Olga Varetska ICF “International HIV/AIDS Alliance in Ukraine”

National roll-out of database for HIV prevention programmes

among civil society organizations in Ukraine

Olga VaretskaICF “International HIV/AIDS Alliance in Ukraine”

XVIII International AIDS Conference 18-23 July 2010, Vienna, Austria

• Most severe AIDS epidemic in Europe – Estimated 1,33% of Ukrainians (age 15-49) living with HIV– 101,000 people officially reported with HIV – 360,000 people estimated living with HIV

• Epidemic concentrated among injecting drug users (IDUs):

- over 70% of people living with HIV have history of injecting drugs - sexual transmission now occurring among IDUs or their sexual

partners– IDUs and their sexual partners focus of HIV prevention efforts.

Programmes also for sex workers, MSM, and prisoners

Epidemic overview

Coverage of HIV prevention programs in Ukraine

0

20000

40000

60000

80000

100000

120000

140000

160000

2006 55922 5944 134 5007

2007 67485 8812 1524 17512

2008 102562 15901 4191 19246

2009 150815 25328 12833 27372

IDUs FSWs MSM Prisoners

SyrEx is a user-friendly database for tracking: • number of individual clients reached• Frequency, type and trends of services accessed

SyrEx developed to monitor prevention programmes for IDUs and sex workers

• Also used by organizations working with MSM and prisoners

• Used by more than 100 NGOs in Ukraine• Currently exists in Russian, English version is

coming

Syr-Ex (Syringe Exchange) database

• PC• PC literacy • Functioning system for client coding

(each client is given a card with a code, which will be used as client ID for all services)

• accurate and timely completion of daily registration forms directly at service provision points

Key user requirements

– Client registration– Keeping track of daily records:

• information on the number of services provided and consumables given out to each client

– Compilation of reports– Data transfer (to an upper level) and

consolidated analysis

SyrEx functions

Coverage of prevention programmes, disaggregated by:

• sex, age, risk group, geographical area • frequency of service access by clients• type and quantity of services

User defined reports

Customizable Reports

1. real-time reporting to donors

2. guiding scale-up of services and mobilization of additional resources

3. data use in managing services to meet changing needs of clients

4. detailed analysis of scope and scale of coverage of prevention programmes

i.e. percentage of injecting drug users regularly reached by harm reduction programs

Civil society organizations can use SyrEx database for:

Examples of data obtained with the help of SyrEx for 2009 within the national harm reduction programme supported by the GF

Client characteristics

Distribution of clients by sex(2009)

male70%

female30%

Distribution of clients by age groups (2009 )

25 and younger(30%)

40 and older(13%)

26-39(57%)

Distribution of the clients by risk groups (2009)

FSW13%

MSM5%

IDU82%

Provision of prevention commodities (per client in 2009)

Number of syringes distributed per IDU 114

Number of condoms distributed per IDU61

Number of condoms distributed per FSW 129

Number of condoms distributed per MSM117

Average number of visits per client per month to prevention programmes

Average number of visits per client in 2009

1,5

2,0

2,5

3,0

Jan09

Feb09

Mar09

Apr09

May09

Jun09

Jul 09 Aug09

Sep09

Oct09

Nov09

Dec09

IDU

FSW

Frequency of visits of IDUs to Needle Exchange Programmes in 2009 (by month)

0

25000

50000

75000

100000

125000

150000

175000

Jan09

Feb09

Mar09

Apr09

May09

Jun09

Jul09

Aug09

Sep09

Oct09

Nov09

Dec09

IDUs

male

female

Examples of data use at national level

• Low number of condoms distributed per IDU per year• 61 per client (SyrEx)

• Increase in sexual transmission of HIV associated with drug use• In 2009 sexual transmission accounted for 43% of all new HIV

infections, versus 36,5% IDU related (data from routine surveillance)

• Low condom use among IDUs • Only 48,3% of IDUs reported condom use during the last sexual

intercourse (BSS data)

• ResultDeveloped new prevention component among IDUs and their sexual partners, aimed at prevention of sexual transmission

More examples of data use• 75% of all IDUs clients are male• 70% of all clients of harm reduction programs are above 25• Mostly opioid drug users are reached with services

(about 90% of all program clients)

Yet: • female drug users are more vulnerable to HIV than male• national behavioral studies indicate increasing proportion of young

stimulant drug users emerging (34.5% of all IDUs were stimulant drug users in 2009 compared to 20% in 2005)

Result: Reprogramming prevention services for IDUs to include:

• gender sensitive counseling and services for female IDUs• Special group level interventions for stimulant users

• Use of databases for monitoring HIV prevention programmes by civil society organizations improves data management and use

• Enables timely reprogramming of prevention programs to optimize their effectiveness

• Free distribution of SyrEx (shareware) among national partners to ensure systematic data collection and use

• SyrEx is being promoted within Eastern Europe and Central Asia• Several NGOs in Belarus are using Syrex; • NGOs in Kyrgyzstan, Tadjikistan and Kazakhstan expressed

interest and were trained to start using SyrEx in near future

Conclusions