Ukraine has one of the fastest growing HIV epidemics in the world, fueled largely by a rise in intravenous drug use. About half of the country’s 390,000 drug users are infected with HIV, and the virus is starting to spread into the general population.
In a new study, Stanford researchers found that the best way to combat the epidemic in Ukraine was to hit it two ways: first by offering substitute drugs, such as methadone, for opiate users and then providing antiretroviral therapy to infected individuals. In doing so, some 8,000 new infections could be prevented over the next 20 years, the researchers found. From a release:
"HIV is spreading in Eastern Europe more quickly than in any other part of the world,” says Margaret Brandeau, PhD, a Stanford professor of engineering. “Our study shows that substitution therapy for injection drug users is an inexpensive and effective means of curbing HIV transmission in the region."
Although the Ukranian government has endorsed a plan that includes substitution therapy, at the same time AIDS rights groups have reported that patients receiving the therapy are being subject to harassment:
“At a time when hope should be on the rise thanks to the new HIV law, the ministry’s new policy direction has had a chilling effect on treatment programs,” says Sabina Alistar, a doctoral student in engineering who was the lead author of the study.
The researchers found that providing drug substitution therapy alone, while beneficial, was not as effective as providing both drug substitution and antiretroviral treatment. Antiretroviral treatment not only helps the infected individuals, but also reduces the amount of virus they carry so they are less likely to transmit it to others in the general population, notes Douglas Owens, MD, a professor of medicine at Stanford and one of the study’s co-authors.