NEXT STEPS FOR UKRAINE ABOLITION OF HIV REGISTRIES, IMPLEMENTATION OF ROUTINE HUMAN IMMUNODEFICIENCY VIRUS TESTING AND EXPANSION OF SERVICES

摘要: Booth et al. should be congratulated on a rigorously conducted study with challenging population. Their work demonstrated that compared to an indigenous leader outreach model, less-expensive, briefer counseling intervention was equally effective at reducing sexual and injection risk-taking [1]. The data also confirm learning one's own HIV+ status significantly reduces HIV risk-taking, independently from each intervention. These are consistent findings elsewhere where diagnosis alone risk [2]. Knowing is essential for accessing life-saving antiretroviral treatment, itself associated decreased transmission [3]. On population level, widespread treatment medications powerful tool in controlling the epidemic among all affected groups [4]. Why then has Ukraine not embarked upon incredibly cost-effective strategies [5] increase identification through deployment of routine testing? Routine testing would most if multiple barriers were removed, including name-based registration programs (e.g. drug dependence) pre-test counseling. registries voluntary stigmatize patients discourage high-risk individuals, particularly when risk-behaviors assessed. Moreover, add significant costs detract prevention, especially current global economic climate. In particular, implementation could effectively existing settings, treated substance abuse, tuberculosis, inpatient services newly-created integrated care settings [6]. The criminal justice system greatly benefit [7] ways al elegantly community harm reduction programs. latter sites may serve as sentinel initiating opioid substitution therapy (OST) contribute epidemic. Though stimulants exist Ukraine, opioids remain mainstay dependence. Therefore, wider OST urgently needed. While identifying risk-behaviors, dramatically [8]. Indeed, since Booth's study, both buprenorphine methadone have been introduced, but sufficient magnitude curb [9]. Though progress made 2005, considerable legal, political, social continue impede prevention efforts. Laws regulating transportation, storage, dispensing therapies currently hamper access. Hospitals rarely offer OST, forcing hospitalized IDUs into agonizing forced-abstinence. Regulations requiring observed, daily dosing create disincentive wanting return workforce. Requirements physicians dispense unneeded expense distract them attending more complex cases. ban driver's licenses similarly ill-advised, limiting uptake further endangering society by encouraging active users out drive under influence illicit drugs. In political arena, ideology stigma regarding must set aside counter explosive spread Ukraine. seemingly daunting, containment now will facilitate better health Ukrainians. time implement now.