This document was generated by the Reference Group to the United Nations on HIV and Injecting Drug Use.

Transcription

1 This document was generated by the Group to the United Nations on HIV and Injecting Drug Use. The data included in this report reflect the results of a systematic search and review of data on a range of indicators reflecting the extent of services provided to people who inject drugs. These data have been searched, reviewed and extracted according to decision rules developed by the Group. Some data have been adjusted to facilitate estimates of standard indicators across countries. Details of the process for searching, grading and including data, along with their interpretation, are detailed in: Mathers B, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick R, et al. HIV prevention, treatment and care for people who inject drugs: A systematic review of global, regional and national coverage. The Lancet DOI: /S (10) For more information on the Group, please go to:

2 Section Table of Contents Page Estimated number of people who inject drugs and number of injectors who are living with HIV 4 1. Needle and syringe programs (NSPs) 5 NSP 1: Availability of NSPs NSP 2: Number of NSP sites NSP 3: Number of pharmacy sites where needles and syringes are available for purchase NSP 4: Total number of sites where needles and syringes are available NSP 5: Number of individual IDUs in contact with NSPs in a 12 month period NSP 6: Number of NSP occasions of service (client contacts) in a 12 month period NSP 7: Number of needles and syringes distributed by NSPs in a 12 month period 2. Opioid substitution programs (OST) 12 OST 1: Availability of opioid substitution treatment (OST) OST 2: Availability of methadone maintenance treatment (MMT) OST 3: Availability of buprenorphine maintenance treatment (BMT) OST 4: Availability of other forms of agonist OST OST 5: Dose and duration of MMT OST 6: Dose and duration of BMT OST 7: Total number of all sites providing OST OST 8: Number of sites providing MMT OST 9: Number of sites providing BMT OST 10: Number of sites providing other forms of agonist OST OST 11: Number of all clients in any OST at a single point in time OST 12: Number of all clients in MMT at a single point in time OST 13: Number of all clients in BMT at a single point in time OST 14: Number of all clients in other forms of OST at a single point in time OST 15: Number of IDUs in any OST at a single point in time OST 16: Number of IDUs in MMT at a single point in time OST 17: Number of IDUs in BMT at a single point in time OST 18: Number of IDUs in other forms of OST at a single point in time OST 19: Number of all clients receiving any OST in a 12 month period OST 20: Number of all clients receiving MMT in a 12 month period OST 21: Number of all clients receiving BMT in a 12 month period OST 22: Number of all clients receiving other forms of OST in a 12 month period OST 23: Number of IDUs receiving any OST in a 12 month period OST 24: Number of IDUs receiving MMT in a 12 month period 1 of 51

3 Section OST 25: Number of IDUs receiving BMT in a 12 month period Table of Contents Page OST 26: Number of IDUs receiving other forms of OST in a 12 month period 3. Other Drug Treatment (ODT) 26 ODT 1: Detoxification ODT 1.1: Number of sites providing detoxification ODT 1.2: Number of IDUs receiving detoxification ODT 1.3: Number of all clients receiving detoxification in a 12 month period and/or at a single point in time ODT 2: Residential Rehabilitation ODT 2.1: Number of sites providing residential rehabilitation ODT 2.2: Number of IDUs in residential rehabilitation ODT 2.3: Number of all clients in residential rehabilitation ODT 3: Outpatient psychosocial support, counselling and psychotherapy ODT 3.1: Number of sites providing outpatient psychosocial support, counselling or psychotherapy ODT 3.2: Number of IDUs receiving outpatient psychosocial support, counselling or psychotherapy treatment ODT 3.3: Number of all clients receiving outpatient psychosocial support, counselling or psychotherapy treatment ODT 4: Peer-based support groups ODT 4.1: Number of sites providing peer-based support groups ODT 4.2: Number of IDUs in peer-based support groups ODT 4.3: Number of all clients in peer-based support groups ODT 5: Drug treatment (treatment type not specified) ODT 5.1: Number of sites providing unspecified drug treatment ODT 5.2: Number of IDUs receiving unspecified drug treatment ODT 5.3: Number of all clients receiving unspecified drug treatment ODT 6: Drug treatment in prisons ODT 6.1: Number of drug treatment sites located in prisons ODT 6.2: Number of IDUs receiving drug treatment in prisons ODT 6.3: Number of all clients receiving drug treatment in prisons ODT 7: Compulsory drug treatment ODT 7.1: Number of compulsory detention sites for drug use ODT 7.2: Number of IDUs in compulsory detention sites for drug use ODT 7.3: Number of all drug users in compulsory detention sites for drug use 4. HIV testing and counselling (T&C) 41 T&C 1: Availability of HIV T&C T&C 2: Number of sites providing HIV T&C that specifically targets IDUs 2 of 51

