ArticleThe lancet. HIV2020
Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study.
Article in The lancet. HIV, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Design and implementation of a Type-2 hybrid, prospective randomized trial of opioid agonist therapies integration into primary care clinics in Ukraine.Contemporary clinical trials · 2024Trial
- Exploring multi-level barriers and human-centered solutions to expand methadone for HIV prevention among people who inject drugs in Kyrgyzstan.Journal of substance use and addiction treatment · 2026Article
- Probation as a targeted entry point for scaling up opioid agonist therapies in Moldova using a modified screening, brief intervention and referral to treatment strategy.PLOS global public health · 2026Article
- Implementation opportunities for optimizing retention on buprenorphine treatment for people with opioid use disorder in West Virginia.Drug and alcohol dependence · 2025Article
- Cost-effectiveness of eHealth-based HIV pre-exposure intervention for recreational drugs using among men who have sex with men in China: a modelling study.BMC public health · 2025Article
- Exploring barriers and potential solutions before implementing a scale-up strategy to expand methadone coverage among people who inject drugs in Tajikistan.Journal of substance use and addiction treatment · 2025Article
- Exploration of the multi-level barriers to scaling up methadone for HIV prevention among people who inject drugs in Kazakhstan.Journal of substance use and addiction treatment · 2025Article
- Article
- The cascade of care for commercially-insured persons with opioid use disorder and comorbid HIV and HCV infections.Drug and alcohol dependence · 2024Article
- Impact of the Russian invasion on opioid agonist therapy programs in Ukraine: A qualitative study.Drug and alcohol dependence · 2024Article
- Preferences and decisional considerations relating to opioid agonist therapy among Ukrainian people who use drugs: A conjoint analysis survey.PLOS global public health · 2024Article
- Trajectory and progress of opioid agonist therapy programs in the Kyrgyz Republic.Global health economics and sustainability · 2024Article
- Global HIV control: is the glass half empty or half full?The lancet. HIV · 2023Review
- OAT and NSP and their potential to reduce HIV incidence among people who inject drugs in low- and middle-income countries.The Lancet regional health. Western Pacific · 2023Article
- Modelling the impact and cost-effectiveness of non-governmental organizations on HIV and HCV transmission among people who inject drugs in Ukraine.Journal of the International AIDS Society · 2023Article
- Introducing methadone maintenance therapy into Ukrainian prisons: a qualitative study of criminal subculture, Russia's full-scale invasion, and contested methadone objects.Frontiers in psychiatry · 2023Article
- Leveraging existing provider networks in Europe to eliminate barriers to accessing opioid agonist maintenance therapies for Ukrainian refugees.PLOS global public health · 2023Article
- Aligning public health and public safety: Probation as a touchpoint to identify and link patients with opioid use disorder to opioid agonist treatment.PLOS global public health · 2023Article
- The development and initial validation of the Russian version of the BASIS-24.Addiction science & clinical practice · 2022Review
- Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war.The lancet. Psychiatry · 2022Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundAs HIV incidence and mortality continue to increase in eastern Europe and central Asia, particularly among people who inject drugs (PWID), it is crucial to effectively scale-up opioid agonist therapy (OAT), such as methadone or buprenorphine maintenance therapy, to optimise HIV outcomes. With low OAT coverage among PWID, we did an optimisation assessment using current OAT procurement and allocation, then modelled the effect of increased OAT scale-up on HIV incidence and mortality for 23 administrative regions of Ukraine.
methodsWe developed a linear optimisation model to estimate efficiency gains that could be achieved based on current procurement of OAT. We also developed a dynamic, compartmental population model of HIV transmission that included both injection and sexual risk to estimate the effect of OAT scale-up on HIV infections and mortality over a 10-year horizon. The compartmental population model was calibrated to HIV prevalence and incidence among PWID for 23 administrative regions of Ukraine. Sources for regional data included the SyrEx database, the Integrated Biological and Behavioral Survey, the Ukrainian Center for Socially Dangerous Disease Control of the Ministry of Health of Ukraine, the Public Health Center of the Ministry of Health of Ukraine, and the Ukrainian Census.
findingsUnder a status-quo scenario (OAT coverage of 2·7% among PWID), the number of new HIV infections among PWID in Ukraine over the next 10 years was projected to increase to 58 820 (95% CI 47 968-65 535), with striking regional differences. With optimum allocation of OAT without additional increases in procurement, OAT coverage could increase from 2·7% to 3·3% by increasing OAT doses to ensure higher retention levels. OAT scale-up to 10% and 20% over 10 years would, respectively, prevent 4368 (95% CI 3134-5243) and 10 864 (7787-13 038) new HIV infections and reduce deaths by 7096 (95% CI 5078-9160) and 17 863 (12 828-23 062), relative to the status quo. OAT expansion to 20% in five regions of Ukraine with the highest HIV burden would account for 56% of new HIV infections and 49% of deaths prevented over 10 years.
interpretationTo optimise HIV prevention and treatment goals in Ukraine, OAT must be substantially scaled up in all regions. Increased medication procurement is needed, combined with optimisation of OAT dosing. Restricting OAT scale-up to some regions of Ukraine could benefit many PWID, but the regions most affected are not necessarily those with the highest HIV burden.
fundingNational Institute on Drug Abuse.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.