Katherine LaMonaca1, Kostyantyn Dumchev2, Sergii Dvoriak3, Lyuba Azbel4, Olga Morozova5, Frederick L Altice6. 1. Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, 135 College Street Suite 323, New Haven, CT, 06510, USA. 2. Ukrainian Institute on Public Health Policy, Kyiv, Ukraine. 3. Academy of Labour, Social Relations and Tourism, Kyiv, Ukraine. 4. London School of Hygiene & Tropical Medicine, London, UK. 5. Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA. 6. Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, 135 College Street Suite 323, New Haven, CT, 06510, USA. Frederick.Altice@yale.edu.
Abstract
PURPOSE OF REVIEW: Scaling up evidence-based HIV prevention strategies like opioid agonist therapies (OAT), syringe services programs (SSPs), and antiretroviral therapy (ART) to mitigate the harms of drug injection is crucial within Eastern Europe and Central Asia (EECA), the only region globally where HIV incidence and mortality are increasing. RECENT FINDINGS: Though the proportion of new HIV cases directly attributable to drug injection has recently declined, it remains a critical driver of HIV, especially to sexual partners. Concurrently, scale-up of OAT, SSPs, and ART has remained low, contributing to a volatile HIV epidemic among people who inject drugs (PWID). Despite evidence that drug injection contributes to an evolving HIV epidemic in EECA, coverage of evidence-based harm reduction programs remains substantially below needed targets. Due to a combination of punitive drug laws, ideological resistance to OAT among clinicians and policymakers, and inadequate domestic and international funding, limited progress has been observed in increasing the availability of these programs.
PURPOSE OF REVIEW: Scaling up evidence-based HIV prevention strategies like opioid agonist therapies (OAT), syringe services programs (SSPs), and antiretroviral therapy (ART) to mitigate the harms of drug injection is crucial within Eastern Europe and Central Asia (EECA), the only region globally where HIV incidence and mortality are increasing. RECENT FINDINGS: Though the proportion of new HIV cases directly attributable to drug injection has recently declined, it remains a critical driver of HIV, especially to sexual partners. Concurrently, scale-up of OAT, SSPs, and ART has remained low, contributing to a volatile HIV epidemic among people who inject drugs (PWID). Despite evidence that drug injection contributes to an evolving HIV epidemic in EECA, coverage of evidence-based harm reduction programs remains substantially below needed targets. Due to a combination of punitive drug laws, ideological resistance to OAT among clinicians and policymakers, and inadequate domestic and international funding, limited progress has been observed in increasing the availability of these programs.
Entities:
Keywords:
Central Asia; Drug injection; Eastern Europe; HIV prevention; Harm reduction; Opioid agonist therapy
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