4 Table of Contents Section T&C 3: Number of T&C sites providing HIV T& to the general population and also accessible to IDUs Page T&C 4: Number of individual IDUs who were tested for HIV in a 12 month period T&C 5: Percentage of IDUs who were tested for HIV in a 12 month period and who know the result 5. Anti-retro-viral (ARV) treatment 45 ARV 1: Number of sites providing ARV treatment ARV 2: Number of IDUs receiving ARVs at a single point in time ARV 3: Restrictions on IDUs' access to ARVs 6. Condoms 48 Condoms 1: Availability of condom programs targeting IDUs Condoms 2: Number of sites distributing condoms to IDUs Condoms 3: Number of individual IDUs receiving condoms Condoms 4: Number of condoms distributed to IDUs 3 of 51

5 Estimated number of people who inject drugs and number of injectors who are living with HIV Estimated prevalence of IDU among general population aged years (%) Year of IDU prevalence estimate 2009 for IDU prevalence estimate Estimated prevalence of HIV among people who inject (%) Year of HIV prevalence among IDU estimate 2008 Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine for HIV prevalence among IDU estimate Kobyscha, Y as cited in Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct General population years of age in (source: UN Population Division, 2009) Estimated IDU population in Estimated number of IDUs living with HIV in of 51

6 NSP 1. Needle and syringe programs (NSPs) NSP 1: Availability of NSPs Are NSPs available? Comments Yes Most recent year of documentation 2009 When were NSPs first introduced? 1998 Are needles and syringes available for purchase from pharmacies? See references for other NSP indicators L.Amjadeen, L.Andrushchak, et al. (2005). A review of work with injecting drug users in Ukraine in the context of the HIV/AIDS Epidemic. Kyiv. Yes Most recent year of documentation 2008 Apteka. (2009). "Infrastructure pharmaceutical market. Part I: Ukraine as a whole " Retrieved 28 October, 2009, from 5 of 51

7 NSP NSP 2: Number of NSP sites 985 sites Year of (1078 sites reported by International HIV/AIDS Alliance Ukraine 223 sites operated by the State Social Service for Youth 22 pharmacies distributing syringes) WHO, UNAIDS., et al. (2009). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector - progress report Geneva, WHO. Skoropatska, J. (Programme Officer: Reporting & Planning), International HIV/AIDS Alliance in Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 6 May Dumchev, K. (Technical Officer STI/HIV/AIDS Prevention), WHO Country Office Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 15 May European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from Cook, C. and N. Kanaef (2008). Global state of harm reduction 2008: Mapping the response to drug related HIV and hepatitis C epidemics. London, International Harm Reduction Association,. Samko, M. (Senior Programme Manager), Programmatic Monitoring and Evaluation and Donor Reporting Unit, International HIV/AIDS Alliance in Ukraine. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use. Svyatyuk, O. (Head of Unit on social and preventive activities), Technical support department, State Social Service for families, children and youth. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use. Assumed count of sites are mutually exclusive Figures taken as range IDU prevalence estimate (%) Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) INDICATOR: Number of NSP sites per 1000 IDUs of 51

8 NSP NSP 3: Number of pharmacy sites where needles and syringes are available for purchase Year of pharmacy sites Apteka. (2009). "Infrastructure pharmaceutical market. Part I: Ukraine as a whole " Retrieved 28 October, 2009, from IDU prevalence estimate (%) 2009 INDICATOR: Number of pharmacy sites per 1000 IDUs (source: UN Population Division, 2009) NSP 4: Total number of sites where needles and syringes are available Total number (NSP sites + Pharmacy sites) IDU prevalence estimate (%) (source: UN Population Division, 2009) INDICATOR: Total number of sites per 1000 IDUs 7 of 51

