Over the past 7 years, one of the country’s largest projects, HealthLink, was being implemented, providing Ukrainians with the opportunity to get tested for HIV and start treatment free of charge, quickly and safely.

Overcoming numerous challenges, such as the Covid-19 pandemic and the beginning of the full-scale invasion, the Alliance for Public Health and CO “100% of Life”, in partnership with 29 non-governmental organizations and more than 700 health care facilities, worked tirelessly to ensure that as many Ukrainians as possible would have access to HIV prevention, testing and treatment. Before the war, the project was being implemented in 12 regions with the highest HIV prevalence (Dnipropetrovs’k, Kirovohrad, Zaporizhzhia, Donetsk, Odesa, Chernihiv, Poltava, Cherkasy, Kherson, Mykolaiv and Kyiv oblasts (regions) and the city of Kyiv). After the outbreak of the war, activities in Kherson region were suspended, and Zhytomyr, Zakarpattia, Lviv, and Ivano-Frankivsk regions were added to the project. The results of the project are really impressive, as we have managed to:

  • test over one million people;
  • detect around 26,000 new HIV+ cases;
  • 90% of newly detected patients started taking ART.

“Despite the very ambitious goals of the project, we were constantly trying to introduce something new. We used a lot of non-standard approaches and innovations that yielded tremendous results, making HIV testing commonplace for all people,” – says Maryna Varban, HealthLink project manager, the Alliance.

“Safe Boxes” Innovation. During Covid and the war, online services became extremely popular. Given that people in the modern world are increasingly striving to maintain their privacy, we have developed the website oraltest.org.ua, which is popular among members of the LGBT community. Here you can order a safe box that contains a rapid HIV test, contraceptives, lubricants, informational materials and stylish souvenirs. This initiative has helped to reach people living in small towns and villages, the most isolated group of men over 35, and the broader MSM community. A total of 15,000 safe boxes have been distributed during the project’s implementation.

“Prevention videos at health care facilities” Innovation. People waiting to see a doctor in the corridor of a health care facility are mostly sitting around doing nothing, so we decided to use this time to good effect. We distributed 180 plasma TV sets among partner medical institutions and created a series of videos on health, hygiene, debunking myths about HIV, pregnancy, etc. Each video ended with a call to get tested, and people who saw this information could immediately ask their doctor about an HIV test. After watching the videos, about 6,000 people sought testing.

“Video Doctor” Innovation program aimed to improve the index testing rate. Doctors were provided with tablets on which they showed videos with information about HIV to the patients during counseling and explained further steps in case of HIV detection. A series of videos with instructions on how to involve partners in testing was also developed. During the intervention, more than 2,000 patients watched the videos and 1,400 of them then referred their partners for testing. About 500 of them were found to be HIV+.

“The Testomats (Test Vending Machines)” Innovation has made free HIV testing even more accessible by allowing people to get an oral HIV test-kit and self-test kits in a place convenient to them. To do this, one needed to visit the respective website, answer the questions, generate 2 QR codes, bring them to the scanner, and receive their HIV test-kit and a box of condoms at the Testomat. In total, 3,700 tests were distributed through these Test Vending Machines.

“Supervisor Support” Innovation. Throughout the project, it provided the professional support and motivation of the staff: health care workers and NGO representatives. The number of face-to-face supervisions was significantly reduced due to the war, but despite the difficulties, supervisors managed to conduct more than 500 supervision visits to NGOs and health care facilities for 5,000 participants. The need in individual supervision led to the creation of the website supervision.org.ua, which provided more than 7,000 supervisions online.

“Online Support Groups” Innovation – combined 2 approaches: peer-to-peer mentoring and an online platform for communication, thereby creating a safe place where people with the same experience could gather. Professional psychologists-moderators of support groups held thematic meetings on living with HIV, provided psychological support and stress management and motivational counseling services to build adherence to ART, and other services. This approach made it possible to support PLHIV at risk of dropping out of treatment and help them to adjust to their new status. In total, the project organized more than 100 support groups for PLHIV, MSM and social workers.

Here is the story of HIV detection efforts from the NGO “Alternative”, Chornomorsk.

“I received a call from a client who is now defending Ukraine in the Armed Forces and who asked me to send him ARV drugs to the front. His wife was supposed to pick up the medication. While talking to her, I found out that she did not know anything and did not want to know about her husband’s HIV status. But I couldn’t just give her the medication and let her go, so I told her about all the risks and why it was important for her to know her HIV status as well and, if necessary, start treatment. I was very much afraid that when she left the office, I would never see her again, so I decided not to wait, but to take an HIV test right away. I had oral test-kits, which came in handy because the result was positive. I wouldn’t say I was surprised, but the main task now was to get the woman to the clinic for further examination and make sure she started her ARV therapy.

The woman refused to see a doctor. She asked to take a few days to think about it and, after receiving therapy for her husband, went home. A few days later, she called me and told me that she had been thinking about the test results and what we had discussed during the meeting. She said she agreed to additional examinations and treatment. Now she is taking ART, and we keep in touch. After a while, I talked to her husband, who was very grateful for the work that was done for his wife”.

We were able to achieve such outstanding results thanks to fruitful and well-coordinated teamwork and support of each other in these difficult times. We would like to express our sincere gratitude to all our partners who have been standing side by side and working purposefully on the result.

The project was implemented with the financial support from the CO “100% of LIFE” and the ICF “Alliance for Public Health” as part of the HealthLink project: “Accelerating Ukraine’s Efforts to End HIV” project implemented with the support from the United States Agency for International Development (USAID).