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ID: HR19-318

Presenting author: Tetiana Saliuk

Presenting author biography:

Tetiana Saliuk, sociologist/epidemiologyst, with 15 years of practical experience in substance abuse, HIV/AIDS and Hepatitis prevention projects. All 15 years Tetiana has been working as a researcher with the program and study data to improve harm reduction strategies and interventions. Tetiana is an author and co-author of 12 scientific publications.

Increasing HIV awareness and reducing the HIV risk: integration of HI directly assisted self-testing in harm reduction program

Tetiana Saliuk, Pavlo Smyrnov, Olga Cheshun

Background:
HIV prevalence in all populations experiencing risky behavior is high. HCT uptake reduces the risky behavior and decreases HIV incidence. Latest IBBS data suggest that only 27% MSM, 54% PWIDs, and 75% SWs are aware of HIV-positive status in Ukraine. The biggest harm reduction program in EECA region implemented in Ukraine reaches about 300,000 clients from vulnerable communities what gives the good background to increase the knowledge of HIV-positive status and link HIV-positive to ART program.

Description:
Directly assisted self-testing was introduces in 2015 to scale up the HTC coverage and increase the number of key communities members knowing HIV-positive status and who are linked to HIV care program. Assisted testing is a combination of self-testing and testing performed by outreach worker or peers. In this model peer outreach workers carry rapid HIV tests while visiting clients to provide free syringes. They offer clients HIV-test and assist them in testing: provide pre-and post-test counseling and follow up on positive cases linking them to care.

Lessons learned:
Proposed new strategy allowed increasing the HTC coverage in 2.4 times in comparison to 2014. The HTC yield among new clients (not exposed by harm reduction programs before) was 5 times more than among old clients of prevention programs, 80% of people with positive results were linked to care. High positive predictive value was confirmed. Clients became more knowledgeable and fearless of doing self-testing and being aware of HIV-status.

Next steps:
Directly assisted self-testing was used as intermediary stage between providers initiated testing and self-testing. The high level of laboratory conformation of HIV positive results obtained through the directly assisted self-testing shows that level of misclassification of test results in community is low and thus, the self-testing approach might be easily implemented community. Other modality of self-testing could be farther evaluated.