9 NSP NSP 5: Number of individual IDUs in contact with NSPs in a 12 month period clients accessed NSPs during 2008 provided by the International HIV/AIDS Alliance Ukraine Year of individual clients covered by NSP services of the State Social Service for Youth. Skoropatska, J. (Programme Officer: Reporting & Planning), International HIV/AIDS Alliance in Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 6 May Dumchev, K. (Technical Officer STI/HIV/AIDS Prevention), WHO Country Office Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 15 May Assumed count of clients from International HIV/AIDS Alliance Ukraine to be of individual clients accessing services For lower bound of estimate assume all clients accessing State Social Service for Youth had also accessed Alliance services For upper bound assume counts are mutually exclusive International HIV/AIDS Alliance Ukraine IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in contact with NSPs in a 12 month period Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) of 51

10 NSP NSP 6: Number of NSP occasions of service (client contacts) in a 12 month period Year of occassions of service at NSPs operated by the International HIV/AIDS Alliance Ukraine Samko, M. (Senior Programme Manager), Programmatic Monitoring and Evaluation and Donor Reporting Unit, International HIV/AIDS Alliance in Ukraine. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use IDU prevalence estimate (%) INDICATOR: Number of NSP occasions of service (client contacts) in a 12 month period per IDU Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) NSP 7: Number of needles and syringes distributed by NSPs in a 12 month period syringes distributed Year of 2008 ( syringes distributed during 12 month period from sites operated by the International HIV/AIDS Alliance Ukraine syringes distributed/exchanged by the State Social Service for Youth in 2008) Skoropatska, J. (Programme Officer: Reporting & Planning), International HIV/AIDS Alliance in Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 6 May Dumchev, K. (Technical Officer STI/HIV/AIDS Prevention), WHO Country Office Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 15 May World Health Organisation (2009). Universal Access Unpublished Data. Figures taken as range IDU prevalence estimate (%) INDICATOR: Total number of needles/syringes distributed in a 12 month period per IDU Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) of 51

