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. 2019 Mar 22:8:323.
doi: 10.12688/f1000research.18573.2. eCollection 2019.

Young people in HIV care in Ukraine: a national survey on characteristics and service provision

Galyna Kyselyova  1 , Violeta Martsynovska  2   3 , Alla Volokha  1 , Nataliya Nizova  2 , Ruslan Malyuta  4 , Ali Judd  5 , Claire Thorne  6 , Heather Bailey  6
Affiliations

Young people in HIV care in Ukraine: a national survey on characteristics and service provision

Galyna Kyselyova et al. F1000Res. .

Abstract

Background: Ukraine's perinatally HIV-infected (PHIV) young people are ageing into adolescence/young adulthood and, alongside those with horizontally-acquired HIV infections, require transitional and other support services. We aimed to map this population and policies/service provision at specialist HIV centres, to inform future service development. Methods: A national survey was conducted of 28 HIV/AIDS centres on number, characteristics (age group, HIV acquisition mode) and care setting (paediatric/adult) of 10-24 year olds in HIV care in each of 24 regions in January 2016. Information was collected on policies/service provision at each centre. Results: Of 13,286 young people aged 10-24 years registered for HIV care nationally in Ukraine in January 2016, 1,675 were aged 10-18 years. Three-quarters of ≤19 year olds were PHIV, while 72% of 20-24-year-olds had sexually-acquired infection. Five regions accounted for two-thirds of 10-18 year olds in paediatric and 85% of 19-24 year olds in adult services. In 2015, 97 young people transitioned from paediatric to adult services nationally, typically at 18 years although with flexibility in timing at 17/28 centres. At 27/28 centres, horizontally HIV-infected young people aged <18 years began their HIV care in paediatric services sometimes (5) or always (22). Transition support most commonly consisted of a joint appointment with paediatrician and adult doctor, and support from a psychologist/social worker (both at 24/28 centres). Only 5/28 centres offered routine HIV care during the evening or weekend, and availability of integrated sexual/reproductive health and harm reduction services was uneven. Of 16/28 centres selectively following-up patients who did not attend for care, 15 targeted patients in paediatric services. Conclusions: Heterogeneity in the population and in service availability at the main regional/municipal HIV/AIDS centres has implications for potential structural barriers to HIV care, and development of services for this group.

Keywords: Eastern Europe; HIV; Ukraine; adolescents; harm reduction; injecting drug use; perinatal HIV infection; reproductive health; transition; youth.

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Conflict of interest statement

Competing interests: Claire Thorne reports personal fees from ViiV Healthcare for Advisory Board attendance, grants from ViiV Healthcare via PENTA Foundation and from AbbVie, Public Health England, European Commission H2020 and PENTA Foundation outside the submitted work; Ali Judd reports grants from Abbvie, Bristol Myers Squibb, Gilead, Janssen Pharmaceuticals and ViiV Healthcare through the PENTA Foundation, and from the Collaborative Initiative for Paediatric HIV Education and Research, Gilead Sciences, NHS England, Medical Research Council and PENTA Foundation outside the submitted work. Heather Bailey reports personal fees from Public Health England; the other authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Maps showing ( a) number of 10–18 year olds in paediatric HIV care and ( b) number of 19–24 year olds in adult HIV care by region, on 1 January 2016. Area of circle is proportional to number of young people. Note different scales for maps ( a) and ( b). Name of region was included for centres with ( a) n≥100 10–18 year olds in paediatric services and ( b) n≥800 19–24 year olds in adult services. Maps were adapted from original versions created by Aleksandr Grigoryev, available at https://commons.wikimedia.org/w/index.php?curid=28880433 under a CC0 license.
Figure 2.
Figure 2.. Of 24 regional and 4 municipal centres in Ukraine, the number with each support service available.
Bars differ in height due to missing data.
See this image and copyright information in PMC

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