| In Ukraine, the HIV/AIDS epidemic has been driven by injecting drug use and PEPFAR programs have focused on prevention and care for injecting drug users. Working with the Government of Ukraine and with other donors, a major recent accomplishment has been the implementation of medication-assisted therapy (MAT) utilizing methadone and buprenorphine. PEPFAR has provided assistance in developing policy and legal frameworks for MAT, as well as supporting the development and implementation of MAT programs. In particular, |
| PEPFAR has supported pilot programs which integrate MAT and HIV care for HIV-positive injecting drug users. In this setting, MAT serves the dual purpose of addressing prevention by reducing injecting drug use and other risk behaviors, and enhancing care by supporting healthy behaviors (e.g. improving adherence to treatment). Pilot programs will be implemented in ten sites in five regions, with the possibility of later expansion to additional sites. PEPFAR supports a range of services in Ukraine, including prevention, counseling and testing, TB/HIV, orphans and vulnerable children, and health system strengthening. Prevention programs focus on most-at-risk populations including injecting drug users and street children and adolescents. Other programs target at-risk youth, working with local communities to improve awareness of HIV and reduce risky behaviors. PEPFAR also supports prevention in military populations, providing HIV prevention information and strengthening counseling and testing services for military personnel. The PEPFAR program in Ukraine also has a strong focus on health system strengthening, providing assistance to strengthen public sector and nongovernmental capacity to deliver HIV/AIDS programs. |