11 Ukraine NSP NSP: All documents reviewed Aceijas, C., M. Hickman, et al. (2007). "Access and coverage of needle and syringe programmes (NSP) in Central and Eastern Europe and Central Asia.[see comment]." Addiction 102(8): AIDS Alliance. (2008). "Programme "Overcoming HIV/AIDS epidemic in Ukraine"." Retrieved 16 February, 2009, from Apteka. (2009). "Infrastructure pharmaceutical market. Part I: Ukraine as a whole " Retrieved 28 October, 2009, from AVERT. (2008). "HIV prevention around the world." Retrieved 30 November, 2008, from AVERT. (2008). "Needle exchanges." Retrieved 30 November, 2008, from Barcal, K., J. Schumacher, et al. (2005). "A situational picture of HIV/AIDS and injection drug use in Vinnitsya, Ukraine." Harm Reduction Journal Bega, A. (2007). HIV/AIDS policy in Ukraine. A civil society perspective. A series of reports on HIV/AIDS policy in Nicaragua, Senegal, Ukraine, the United States, and Vietnam. New York, Open Society Institute. Bremen Institute for Drug Research (BISDRO) University of Bremen, Centre for Interdisciplinary Addiction Research (CIAR) University of Hamburg, et al. (2008). Final report on prevention, treatment, and harm reduction services in prison, on reintegration services on release from prison and methods to monitor/analyse drug use among prisoners. Burrows, D. (2006). "Advocacy and coverage of needle exchange programs: results of a comparative study of harm reduction programs in Brazil, Bangladesh, Belarus, Ukraine, Russian Federation, and China." Cadernos de Saude Publica 22(4): Burrows, D. (2006). High coverage sites: HIV prevention among injecting drug users in transitional and developing countries: case studies. UNAIDS best practice collection, UNAIDS. Canadian HIV/AIDS Legal Network (2006). Prison needle exchange: Lessons from a comprehensive review of international evidence and Central and Eastern European Harm Reduction Network (2007). Hepititis C among injecting drug users in the new EU member states and neighboring countries: Situation, guidelines and recommendations. Dumchev, K. (Technical Officer STI/HIV/AIDS Prevention), WHO Country Office Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 15 May Eurasian Harm Reduction Network (2007). Hepatitis C among Injecting Drug Users in the New EU Member States and Neighboring Countries: Situation, Guidelines and Recommendations. Vilnius, Central and Eastern European Harm Reduction Network,. European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from Human Rights Watch (2006). Rhetoric and Risk: Human Rights Abuses Impeding Ukraine s Fight against HIV/AIDS. A Human Rights Watch Report 18(2(D)). New York, HRW. Human Rights Watch (2008) World AIDS day: address needs of drug users. Ensure access to HIV prevention and treatment. International Harm Reduction Development Program (2008). Harm reduction developments New York. Jurgens, R. (2007). Interventions to address HIV in prisons: needle and syringe programmes and decontamination strategies. Geneva, World Health Organisation (WHO). Jurgens, R. and G. Betteridge (2005). "Prisoners who inject drugs: public health and human rights imperatives." Health & Human Rights 8(2): 46- L.Amjadeen, L.Andrushchak, et al. (2005). A review of work with injecting drug users in Ukraine in the context of the HIV/AIDS Epidemic. Kyiv. Ministry of Health Ukraine (2008). National Report on Monitoring Progress Towards the UNGASS Declaration of Commitment on HIV/AIDS. Kyiv. Olexander Yaremenko Ukrainian Institute for Social Research and UNICEF (2008). Core MARA indicators for UNICEF programme: HIV prevention in most-at-risk adolescents (MARA) in Ukraine and South-Eastern Europe. Olexander Yaremenko Ukrainian Institute for Social Research, DV8 Research Training and Development, et al. (2006). Risk and protective factors in the initiation of injecting drug use: Analytical report and strategy paper preventing the Initiation of injecting drug use among vulnerable adolescents and young people. Kyiv. Samko, M. (Senior Programme Manager), Programmatic Monitoring and Evaluation and Donor Reporting Unit, International HIV/AIDS Alliance in Ukraine. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use. Skoropatska, J. (Programme Officer: Reporting & Planning), International HIV/AIDS Alliance in Ukraine,. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Ukraine, Received by the Group to the UN on 10 of 51

12 Ukraine NSP NSP: All documents reviewed Use on 6 May Svyatyuk, O. (Head of Unit on social and preventive activities), Technical support department, State Social Service for families, children and youth. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use. Ukrainian Harm Reduction Association. (2008). "Harm reduction among IDUs." from UNAIDS (2006). High coverage sites - HIV prevention among injecting drug users in transitional and developing countries. UNAIDS best practice collection. Geneva. UNAIDS (2007). Harm reduction to be scaled up in Ukraine, UNAIDS knowledge centre feature story. WHO and UNAIDS (2008). Progress on implementing the Dublin Declaration on partnership to fight HIV/AIDS in Europe & Central Asia WHO. WHO, UNAIDS., et al. (2009). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector - progress report Geneva, WHO. 11 of 51

13 OST 2. Opioid substitution treatment (OST) OST 1: Availability of opioid substitution treatment (OST) Are any forms of agonist OST available? Comments Yes Most recent year of documentation 2009 When was agonist OST first available? 2004 See references for other OST indicators Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct OST 2: Availability of methadone maintenance treatment (MMT) Is MMT available? Comments Yes Most recent year of documentation 2009 When was MMT first available? 2008 See references for other OST indicators Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct OST 3: Availability of buprenorphine maintenance treatment (BMT) Is BMT available? Comments Yes Most recent year of documentation 2009 When was BMT first available? 2004 See references for other OST indicators Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct OST 4: Availability of other forms of agonist OST Are other forms of OST available? Comments NO Most recent year of documentation 2009 When were other forms of OST first available? Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct of 51

