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Providence/Boston CFAR
Our study aims to examine alcohol consumption and the prevalence of alcohol use disorders, as well as comorbidities including smoking, substance use, and mental health of people living with HIV and TB co-infection in Ukraine. This study will also provide data on participants’ willingness to engage in treatment for these comorbidities and explore participants’ readiness for reduction of alcohol intake, addiction treatment and depression treatment.
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Identifying the main mechanisms and ways to involve injecting drug users and men who have sex with men to receive primary care services.
- To find out the general perception of PWID and MSM to family doctors and the readiness to receive medical services, including those related to HIV, at the primary care;
- Identify existing and in-demand primary care services for PWID and MSM;
- Identify the main barriers and factors that contribute to the treatment of PWID and MSM for the primary care services;
- Identify existing and in-demand sources and channels of information about the primary care services for PWID and MSM (including potential messages, topics, etc.);
- Determine the perception and willingness of NGO representatives to work with family physicians to provide services to PWID and MSM in the prevention and treatment of HIV, hepatitis C, tuberculosis and other socially dangerous diseases;
- To find out the existing and demanded role of family doctors in providing services to PWID and MSM in the prevention and treatment of HIV, hepatitis C, tuberculosis and other socially dangerous diseases;
- To identify the existing mechanism of interaction between PWID/MSM, NGOs and family doctors in the context of receiving medical services, including those related to HIV prevention;
- To identify the optimal model of interaction between PWID/MSM, NGOs and family doctors in the context of receiving medical services, including those related to HIV prevention;
- Provide recommendations for increasing the demand for PWID and MSM to receive primary care services, communication strategy for it and establishing a process of interaction between PWID / MSM, NGOs and family physicians.
National Institute on Drug Abuse (NIDA)
The aim of this project is to study the effectiveness of the modified SBIRT, where instead of offsite psychiatric referral, depression is treated onsite using SSRIs. Also, we will use ECHO (Extension for Community Healthcare Outcomes), a collaborative learning process, to facilitate mSBIRT activities and reinforce integration of COD services in OAT clinics.To enhance ECHO implementation, evidence-based pay-forperformance (P4P) intervention, aligned with Ukraine’s health reform, will be added to determine if incremental benefits are derived from this EBP, in an effort to strengthen and support ongoing healthcare reform efforts in Ukraine.
1. To compare both service-level (screening and brief intervention adoption and penetration) and patient-level (SSRI initiation, OAT drop-out and psychiatric quality of life) outcomes in 1,350 patients with opioid use disorders receiving OAT from 4 regions (clusters) and 12 clinical settings using a randomized, cluster-controlled design over 24 months. Before site randomization, all OAT clients at each participating site will have baseline assessments followed by site randomization to receive standard of care (N=450) versus integrated care using ECHO-COD facilitation with (N=450) or without (N=450) P4P incentives;
2. Using a multi-level implementation science framework, to examine the contribution of client, clinician and organizational factors that contribute to the primary and secondary outcomes;
3. To conduct a cost-effectiveness analysis (CEA) of integrating COD services into OAT clinics, with or without P4P, compared to a control group of OAT sites.
Machavariani E., Bromberg D., Dumchev K., Dvoriak S., Zeziulin O., Morozova O., Esserman D., Pykalo I., Saichuk N., Ivasiy R., Haddad M., Altice F. Design, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine. Contemporary Clinical Trials, 2023 May 30 (EN)
World Health Organization
The study will look at the feasibility and impact of expanding the availability and accessibility of community management of opioid overdose (including training and take-home naloxone) in participating countries/sites.
The study will produce evidence on the implementation barriers and facilitators for community management of opioid overdose, including trainings, outreach activities and settings that are better placed to reach many people at risk to prevent opioid overdose. The initiative's targets include saving lives by making naloxone and training on overdose management available to all people likely to witness an overdose, including peers and family members. The initiative sets a global implementation target of 90-90-90 as a joint point of reference:
1) 90 per cent of the relevant target population should be trained in overdose risk and emergency management;
2) 90 per cent of those trained should carry take-home naloxone;
3) 90 per cent of those who have been given a naloxone supply should use naloxone at overdoses they witness.
