How Ukrainians with HIV are surviving the war. Stories of a military man and a pregnant woman

As of 2021 83% of people with HIV infection in Ukraine received antiretroviral therapy — the main component of medical care for this disease. This is 3% more than in 2019, and in accordance with the state strategy in the field of combating HIV infection/AIDS, tuberculosis and viral hepatitis, the indicator should be 95% by 2030.

However, Russian aggression put the trend in jeopardy.

Due to the disruption of transport connections, the timely delivery of the main stock of antiretroviral drugs and medical products for 2022 was interrupted, which led to a critical situation both with the provision of treatment and the threat of interruption of HIV treatment throughout the country, as well as with monitoring the effectiveness of treatment, - notes in the report of the Public Health Center of the Ministry of Health of Ukraine.

In order to prevent a humanitarian catastrophe, in many settlements that were under attack, volunteers, and doctors delivered the necessary drugs at their own risk. However, it was certainly impossible to ensure the pre-war level of coverage.

According to the charitable organization "100% Life", thanks to unprecedented coordination with international donors with the support of the PEPFAR program, immediately after the start of the full-scale invasion, they managed to bring in a supply of ARV therapy for a year and a half, thereby saving more than 100 thousand patients from interruption of treatment.

For this, PEPFAR has allocated 13 million dollars. Currently, PEPFAR has already announced that more than 100 million dollars will be invested through USAID for the purchase of 100 million doses of ARV therapy for the next two years, the organization says.

This, for example, can be seen at the diagnostic level. According to 2022 found about 12 thousand HIV-infected people, and in 2021 there were 3 thousand more of them. The level of testing has particularly fallen due to the temporary occupation of a number of regions. As well as treatment. According to the Centers for Disease Control and Prevention, 30% of infected people had episodes of interruption of therapy.

Mass evacuation of people also complicates access to treatment. Odesa, Mykolaiv, and Dnipropetrovsk regions, which traditionally recorded the highest rates of HIV, also turned out to be one of the most dangerous regions due to the Russian invasion. And their residents, who were forced to leave, could not immediately receive treatment in the new place. At the same time, according to WHO forecasts, the number of Ukrainian adults with HIV who will find themselves abroad may exceed 30,000.

However, the reoccupation of the territories is gradually improving the work of doctors and volunteers. For the first three months in 2023, the number of detected new cases of HIV infection increased as a result of improved diagnostics.

And it was possible to provide help even in the most extreme conditions. For example, under shelling in Donbas cities and soldiers from the front line.

The largest patient organization BO "100% Life", which has been fighting for the lives of Ukrainians with HIV for 20 years, told Social Portal two stories about how people cope with HIV during the war.

When I heard that I had HIV, I was worried that I would not be allowed to fight. I didn't want to leave my brothers, we went through a lot with them anyway, - said 36-year-old Denys (name changed).

He had no idea about the infection. He and his wife have been together for 12 years. There was always trust in the relationship, and plans for the future life.

He recalls how his wife complained on the phone that she had suddenly lost weight and that her body temperature was unstable. Denis insisted that she go to the family doctor for a medical examination. And once, when he endured another attack from the enemy, he called her. Mira (name changed) said:

I have HIV. The doctor prescribed medicine - antiretroviral therapy. I have already registered. And she started taking the first pills. Please find an opportunity to get tested for HIV. You and I dreamed of a son. Still ahead.

Denis did not wait for the rotation to check his health. He fought in the Donetsk region. It was difficult, sometimes impossible. He is reluctant to talk about the details, the main thing — found an opportunity and passed the test.

I googled where to test for HIV in the Donetsk region. I found the contacts of the charity organization "Ukrainian Resource Center". We agreed with the social worker about the day and time. I came to the testing center, I was given a test. The result was positive. I calmly responded that I have HIV. The day before, the wife said by phone that there are medicines, even in wartime they are free and available. On the same day, the social worker took me to the "Trust" office. I was registered, prescribed Arttherapy, — Denis shares.

The man was worried that he would not be able to continue military service. However, HIV did not stand in the way, and currently Denys continues his service in the Donetsk region. He was offered support and social support at the charity organization he turned to for help.

Currently, Denis has been under our supervision since January. He receives ARV therapy in one of the medical institutions of the Donetsk region. He continues his service, so sometimes he does not always have time to come for medicine. Our social worker will always lend a helping hand. She receives the medicine, and when it is convenient for Denis, he comes to her home or to our charity organization to get it. In general, during the war, tens of thousands of people with HIV are at risk of treatment interruption. Air strikes and shelling, forced relocations and loss of contact with their doctors, complicated logistics of drug delivery, lack of access to medicine in temporarily occupied territories and war zones. We try to help every person with HIV. As of now, our region has stocks of ARV therapy, — says Anastasia Smirnova, deputy head of the HealthLink project/head of the regional office of the "Ukrainian Resource Center".

Denys says that he found out about HIV in time and started treatment.

My wife and I dreamed of a son. Somehow it didn't happen before… Now, when the war, our dreams have more power, life — greater value. My wife and I are taking ART and know that despite HIV, we will have a healthy child, — says Denis.