14 OST OST 5: Dose and duration of MMT Average/standard maintenance dose of MMT Comments Year mg - 80 mg Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Average/standard duration of MMT (range) Comments Year World Health Organisation (2009). Global health ATLAS data. OST 6: Dose and duration of BMT Average/standard maintenance dose of BMT Comments Year mg - 14 mg Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Average/standard duration of BMT (range) Comments Year World Health Organisation (2009). Global health ATLAS data. OST 7: Total number of all sites providing OST 79 OST sites Year of OST sites in total WHO, UNAIDS., et al. (2009). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector - progress report Geneva, WHO. Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Figure taken as range IDU prevalence estimate (%) Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) INDICATOR: Number of OST sites per 1000 IDUs of 51

15 OST OST 8: Number of sites providing MMT 77 MMT sites Year of MMT sites 98 MMT sites Sultanov, M. (HIV/AIDS Advisor), UNODC. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Received by the Group to the UN on HIV and Injecting Drug Use on 13 May (Unpublished). Combating the Twin Epidemics of HIV/AIDS and Drug Addiction: Opportunities for Progress and Gaps in Scale - A Report of the CSIS Task Force on HIV/AIDS, Center for Strategic and International Studies. Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Highest and lowest figures taken as a range IDU prevalence estimate (%) Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) INDICATOR: Number of MMT sites per 1000 IDUs OST 9: Number of sites providing BMT Year of BMT sites Sultanov, M. (HIV/AIDS Advisor), UNODC. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Received by the Group to the UN on HIV and Injecting Drug Use on 13 May Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from 28 IDU prevalence estimate (%) Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) INDICATOR: Number of BMT sites per 1000 IDUs of 51

16 OST OST 10: Number of sites providing other forms of agonist OST Year of 2009 Other forms of OST not available Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct IDU prevalence estimate (%) INDICATOR: Number of sites providing other forms of OST per 1000 IDUs Ukrainian AIDS Center of the Ministry of Health of Ukraine, World Health Organization, et al. (2009). National estimate of HIV/AIDS in Ukraine as of beginning of Kyiv, Ukraine (source: UN Population Division, 2009) of 51

17 OST OST 11: Number of all clients in any OST at a single point in time 3793 clients in MMT Year of clients in BMT Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on any OST at census date : 100 IDUs null OST 12: Number of all clients in MMT at a single point in time 3793 clients on MMT 1 October 2009 Year of 2009 Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on MMT at census date : 100 IDUs null of 51

18 OST OST 13: Number of all clients in BMT at a single point in time 841 clients on BMT 1 October 2009 Year of 2009 Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on BMT at census date : 100 IDUs null OST 14: Number of all clients in other forms of OST at a single point in time Year of IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on other forms of OST at census date : 100 IDUs 17 of 51

19 OST OST 15: Number of IDUs in any OST at a single point in time 3793 clients in MMT Year of clients in BMT all clients on OST are IDUs Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in OST at a single point in time null OST 16: Number of IDUs in MMT at a single point in time 3793 clients on MMT 1 October 2009 Year of 2009 all clients on MMT are IDUs Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in MMT at a single point in time null of 51

20 OST OST 17: Number of IDUs in BMT at a single point in time 841 clients on BMT 1 October 2009 Year of 2009 Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in BMT at a single point in time null OST 18: Number of IDUs in other forms of OST at a single point in time Year of null null null null null IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in other forms of OST at a single point in time null null null null null null null 19 of 51

21 OST OST 19: Number of all clients receiving any OST in a 12 month period Year of 2008 OST available but number of clients on OST not known Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from NK IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on any OST in a 12 month period : 100 IDUs null NK NK NK OST 20: Number of all clients receiving MMT in a 12 month period Year of 2009 MMT available but number of clients not known Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from NK IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on MMT in a 12 month period : 100 IDUs null NK NK NK 20 of 51

22 OST OST 21: Number of all clients receiving BMT in a 12 month period Year of 2009 BMT available but number of clients not known Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct NK IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on BMT in a 12 month period : 100 IDUs null NK NK NK OST 22: Number of all clients receiving other forms of OST in a 12 month period Year of IDU prevalence estimate (%) INDICATOR: Ratio of total number of all clients (including IDUs and non-idus) on other forms of OST in a 12 month period : 100 IDUs 21 of 51