The Providence/Boston (Center for AIDS Research) CFAR
Retrospective assessment of pediatric TB in Ukraine. Prospective assessment of active TB among children in Ukraine.
1. To define real mortality from TB among children (HIV-positive and HIV-negative) in 2 regions of Ukraine.
2. To document the number of bacteriologically confirmed and clinically diagnosed cases of TB among children in 2 regions of Ukraine.
World Health Organization
Evaluation of changes of clinical practice of those primary health care workers who completed Essential Training on the Integrated Management of Hypertension and Diabetes in 7 pilot regions.
- To understand how the training was able to influence changes in PHC clinical practice in pilots in order to plan further improvements/adjustments of training’s content and teaching approaches, but also to identify other factors that need to be strengthened at PHC level for better NCDs prevention, early detection, care and support.;
- The evaluation of the project is planned to be carried out using three data collection approaches. Changes in risk assessment and treatment practices and outcomes will be evaluated by collecting information from patient records. Organizational changes in clinics and changes in division of tasks will be assessed performing observations of patient pathways. Focus group interview will be carried out to assess professionals’ opinions on effects of training in changing the practice and related possibilities and challenges.
Yale University
Using qualitative interviews with HIV care providers and with 50yo+ patients diagnosed with HIV in the last 6 months, to explore diverse factors that shape HIV risk and HIV care engagement for HIV+ 50yo+, and challenges experienced by HIV care providers in reaching and servicing this population.
1) Explore HIV care providers’ views on what factors shape (dis-)engagement with HIV care for their 50yo+ clients newly diagnosed with HIV, what challenges they experience when working with this population group, and how they respond to these challenges.
2) Describe the patient-level factors that shape HIV risk practices and health expectations for 50 yo+ newly diagnosed with HIV.
3) An additional strength of this study is to further quantitative study of 100 patients views on how the pandemic coronavirus and quarantine affected the life and behavior of 50+ patients with HIV-positive diagnosis, including their understanding of the risks СOVID-19, HIV and other diseases during the quarantine and how patients cope with these difficulties.
Johns Hopkins University
The proposed research project will explore the social and place-based context of injection drug use and HIV and HCV risk among people who inject drugs (PWID) in Ukraine. Study participants will include men and women 18 years of age and older in Dnipro, Ukraine.
Holding an international conference after the publication in the journal "The Lancet"
A two-day meeting in Kyiv (28-29 July, 2017) explored the range of possibilities to improve health services access for people who use drugs at three distinct time periods: pre-incarceration, incarceration and immediately post incarceration. The meeting focused on aligning current advocacy, policy directions and future research in EE&CA towards enhanced health and criminal justice outcomes for key stakeholders working across the interface of drug use, health service provision and criminal justice systems in the region. The meeting included a formal press event to cast a Ukrainian and EE&CA lens on challenges and opportunities in responding to the dual issues of drug policy and health in the criminal justice system in the region.
