Counseling and Testing for HIV as One of the Key Program Activities in Chernihiv Region

Increasing access and scale of testing people with high risk of HIV infection is the priority preventive measure to counteract HIV. The purpose of the work is to evaluate the effectiveness of the implemented services in the Chernihiv region. Materials and methods. The approach to the evaluation combined WHO recommendations, analysis of impact indicators, cascading analysis and implemented in desk research. An analysis of seroepidmonitoring, routine epidemiological surveillance, behavior monitoring and HIV prevalence among key population groups based on the results of integrated bio-behavioral research, programmatic monitoring of the Alliance of Public Health, ICF (SYREX electronic database) during 2009-2016. The assessment was carried out by specialists of the Regional Center for AIDS Prevention and AIDS in cooperation with the Center for Public Health of the Ministry of Health of Ukraine and the Alliance of Public Health ICF with the financial support of the United States Centers for Disease Control and Prevention. Results and discussion. The proportion of convicts covered by the counseling and testing for HIV in 2013 and 2016 was 31%, with the smallest indicator in 2014 (9.9%) associated with testing only for the first time arriving to penitentiary institutions due to the funding decrease. The percentage of TB patients covered by the counseling and testing in its overall structure increased from 3.9% (2014) to 25.9% (2016), which is the result of widespread implementation of HIV prevention measures in the phthisiatric health care institutions. The simultaneous establishment of tuberculosis and HIV infection was recorded at 51% in 2016 (by 2015 - 38%, in 2014 - 44%). The proportion of counseling and testing among pregnant women in the period of 2009-2016 ranges from 16-36%. The share of counseling and testing for HIV conducted among blood donors for the period of 2009-2016 ranges from 16-22%. The late detection of HIV in the AIDS stage indicates the inadequate work of health care institutions in terms of timely detection and taking them under medical supervision. There is an increase in the proportion of people with positive results in HIV testing among MSDs and MSM, and the decrease among IDUs and convicts. There is a sufficient coverage of patients with tuberculosis, donors and pregnant women by counseling and testing. Counseling and testing services are provided by HIV-service NGOs of the region, but the redirection efficiency remains low. Counseling and testing services are not well-integrated and synergistic with other medical and HIV services. The percentage of people with a positive test results is increased, but mainly due to people with a previously diagnosed HIV.