23 OST OST 23: Number of IDUs receiving any OST in a 12 month period Year of 2009 OST available but number of IDU on OST not known Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs receiving OST in a 12 month period null NK NK NK OST 24: Number of IDUs receiving MMT in a 12 month period Year of 2009 MMT available but number of IDU receiving MMT during 12 month period not known Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs receiving MMT in a 12 month period null NK NK NK 22 of 51

24 OST OST 25: Number of IDUs receiving BMT in a 12 month period Year of 2009 BMT available but number of IDUs receiving BMT during 12 month period not know Ukrainian Institute of Public Health Policy. (2009). "Bi-weekly OST monitoring Report." Retrieved October 1, 2009, from Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Personal Communication: Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs receiving BMT in a 12 month period null NK NK NK OST 26: Number of IDUs receiving other forms of OST in a 12 month period Year of null null null null null IDU prevalence estimate (%) INDICATOR: Percentage of IDUs receiving other forms of OST at a single point in time null null null null null null null null 23 of 51

25 Ukraine OST OST: All documents reviewed (2007). "In Ukraine, the introduction of substitution therapy progarms for drug addicts meets current legislation and WHO guidelines." Retrieved 23 March, 2009, from < (2008). "MOH figures for first half of 2008." Retrieved 23 March, 2009, from < (2009). "132 addicts receive methadone Nukolayivi ST." Retrieved 23 March, 2009, from < (2009). "Started PTA Methadone Progarm in Lugansk." Retrieved 23 March, 2009, from < AIDS Alliance. (2008). "Programme "Overcoming HIV/AIDS epidemic in Ukraine"." Retrieved 16 February, 2009, from AVERT. (2008). "HIV and AIDS in Russian Eastern Europe & Central Asia." Retrieved 30 November, 2008, from Barrett, D., R. Lines, et al. (2008). Recalibrating the Regime: The Need for a Human Rights-based Approach to International Drug Policy. Oxford, Human Rights Watch, the International Harm Reduction Association and the Canadian HIV/AIDS Legal Network.. Bega, A. (2007). HIV/AIDS policy in Ukraine. A civil society perspective. A series of reports on HIV/AIDS policy in Nicaragua, Senegal, Ukraine, the United States, and Vietnam. New York, Open Society Institute. Bruce, R. D., S. Dvoryak, et al. (2007). "HIV treatment access and scale-up for delivery of opiate substitution therapy with buprenorphine for IDUs in Ukraine--programme description and policy implications." International Journal of Drug Policy 18(4): Burrows, D. (2006). High coverage sites: HIV prevention among injecting drug users in transitional and developing countries: case studies. UNAIDS best practice collection, UNAIDS. Central and Eastern European Harm Reduction Network (2007). Hepititis C among injecting drug users in the new EU member states and neighboring countries: Situation, guidelines and recommendations. Committee for combating HIV/AIDS and other socially dangerous diseases. (2009). "Information on the situation of HIV/AIDS in Ukraine." Retrieved 23 March, 2009, from < Csete, J. and D. Wolfe (2007). Closed to Reason: The International Narcotics Control Board and HIV/AIDS. Toronto and New York, Canadian HIV/AIDS Legal Network and the International Harm Reduction Development Program of the Open Society Institute. Eurasian Harm Reduction Network (2007). Hepatitis C among Injecting Drug Users in the New EU Member States and Neighboring Countries: Situation, Guidelines and Recommendations. Vilnius, Central and Eastern European Harm Reduction Network,. Eurasian Harm Reduction Network, ECCB, et al. (2008). Substitution therapy in 9 countries in Eastern Europe and Central Asia. European AIDS Treatment Group (2008). Antiretroviral treatment for injecting drug users in Central and Eastern Europe. European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from Human Rights Watch (2006). Rhetoric and Risk: Human Rights Abuses Impeding Ukraine s Fight against HIV/AIDS. A Human Rights Watch Report 18(2(D)). New York, HRW. Human Rights Watch (2008) World AIDS day: address needs of drug users. Ensure access to HIV prevention and treatment. International AIDS Society (2008). Expanding access to opioid substitution therapy for injecting drug users in Eastern Europe and Central Asia. IAS Yalta Scientific Leadership Summit. International AIDS Society (2008). Opioid substitution therapy in selected countries of East European and Central Asia. International Harm Reduction Association (2008). Harm Reduction and Human Rights: The Global Response to Injection-Driven HIV Epidemics: International Harm Reduction Association (IHRA) (2007). Conference abstracts book. 18th International Conference on the Reduction of Drug Related Harm, Warsaw, Poland. International Harm Reduction Development Program (2008). Harm reduction developments New York. Joint United Nations Programme on HIV/AIDS (UNAIDS) (2005). AIDS epidemic update. Geneva, Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organisation (WHO). Klepikov, A. (2006). "Fighting HIV/AIDS in Ukraine." Retrieved 8/12/2008, 2008, from < 24 of 51