Presentations:
HPTN 074 Ukraine Site Progress (EN)
Articles:
Kathryn E Lancaster, Irving F Hoffman, Brett Hanscom, Tran Viet Ha, Kostyantyn Dumchev, et al. Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN074): a baseline analysis. Journal of the International AIDS Society. Oct 22, 2018 (EN)
William C Miller; Irving F Hoffman; Brett S Hanscom; Tran V Ha; Kostyantyn Dumchev; Zubairi Djoerban; Scott M Rose; Carl A Latkin; David S Metzger; Kathryn E Lancaster; Vivian F Go; Sergii Dvoriak; et al. A scalable, integrated intervention to engage people who inject drugs in HIV care and medication-assisted treatment (HPTN 074): a randomised, controlled phase 3 feasibility and efficacy study. The Lancet. September 01, 2018 (EN)
Вільям С. Міллер, Ірвінг Ф. Гоффман, Бретт С. Ганском, Тран В. Га, Костянтин Думчев та ін. Розширювана інтегрована інтервенція із залучення осіб, які вживають ін’єкційні наркотики, до програм лікування ВІЛ та медикаментозного підтримуючого лікування наркозалежності (HPTN 074): рандомізоване контрольоване дослідження третьої фази щодо здійсненності та дієвості (Переклад з англ.) The Lancet. September 01, 2018 (UA)
Sugarman J, Barnes M, Rose S, Dumchev K, Sarasvita R, Viet HT, et al. Development and implementation of participant safety plans for international research with stigmatised populations. The lancet HIV. 2018;5(8) (EN)
Fogel JM, Zhang Y, Palumbo PJ, Guo X, Clarke W, Breaud A, et al. Use of Antiretroviral Drug Testing to Assess the Accuracy of Self-reported Data from HIV-Infected People Who Inject Drugs. AIDS and behavior. 2019 (EN)
Kiriazova T., Go V.F., Hershow R.B. et al. Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine, and Vietnam: HPTN 074 study. Harm Reduct J, 2020 Oct 01 (EN)
Study of the aspects of stigma (as a barrier to HIV treatment) that can be changed through the development and implementation of interventions
Centers for Disease Control and Prevention (CDC)
The purpose of the project is to develop a coherent system of evaluation and quality improvement which can be used by institutions implementing opioid substitution therapy, as well as by national agencies responsible for the implementation and effectiveness of the program.
In 2017 4 video courses for physicians, nurses, psychologists, and social workers were developed and recorded: 1. Treatment of opioid dependence; 2. Integrated care to people with mental and behavioral disorders due to the use of opioids; 3. Organizational aspects of providing integrated services to people with mental and behavioral disorders due to the use of opioids; 4. Psychosocial support for patients with opioid dependence in accordance with international recommendations and national standards. More than 500 clinicians and other healthcare workers were trained on Public Health Center of Ukraine online platform. 1st and 2nd courses were updated.
The concept of the quality assessment system is developed. It consists of the following components:
2. Periodic external evaluation of quality indicators (a monitoring form has been developed and piloted)
3. Periodic sample evaluation of patient satisfaction (the patient satisfaction assessment questionnaire was developed and piloted)
Pact Inc. / USAID «RESPOND»
To evaluate eligibility of the integration care model for opioid addicts in non-specialized setting, particularly on basis of three primary care policlinics. Outcomes of interest include public health, substance abuse, HIV and TB.
13/01/2017 Вийшов друком навчально-методичний посібник
National Institutes of Health (NIH), Harvard University
Collection of samples and observation of the growth of culture in dense nutrient media and incubation in test tubes with an indicator of growth of mycobacteria
Management Science for Health (MSH)
The study was conducted on the use of drugs for ART in order to improve the quality of treatment, optimize its costs and improve the patients’ condition, as well as increase the professional level of physicians involved in the treatment of patients with HIV-infection.
Global Health Initiative, Brown University
Supervision of the purchase of equipment and reagents for the cultivation of TB samples.
Pact Inc. USAID «RESPOND»
Randomized prospective study, main aim of which is evaluation of conscientiousness of implementation of perspective behavioral interventions “Steps towards health” and “TB is curable”, as well as its effectiveness and cost.
USAID HIV Reform in Action Project / Deloitte Consulting Overseas Projects Llc
The main goal of the project was improvement and optimization of resource allocation and funding of national and some regional programs to fight HIV / AIDS on the most vulnerable groups.
Using a randomized clinical trial (RCT), this study was designed to assess the effectiveness of HIV risk-reduction interventions targeting injection drug users (IDUs) in three Ukraine regions. The investigators proposed to compare the effectiveness of a revised and updated manually-driven HIV testing and counseling intervention, the Counseling and Education (C & E) model developed by NIDA, with the C & E plus a manualized network intervention.
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR)
The purpose of this study was to test the effectiveness of two strategies: a community initiated treatment intervention (CITI) and MAT on HIV care enrollment and ART enrollment compared to the standard of care
Abstract “Implementing large multisite experimental study in Ukraine” was presented at NIDA International Forum 2016