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Multidisciplinary approach in functioning of mobile gynecological clinics providing HIV prevention services to representatives of groups, vulnerable to HIV, in Ukraine
O. Burgay1, S. Filippovych2, T. Deshko1
1International HIV/AIDS Alliance in Ukraine, Field Programmes, Centre, Kyiv, Ukraine, 2International HIV/AIDS Alliance in Ukraine, Treatment, Procurement & Supply Management, Kyiv, Ukraine
Background: HIV/AIDS epidemic is developing in Ukraine: during 2008, 19000 new cases of HIV and 4380 of AIDS were registered. Sexual transmission of HIV is growing (42% new cases in 2008 compared to 38,4% in 2007). STIs significantly increase risk of sexual transmission of HIV. STIs are diagnosed within 50% of patients with HIV, 63% of patients indicate STIs in anamnesis.
Methods: In Ukraine, within GFATM program, 14 specially equipped mobile gynecological clinics (MGC) were purchased, whose conditions allow providing social, preventive services, primary medical care to representatives of risk groups (IDUs, FSW, MSM) in 12 regions. Multidisciplinary team of MGC consists of social worker, nurse and doctors (specialist in skin/venereal diseases, infectiologist, etc.). Services provided in MGC include syringe/condom/lubricant/information material distribution, rapid testing for HIV and STIs, medical examination and consultation, seizure of blood samples and excreta from genitals for laboratory diagnosis.
Results: During one month of MGC functioning, 5977 visits of representatives of vulnerable groups were recorded, primarily of IDUs. Availability of rapid HIV testing in MGC allows early detection of HIV. Results of rapid testing for STI showed FSW to be most vulnerable to STI: 7,7% positive results compared to 2,3% in IDUs. Percentage of positive results differs by nosologies - 3,5% positive for syphilis, 7,3% - for gonorrhea, 12,4% - for chlamydia.
Conclusions: Further use of MGC is perspective, representatives of risk groups are willing to use it. Prevalence of STIs among vulnerable groups significantly exceeds official statistics (prevalence of syphilis 0,025%). Top-priority is receiving a permit to conduct capture of sputum samples for diagnosis of tuberculosis, to appoint single treatment schemes of STIs, to provide MGC with drugs to treat STIs, to establish a system for treatment monitoring in conditions of MGC. During one year, over 39200 visits to the clinics are expected .
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