAL ENTERPRISE “Chernivtsi Regional Center for AIDS Prevention and Control in Chernivtsi;
3. KNP “Transcarpathian Regional Center of Public Health ZOR” in Uzhhorod;
4. Communal non-commercial enterprise “Ivano-Frankivsk Regional Clinical Infectious Hospital of the Ivano-Frankivsk Regional Council” in Ivano-Frankivsk

Interviews were held and contracts concluded with medical consultants of the above-mentioned health centers to serve the project’s clients in the listed regions. In the cities of Lviv and Chernivtsi, a tender was held for renting premises, the project offices were opened. In the city of Lviv, a “short route” for obtaining PrEP has been implemented, in the city of Chernivtsi, consultations and testing are held in the office, and clients receive the medication according to the “classic route”.

In the cities of Uzhgorod and Ivano-Frankivsk, work was established on the methodology of “PrEP-travellers”, when social workers from Lviv come to the city for Internet outreach, counseling, motivation, testing and accompanying clients at the PrEP to the doctor in the health center according to the classic route. As of April 2022, the office in the city of Lviv is the most modern and convenient point of quick receipt of the PrEP in Ukraine. The point is located in the central area of the city, and the time of issuing a PrEP takes from 20 to 30 minutes. For the offices of Lviv and Chernivtsi, additional fundraising was carried out and the lease of premises was secured, modern furniture for the office was purchased through fundraising.

In the second half of the year, in the cities of Chernivtsi and Uzhhorod, the work was carried out according to the classic route of escorting to the health center, and in the city of Ivano-Frankivsk, work was carried out according to the methodology of “PrEP traveling salesmen”, when social workers from Lviv come to the city for Internet outreach where he counseling, motivation, testing, motivate and redirect clients to accompanying by PrEP program to the doctor in the health center according to the classic route.

Actual regions of activity in 2022 ( Blue – based regions, green – additional regions from 24.02.22, pink – the regions for telemedicine case, red – the regions where the services were stoped)

In the same time work were continued in the cities of Kyiv, Bucha, Irpin, Kharkiv, Dnipro with clients returning to their “home” regions and clients moving to the specified regions from the temporarily occupied territories.

Thanks to the “bring a friend” component, community awareness about PrEP was increased and more clients were attracted to the project thanks to their friends, which is provided by the component in the city of Kyiv, Kharkiv and Kyiv region. In Kharkiv, thanks to the component, the PrEP indicator was exceeded, and in the Kyiv region, thanks to the component, the PrEP indicator of the second half of the year was achieved.

Normaly during the project a social workers recruit clients, counsel them about PrEP and sexual behavior, provide assistance in obtaining the medication and follow-up. In 2022 the organization has get partnership agreements with 8 health care facilities in 8 regions where it is kept on the balance of PrEP.

When a client applies to the issuance site by going directly to the project office, the social worker must establish the candidate’s compliance with the specified conditions for selecting clients to participate in the project.

The social worker draws the potential client’s attention to the fact that in order to participate in this project, he must meet a number of requirements and explain to the client the benefits of participating in the project. The social worker initiates the screening with the help of a special questionnaire. If the eligibility criteria are met, the potential participant will be informed about the need to undergo the next stage of screening procedures – mandatory medical diagnosis on the basis of partner medical institutions in accordance with the list of examinations.

Potential clients have the opportunity to get to the points of issuance of PrEP on their own or with the assistance of employees of the organization and contact a responsible medical professional. Participants are invited to use the services of a social worker to undergo all types of diagnostics included in medical screening.

Project Implementation Results:

During January-December 2022 a 2145 clients in 9 regions received services (consultations on PrEP, HIV testing,  accompaniment by social workers to the aids center to receive a PrEP medication). 820 of them receive a service in Kyiv city, 412 in Kyiv region, 382 in Kharkiv’ city, 273 in Lviv, 135 in Dnipro city, 45 in Uzhgorod, 37 in Chernihiv city, 24 in Ivano-Frankivsk 17 in Chernivtsi.