26 Ukraine OST OST: All documents reviewed Lazarus, J. (2006). Ukraine: Reduction of drug-related harm - National conference on the reduction of drug-related harm. CD News - Quarterly Communicable Disease Report,. Copenhagen: 2. Ministry of Health Ukraine (2008). National Report on Monitoring Progress Towards the UNGASS Declaration of Commitment on HIV/AIDS. Kyiv. Ministry of Health Ukraine (2008). National Report: Implementation of decisions declaration about dedication wrestling since HIV/AIDS. Kyiv. Olexander Yaremenko Ukrainian Institute for Social Research, DV8 Research Training and Development, et al. (2006). Risk and protective factors in the initiation of injecting drug use: Analytical report and strategy paper preventing the Initiation of injecting drug use among vulnerable adolescents and young people. Kyiv. Open Society Institute and Government fo Canada through the Canadian International Development Agency (2008). Treatment of drug addiction in Ukraine and its evaluation efficiency. Sidyak, S. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine" Received by the Group to the UN on HIV and Injecting Drug Use on 6 May Sultanov, M. (HIV/AIDS Advisor), UNODC. Personal Communication: Response to the "UN HIV and IDU Group: Request to fill data gaps - Ukraine". Kyiv, Received by the Group to the UN on HIV and Injecting Drug Use on 13 May Ukrainian Institute of Public Health Policy. (2009). "Summary of patients substitution maintenance treatment programs in Ukraine (as at )." Retrieved 23 March, 2009, from < Ukrainian Medical and Monitoring Cneter on Alcohol & Drugs. "Current drug situation in Ukraine as of " Retrieved 23 March, 2009, from < UNAIDS (2007). Harm reduction to be scaled up in Ukraine, UNAIDS knowledge centre feature story. UNAIDS. (2008). "Making a difference: UNAIDS in Ukraine." from WHO and UNAIDS (2008). Progress on implementing the Dublin Declaration on partnership to fight HIV/AIDS in Europe & Central Asia WHO. 25 of 51

27 ODT 3. Other drug treatment (ODT) ODT 1 - Detoxification ODT 1.1: Number of sites providing detoxification Is detoxification available? Yes Number of sites - data reported Inpatient & Outpatient detox provided at all 47 territorial narcological facilities, 4 narcological hospitals, some mental healthcare facilities and rural outpatient units Year of 2008 European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from > 51 IDU prevalence estimate (%) INDICATOR: Number of detoxification sites per 1000 IDUs null of 51

28 ODT ODT 1.2: Number of IDUs receiving detoxification Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator drug users received detoxification treatment in 2008, 92% of these were opiate injectors National Drug Observatory within the National Center for Health Management (2009). cited in Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct Republican Narcological Dispensary (2009). cited in Sultanov, M. (HIV/AIDS Advisor in Ukraine and Moldova), UNODC. Response to "Ukraine - UN Group - Final Data Check". Kyiv, Ukraine, Received by the Group to the UN on HIV and Injecting Drug Use on 14 Oct NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in detoxification in a 12 month period INDICATOR: Percentage of IDUs in detoxification at a single point in time null NK NK NK 27 of 51

