HIV Rapid Testing in Clinical Settings in Dnipropetrovsk Region of Ukraine Irina Grishayeva, Marina Haletskaya, Clinton Health Access Initiative Alena Maksimenok, PhD., Lev Gromashevsky Institute of Epidemiology and Infectious Diseases AMS Svitlana Osipova NGO Public Health, Kryviy Rih, Ukraine IAS Conference, Vienna April 2010 April 2010

HIV RT in Ukraine RT use untill 2009:  Donors and pregnant women in urgent cases  Negative and positive results to be confirmed by screening and confirmation (IFA, WB)  RT results not included into official HIV statistics RT use since 2009: Legislation on RT use in TB, DD, STI, infect disease clinics 2 RTs algorithms Certificate based on 2 RTs result 2 HTC in 2008: 3,349,515 HIV tests among them 1.1 % - IDUs 0.93% - CSWs 1,7% - STI

HIV RT implementation in clinical settings Phase I, project goals:  To compare diagnostic efficiency of two serial HIV RT (different manufacturers) to the actual reference method  To pilot two serial RT algorithm within clinical settings  To strengthen referal for HIV+ Implementors: 3 Drug Dependence Treatment Clinics, 2 TB Number of clients involved: 1,078 Number of positive cases: 33% Phase II, project goals:  To scale up two serial RT in clinical settings in the region  To introduce RT in STI and inflectional disease clinics in addition to DD and TB  To introduce RT in the remote settings Implementors: 6 Drug Dependence Treatment Clinics, 3 TB, 3 STI, Number of clients involved: 7,205 Number of positive cases: 16% 3

Results by sites (Phase I and II) 4

Follow up Services clients Pre- and post-test counselling 100 % HIV + 33 % Reached AIDS Centers for further services (from 353 HIV+) 60% clients Pre- and post-test counselling100 % HIV +16,3 % Reached AIDS Centers for further services (from HIV+)66% 5

6 Main conclusions HIV Rapid Testing in clinical settings:  Could be an efficient method in reaching risk groups with T&C and follow up services  Essentially reducing the results turnaround time  Increasing effectiveness of post-test counseling  Enabling timely development of follow up treatment plan by doctor  Enabling adequate referral  Reducing time to get care and treatment services Strengthening links and coordination between different medical services (TB, DD, STI and HIV) Collaboration with NGO is key to get vulnerable populations to services and provide follow up support

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