Early disruptions to syringe services programs during the Russian invasion of Ukraine
IntroductionThe widespread HIV epidemic in Ukraine is concentrated among people who inject drugs (PWID), making access to sterile injection paraphernalia (SIP) like sterile needles and syringes a critical method of HIV/AIDS prevention; however, the Russian invasion has threatened to disrupt the oper...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1229057/full |
| _version_ | 1827663312345628672 |
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| author | Benjamin M. Nikitin Daniel J. Bromberg Iryna Pykalo Roman Ivasiy Zahedul Islam Frederick L. Altice |
| author_facet | Benjamin M. Nikitin Daniel J. Bromberg Iryna Pykalo Roman Ivasiy Zahedul Islam Frederick L. Altice |
| author_sort | Benjamin M. Nikitin |
| collection | DOAJ |
| description | IntroductionThe widespread HIV epidemic in Ukraine is concentrated among people who inject drugs (PWID), making access to sterile injection paraphernalia (SIP) like sterile needles and syringes a critical method of HIV/AIDS prevention; however, the Russian invasion has threatened to disrupt the operations of syringe services programs (SSPs), creating a risk of HIV outbreaks among PWID.MethodsWe conducted 10 semi-structured interviews with outreach workers from SSPs. Interviews were purposively sampled to cover three prototypic regions of Ukraine: temporarily Russian-controlled, frontline, and destination. Qualitative results from interviews were then compared against a standardized, nationwide harm reduction database.ResultsWe found that the Russian invasion triggered both supply and demand challenges for SSPs. Demand increased for all regions due to client transitions from pharmacies that closed to SSPs, increases in illicit drug use, greater client openness to NGO support, and displacement of clients to destination regions. Supply decreased for all areas (except for remote destination regions) due to battle-related barriers like curfews, roadblocks, and Internet disruptions; diminished deliveries of SIP and funding; and staff displacement. Time series plots of the number of unique clients accessing harm reduction services showed that an initial decrease in service provision occurred at the start of the war but that most regions recovered within several months except for Russian-controlled regions, which continued to provide services to fewer clients relative to previous years.ConclusionTo ensure continued scale-up of SIP and other HIV prevention services, the SyrEx database should be leveraged to serve as a streamlined harm reduction locator that can inform workers and clients of open site locations and other pertinent information. |
| first_indexed | 2024-03-10T00:41:03Z |
| format | Article |
| id | doaj.art-4b18ac7228354e1497e3e5c318a8a5b3 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-10T00:41:03Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-4b18ac7228354e1497e3e5c318a8a5b32023-11-23T15:06:58ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-11-011110.3389/fpubh.2023.12290571229057Early disruptions to syringe services programs during the Russian invasion of UkraineBenjamin M. Nikitin0Daniel J. Bromberg1Iryna Pykalo2Roman Ivasiy3Zahedul Islam4Frederick L. Altice5Yale School of Medicine, New Haven, CT, United StatesYale School of Medicine, New Haven, CT, United StatesUkrainian Institute on Public Health Policy, Kyiv, UkraineYale School of Medicine, New Haven, CT, United StatesInternational Alliance for Public Health Ukraine, Kyiv, UkraineYale School of Medicine, New Haven, CT, United StatesIntroductionThe widespread HIV epidemic in Ukraine is concentrated among people who inject drugs (PWID), making access to sterile injection paraphernalia (SIP) like sterile needles and syringes a critical method of HIV/AIDS prevention; however, the Russian invasion has threatened to disrupt the operations of syringe services programs (SSPs), creating a risk of HIV outbreaks among PWID.MethodsWe conducted 10 semi-structured interviews with outreach workers from SSPs. Interviews were purposively sampled to cover three prototypic regions of Ukraine: temporarily Russian-controlled, frontline, and destination. Qualitative results from interviews were then compared against a standardized, nationwide harm reduction database.ResultsWe found that the Russian invasion triggered both supply and demand challenges for SSPs. Demand increased for all regions due to client transitions from pharmacies that closed to SSPs, increases in illicit drug use, greater client openness to NGO support, and displacement of clients to destination regions. Supply decreased for all areas (except for remote destination regions) due to battle-related barriers like curfews, roadblocks, and Internet disruptions; diminished deliveries of SIP and funding; and staff displacement. Time series plots of the number of unique clients accessing harm reduction services showed that an initial decrease in service provision occurred at the start of the war but that most regions recovered within several months except for Russian-controlled regions, which continued to provide services to fewer clients relative to previous years.ConclusionTo ensure continued scale-up of SIP and other HIV prevention services, the SyrEx database should be leveraged to serve as a streamlined harm reduction locator that can inform workers and clients of open site locations and other pertinent information.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1229057/fullUkrainewarharm reductionHIVsyringe services programsimplementation science |
| spellingShingle | Benjamin M. Nikitin Daniel J. Bromberg Iryna Pykalo Roman Ivasiy Zahedul Islam Frederick L. Altice Early disruptions to syringe services programs during the Russian invasion of Ukraine Frontiers in Public Health Ukraine war harm reduction HIV syringe services programs implementation science |
| title | Early disruptions to syringe services programs during the Russian invasion of Ukraine |
| title_full | Early disruptions to syringe services programs during the Russian invasion of Ukraine |
| title_fullStr | Early disruptions to syringe services programs during the Russian invasion of Ukraine |
| title_full_unstemmed | Early disruptions to syringe services programs during the Russian invasion of Ukraine |
| title_short | Early disruptions to syringe services programs during the Russian invasion of Ukraine |
| title_sort | early disruptions to syringe services programs during the russian invasion of ukraine |
| topic | Ukraine war harm reduction HIV syringe services programs implementation science |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1229057/full |
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