29 ODT ODT 1.3: Number of all clients receiving detoxification in a 12 month period and/or at a single point in time Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator 92 % of drug disorder treatment cases registered were for detoxification European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from Derived estimate from NK IDU prevalence estimate (%) INDICATOR: Ratio of number of all clients in detoxification in a 12 month period : number of IDUs INDICATOR: Ratio of number of all clients in detoxification at a single point in time : number of IDUs null NK NK NK 28 of 51

30 ODT ODT 2 - Residential rehabilitation ODT 2.1: Number of sites providing residential rehabilitation Is residential rehabilitation present? Number of sites - data reported Yes 50 Inpatient rehabilitation programmes centres Year of Therapeutic communities 40 inpatient programmes of spiritual psychotherapy and religious rehabilitation European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from Assumed counts are mutually exclusive 110 IDU prevalence estimate (%) INDICATOR: Number of residential rehabilitation sites per 1000 IDUs null ODT 2.2: Number of IDUs in residential rehabilitation Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator Residential rehabilitation present but number not known European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from NK NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in residential rehabilitation in a 12 month period INDICATOR: Percentage of IDUs in residential rehabilitation at a single point in time null NK NK NK NK NK NK 29 of 51

31 ODT ODT 2.3: Number of all clients in residential rehabilitation Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator Residential rehabilitation present but number not known European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from NK NK IDU prevalence estimate (%) INDICATOR: Ratio of number of all drug users in residential rehabilitation in a 12 month period : number of IDUs INDICATOR: Ratio of number of all drug users in residential rehabilitation at a single point in time : number of IDUs null NK NK NK NK NK NK 30 of 51

32 ODT ODT 3 - Outpatient psychosocial support, counselling and psychotherapy ODT 3.1: Number of sites providing outpatient psychosocial support, counselling or psychotherapy treatment Is outpatient psychosocial support, counselling or psychotherapy present? Number of sites - data reported Yes Year of 2008 Psychosocial support and counselling present but number not known European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from NK IDU prevalence estimate (%) INDICATOR: Number of outpatient psychosocial support, counselling or psychotherapy sites per 1000 IDUs null NK NK NK ODT 3.2: Number of IDUs receiving outpatient psychosocial support, counselling or psychotherapy treatment Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator Psychosocial support and counselling present but number not known European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from NK NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in outpatient psychosocial support, counselling or psychotherapy in a 12 month period INDICATOR: Percentage of IDUs receiving outpatient psychosocial support, counselling or psychotherapy at a single point in time null NK NK NK NK NK NK 31 of 51

33 ODT ODT 3.3: Number of all clients receiving outpatient psychosocial support, counselling or psychotherapy treatment Psychosocial support and counselling present but number not known Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator European Monitoring Centre for Drugs and Drug Addiction. (2008). "Country Overview:Ukraine." Retrieved 8 Decemeber, 2008, from NK NK IDU prevalence estimate (%) INDICATOR: Ratio of number of all drug users in outpatient psychosocial support, counselling or psychotherapy in a 12 month period : number of IDUs INDICATOR: Ratio of number of all drug users in outpatient psychosocial support, counselling or psychotherapy at a single point in time : number of IDUs null NK NK NK NK NK NK 32 of 51

34 ODT ODT 4 - Peer-based support groups ODT 4.1: Number of peer-based support groups sites Are Peer-based support groups present? Number of sites - data reported Yes Year of NA meetings per week Narcotics Anonymous World Services (2009). Quadrennial report for non-governmental organizations - July Assumed each meeting per week occurs at a separate location 74 IDU prevalence estimate (%) INDICATOR: Number of peer-based support groups sites per 1000 IDUs null ODT 4.2: Number of IDUs in peer-based support groups Year of 2008 Final/Adjusted data for 12 month period (to be used as indicator Final/Adjusted data for single point in time (to be used as indicator Narcotics Anonymours present but number not known Narcotics Anonymous World Services (2009). Quadrennial report for non-governmental organizations - July NK NK IDU prevalence estimate (%) INDICATOR: Percentage of IDUs in peer-based support groups in a 12 month period INDICATOR: Percentage of IDUs in peer-based support groups at a single point in time null NK NK NK NK NK NK 33 of 51