final program.qxd - Parallels Plesk Panel

Certain aspects of drug use in Ukraine make users more vulnerable to HIV infection. The
most commonly injected opiates in Ukraine are kitchen-based domestically produced
derivatives of poppy straw and between 70% and 95% of Ukrainian IDUs inject these
drugs regularly. Injection "amphetamine-like" drugs are also domestically produced from
readily available chemicals that can be purchased at drug stores and local pharmacies.
Methods of liquid drug production may have a direct link with HIV transmission. HIV may
enter the production process via containers and mixes used to collect up, decant and mix
the solutions ingredients during and between heating, and via injection equipment used to
test the liquid directly from mixing containers. Moreover, human blood may be added to
the drug solution in order to stabilize acidity or as a cleansing agent. This practice was
reported by 10% to16% of the IDUs nationwide, among them almost one third did not heat
the solution after adding blood. About 34-43% received narcotic substances by filling a
syringe from a common container; 26-35% filled their syringes from the dealer's syringe;
one fifth received drugs in a readily filled syringe. About 27-43% of IDUs reported sharing
mixing containers in the month prior to interview in 2001-2004.
ABSTRACTS
Available data suggest that reported levels and frequency of needle or syringe sharing
among IDUs in Ukraine are relatively high. In a synthesis of studies conducted between
1999 and 2003, reported rates of ever sharing needles and syringes varied between 14
and 40% in the majority of cities. A recent nationwide study suggests that at least 29% of
IDUs practiced receptive needle or syringe sharing in the month prior to interview. About
50-70% of the IDUs use their own syringes repeatedly, while majority among them take a
drug dose from the shared containers and "disinfect" syringes by water and moreover in
the shared utensils. Although there is some emerging evidence for changes in injection
behaviour among IDUs attending needle exchange, coverage rates of IDU populations by
harm reduction programmes are currently low, and were recently estimated at only
10-15%.
While the use of injected drugs continues to predominate, since 1997 the proportion of
IDUs among all officially registered HIV-positive Ukrainians has dropped, from a peak of
84% to 46% in 2004. At the same time, the proportion of new HIV diagnoses attributed to
heterosexual transmission has increased continuously between 1996 and 2004, from 13%
to 32% (fig. 2). With women accounting for 42% of people newly-diagnosed with HIV in
Ukraine in 2004, the number of children born to HIV-positive mothers continued to rise,
and was over 2,200 in that year (66% increase as compared to 2002).
About 63-87% of IDUs reported sexual contacts during three months prior to the interview
and about 39-43% of sexually active IDUs were engaged in sex with multiple partners.
Based on surveys among IDUs, 44-60% of them have casual sexual partners and 20-60%
have partners who are not IDUs. Regular condom use rates were only 15-28% among
those who were sexually active and about 37-45% seldom or never used condoms.
Available data also suggest that about 40% of those who had sexual contacts with casual
partners used condoms consistently, while only 15-25% declared using condoms with
regular partners. Among those who declared their HIV positive status about 45% had more
than three casual sexual contacts during the month prior to interview, while only 60%
reported regular condom use.
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