Olesya (name changed) lives in Kramatorsk. When the war started, she was already pregnant. Under bullets and rocket fire, the woman had to undergo important medical examinations. One of which – HIV testing, which the woman underwent at the Ukrainian Resource Center.

From the Public Health Center, we received permission to test pregnant women for HIV. Since the war continues, and it is very difficult in our territory, the regional AIDS center had to evacuate. We work, test, detect, bring to treatment. We protested about HIV and Olesya, who contacted us. Tested with rapid tests that we have thanks to the HealthLink project. The woman's result was positive. We told her about it, advised her to undergo confirmatory testing with rapid tests from another manufacturer, as prescribed by the protocol. We called the hospital in Kostyantynivka, 30 kilometers from us, where this test could be taken. No other tests were available in Kramatorsk. In Kostyantynivci agreed to receive us. And our team began to look for opportunities to bring the woman to the examination, — says the head of the "Ukrainian Resource Center" Anastasia Smirnova.

Medical workers at the Kostyantynivka hospital performed the recommended testing on the woman. The diagnosis was confirmed there. Olesya explained that you can live a normal life with HIV and give birth to a healthy child if you take antiretroviral therapy. But then the woman did not ask anything about HIV, as if she already knew about her status. Then it disappeared altogether – did not answer calls, did not come to the charity organization.

Social worker Alla Ruban tried to reach the woman in order to save her and the child's life.

And a miracle happened – Olesya answered my call and listened to me. I insisted on the need to take antiretroviral therapy. "If you want to give birth to a healthy child, start taking medicine. At this moment, you decide the fate of the child» - these are the words that moved the woman. The very next day she was in our office. I helped her get registered, brought her to treatment. Olesya's civilian husband was also tested for HIV, and he had a negative result. He supported his wife. During pregnancy, the woman took therapy, — shares the social worker.

In the summer of 2022, Olesya gave birth to a healthy baby girl. Currently, the results show that the child does not have HIV infection. Olesya continues to take medication and thanks the charitable organization for supporting her during that critical period.

I had a hard time. I thought that life had stopped. War. OX. Only now did I understand: if I had not started treatment then, I would have harmed my child. Thanks to the team of the HealthLink project, which saved me and the child, — says Olesya.

Medical workers assure that the sooner a pregnant woman with HIV status starts taking anti-rotavirus therapy, the greater the chances that she will give birth to a healthy child.

There are three ways of HIV transmission – through blood and other biological fluids, during sexual contact and during pregnancy, childbirth and breastfeeding. Women during pregnancy are examined twice, and who belongs to the risk group – three times. If a woman has not been examined in time, especially now during the war, the woman is examined in the maternity hospital. If a pregnant woman is diagnosed with HIV, she is prescribed antiretroviral therapy. The earlier a pregnant woman with HIV starts taking Arttherapy, the greater the chances that the child will be born healthy. According to statistics, 40% of children were infected with HIV from their mothers before the start of ARV therapy. With the adoption of ARV therapy, this percentage has significantly decreased – 1% Therefore, every woman who has been diagnosed with HIV must take medication, says Iryna Kuznetsova, an epidemiologist at the Donetsk Regional Center for the Prevention of HIV Infection and the Fight against AIDS, and a specialist in HIV testing in the Donetsk region.

HIV treatment in Ukraine is free of charge, initial diagnosis and treatment are most often carried out by a family doctor or specialized organizations.

• What to do at the risk of infection

For people who have encountered a situation that could be potentially dangerous (unprotected sex, skin damage, contact of other people's biological fluids on the mucous membranes), it is necessary to consult a doctor no later than 72 hours later. This allows you to get post-contact prevention. It will be necessary to take pills for 28 days, which significantly reduces the risk of developing the disease.

If the time is missed, the person will be prescribed an HIV test after three months.

• Symptoms of HIV

In the first few weeks after infection, cold-like symptoms may occur: high fever, headache, sore throat, weakness, joint pain, and lymph nodes.

Once symptoms disappear, HIV can be asymptomatic for several years. However, with the destruction of immunity, serious infections can occur, such as tuberculosis, pneumonia, cytomegalovirus, toxoplasmosis, herpes.

Since all these symptoms are manifestations of other diseases, HIV can only be detected through a test.

• Where to take tests and get help

The HIV test is included in the basic package of medical services of a family doctor. It can also be bought at a pharmacy, or obtained from specialized non-governmental organizations or specialized offices of "Trust" and AIDS Centers. To find out about such opportunities in your region, you should use the chatbot http://t.me/HIVfree_bot . And those who found themselves abroad can contact http://t.me/HIV_AIDS_bot.

The USAID HealthLink project, the largest HIV testing project in the country, which implements the "100% Life" PO, provides an opportunity to order an oral HIV test at home by mail. To do this, you need to use the option "I want to be examined" on the website prozdorovia.in.ua. The site will offer the user to complete a questionnaire in order to find out about their own risks of HIV infection, and to order a test at home or help to find the nearest testing point in their city.

Testing allows you to detect the disease in the early stages, when only antiretroviral therapy will be enough for a full life. People who are already receiving treatment and were forced to move should contact their social worker or similar organizations. Thanks to the patient database with HIV, the treatment scheme will be available even if all documents are lost.