Prevention HIV program in Western Ukraine during the emergency situation in Ukraine among evacuated MSM including the support for Prevention Organisation employees and clients who displaced to west part of Ukraine.

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:

The project was born during the emergency situation in Ukraine, part of the population, including the HIV risk group MSM (MSM key population group), was evacuated from Central, South and East regions of Ukraine to the Western regions of Ukraine.  Since HIV service programs in these regions were not ready for such migration, now the regions require increased attention, expertise and social work to provide MSM at risk with HIV testing, assistance in dispensary registration and initiation of ART treatment for newly diagnosed cases of HIV infection, search for and assistance in coordinating and registering for dispensary registration and ART of those clients who have moved due to evacuation and have lost the opportunity to receive ART in their region.  There is also a need for crisis counselling and redirection clients to PrEP assistance for new cases and for those clients who have moved due to evacuation and have lost the ability to receive PrEP in their area.

The project has a few parts. The first part of the project provides for the start of the work of social workers of ALLIANCE.GLOBAL in several Western regions of Ukraine, where MSM have migrated.  Social workers through social networks and MSM dating apps has  contacting with the clients, identify client needs, provide counselling and offer free HIV testing services.  The tasks of social workers were include:   1) crisis counselling;   2) HIV counselling;   3) testing for HIV;   4) providing oral HIV tests or sending by postal services;   5) accompanying clients to medical facilities to receive ART (for clients with newly diagnosed HIV status and clients with a long-standing status who migrated to Western Ukraine and lost the opportunity to receive ART in their region – this way the service will help maintain adherence);   6) redirection clients to the PrEP program where they escorting clients to medical institutions to receive PrEP (new clients to receive PrEP and clients who previously participated in the program, but migrated to Western Ukraine and thus lost the opportunity to receive PrEP in their region – the service will help maintain adherence),   7) advising on redirection to the network of shelters in the cities of Kyiv and Dnipro (for refugees from the Eastern part of Ukraine), as well as to shelters for people who migrated to Western Ukraine in the cities of Chernivtsi, Lviv, Ivano-Frankivsk.  8) Redirection to the program of receiving free condoms, lubricants furing HIV prevention program for MSM.

The second part of the project has been directed to the organization employees who during emergency situation in Ukraine, were evacuated to the Western regions of Ukraine.  For those employees the project has provides support for evacuated employees by paying rent for employees in settlements where there is no possibility of free accommodation (it was include payment for hostels, hotels or flat or apartments for the duration of the employees’ stay while working in Western Ukraine) and for the employees who made working visits to other western regions of Ukraine.

Project Implementation Results:

Thanks to this project, the organization was able to retain and support its employees in the field of HIV prevention, as well as redeploy some of its employees and social workers to the western regions of Ukraine, devise and implement new routes for recruiting clients and providing services to clients, grow the territory of its activities, retain employees , who were potentially going to leave the territory of Ukraine, as well as support and even preserve other key projects of the organization. For example, the PrEP (pre-expouse exposure) project, which was at risk of being lost, due to the predicted non-fulfillment of indicators, due to the fact that all the base regions of PrEP project activity in February-May were in the war zone, from which clients were forced to migrate to the western regions of Ukraine and the activities in these regions were reduced or stopped.

Thanks to this project, it was possible to support the transfer of preventive activities of the organization to Lviv, Uzhhorod, Ivano-Frankivsk, Chernivtsi and to continue its activities in these regions in the future. Keeping its key employees in safe regions of Ukraine made it possible to continuously carry out management processes in prevention projects and conduct field meetings with the directors of AIDS centers, meet with representatives of other donors and sign agreements on cooperation and establishing partnerships with health care institutions in four western regions of Ukraine .

Contacts were established, meetings were held and cooperation agreements were signed in the period from April to June 2022 in the following regions: Lviv region (city of Lviv), Chernivtsi region (city of Chernivtsi), Zakarpattia region (city of Uzhhorod), Ivano-Frankivsk region (city Ivano-Frankivsk). In all of the listed works, work was started on the prevention of HIV infection and the redirection of clients to related projects (PrEP, social support of HIV+ clients).

Following to our clients thanks to 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” has moved HIV-service activities from Kyiv, Kyiv region, Chernihiv, Kharkiv to Lviv, Chernivtsi, Ivano-Frankivsk and Uzhgorod, where MSM migrated most, fleeing hostilities from the central, eastern and southern regions Ukraine.

Having retained only a small part of the activities in the base regions for the organization (the central regions of the country), we noted an increased number of MSM and work in the western regions. Our project allowed us to continue working with MSM and come up with new approaches.  The organization first started working in 4 western regions of Ukraine, providing HIV prevention services for displaced MSM and for local MSM.

To start work, cooperation agreements were signed with local healthcare institutions (In Ukraine only a state institution have drugs and medicines on their balance sheets, as well as dispensary registration of people who join the pre-exposure prophylaxis program and dispensary registration of people who have been diagnosed with HIV infection).

For work in the city of Lviv and the Lviv region, negotiations were held and a memorandum was signed with the healthcare institution “Lviv Regional Phthisis-Pulmonology Clinical Diagnostic Center”.  For work in the city of Chernivtsi and the Chernivtsi region, negotiations were held and a memorandum was signed with the “Chernivtsi Regional Center for Prevention and Combating AIDS”.

For work in the city of Ivano-Frankivsk and the region, negotiations were held and a memorandum was signed with the “Ivano-Frankivsk Regional Clinical Infectious Diseases Clinic of the Ivano-Frankivsk Region”.

For work in the city of Uzhhorod and the Transcarpathian region, negotiations were held and a memorandum was signed with the “Transcarpathian Regional Community Health Center” in Uzhgorod.

Then the offices were opened in the cities of Lviv and Chernivtsi, employees were relocated and work to recruite and test clients has been began.  In the cities of Uzhgorod and Ivano-Frankivsk, “outreach and hiv-testing/prep traveling spokesman”. routes were established. (“outreach and hiv-testing/prep traveling spokesman” route – is when a social worker came to the city for several days to work with clients and provide them with counseling and HIV testing services and accompany them to healthcare facilities to start taking pre-exposure prophylaxis (PrEP)).

Thanks to agreements with healthcare institutions, it was possible to work on the basis of the health care institutions using the offices located on their territory.

During the project in 2022 a 329 MSM has been consulted and redirected for join (or renewed) the project of Pre Espouse Proxylaxy program (PrEP) in west regions of Ukraine, 466 MSM has been tested by rapid HIV test based on our testing points in west Ukraine regions by our social workers, 409 Oraquick HIV test has been issued for testing, 147 MSM local and migrants has been provided a food certificates,  22 MSM has been diagnosed with newly HIV infection during our project in west regions of Ukraine. The clinets has received crisis counseling and has been redirected to the program of helping to get dispensary registration and help for receiving ART.