1. Injection drug users’ knowledge about overdose prevention and take home Naloxone in Ukraine. ICF 'International HIV/AIDS Alliance in Ukraine Liudmyla Shulga Anna Tokar

2. Presentation outline Reasons for paying attention to OD – Ukrainian context Data available Challenges and solutions

3. Background 2008 Literature review on OD scale and use of Naloxone. First training on OD prevention and Naloxone use. No systemic work on organizational level. 2009 Start of OD prevention programs with take home Naloxone in 37 NGOs –Training on programme implementation for social workers –Evaluation of Naloxone use efficacy During 12 months 500 ampoules of Naloxone distributed. 2010 81 Alliance-Ukraine supported organizations implement OD prevention 57 of them buy Naloxone (15 948 ampoules).

4. Addressing concerns Behavioral surveys (2007, 2009): 11-14% Peer Driven Intervention: 30-33% Survey, 2010: 49 (F) - 53 (M)%

5. Survey, 2010 Location: 15 cities Sample size: 2821 IDUs (72% M, 28% F), aged 17 - 58 y.o. Recruited by word of mouth Interviewer-assisted questionnaires

6. Respondent Characteristics

7. OD cases

8. During Naloxone refill: which drugs did you use at last OD?

9. Challenges “behind the curtains” Naloxone is a prescription drug which makes its distribution more expensive and not anonymous. Absence of official statistic on OD prevalence and prevalence of OD-induced deaths. Death certificates contain information about “poisoning” without specification. This happens due to lack of equipment the cost of which is not affordable for the state. Naloxone is used as a method of IDUs control.

10. Instruction for naloxone use from the Ministry of Health documents

11. Alarming Issues Although there is educational programme on OD, absence of naloxone makes it less effective.

12. When observing OD in someone what did you do?

13. Alarming Issues: not calling ambulance 65% didn’t even try to cal an ambulance Out of those who called the ambulance, it arrived in 95% of cases Common reasons: fear of police: 35% - 67% Fear of dealing with medical staff: 26% - 35% Believed in being able to cope on their own: 42% - 57%

15. Acknowledgement Anna Tokar, MSc Maryna Varban, PhD Ukrainian organizations that took part in the survey with no extra funding.