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About the Authors:
Charles R. Vitek
* E-mail: [email protected]
Affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Kyiv, Ukraine
Jurja-Ivana Čakalo
Affiliation: World Health Organization Collaborating Centre for HIV Surveillance, University of Zagreb, Zagreb, Croatia
Yuri V. Kruglov
Affiliation: Ukrainian Center for Socially Dangerous Disease Control of the Ministry of Health of Ukraine, Kyiv, Ukraine
Konstantin V. Dumchev
Affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Kyiv, Ukraine
Tetyana O. Salyuk
Affiliation: International HIV/AIDS Alliance in Ukraine, Kyiv, Ukraine
Ivana Božičević
Affiliation: World Health Organization Collaborating Centre for HIV Surveillance, University of Zagreb, Zagreb, Croatia
Andrew L. Baughman
Affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Hilary H. Spindler
Affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
Violetta A. Martsynovska
Affiliation: Ukrainian Center for Socially Dangerous Disease Control of the Ministry of Health of Ukraine, Kyiv, Ukraine
Yuri V. Kobyshcha
¶¶ Retired.
Affiliation: World Health Organization, Kyiv, Ukraine
Abu S. Abdul-Quader
Affiliation: Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
George W. Rutherford
Affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
Introduction
With the explosive growth of HIV transmission among persons who inject drugs (PWID) in Ukraine beginning in 1995, a wave of HIV infection spread across the former Soviet Union [1]. With continued increases in cases among PWID and, to a lesser degree, other key populations (KP), Ukraine developed the most severe epidemic in Europe and Central Asia with an estimated 440,000 persons living with HIV (PLHIV) in 2007 [2]. Prevention and care responses began with spontaneous local efforts supported by limited local and state budgets and uncoordinated external grants. Beginning in 2004, coordinated external support from the Global Fund, US government, and others allowed a major expansion of prevention programs focused on KP and antiretroviral therapy (ART). In 2011, the number of PWID reached with prevention activities was 160,000 as compared to 54,000 in 2006, while the number of PLHIV on ART increased from...