HIV/AIDS, Children and Youth Programme
Ukraine is the country worst affected by HIV/AIDS in Europe. An estimated 440,000 people aged 15-49 are living with HIV/AIDS – 1.63 per cent of the adult population. Three regions – Kyiv, Odessa and Donetsk – have recently crossed the threshold of one per cent HIV infection among pregnant women, indicating the increasing generalization of the epidemic.
Injecting drug use is still driving the spread of HIV but the disease is now spreading fast among the broader young population through unprotected sex and from mothers to their babies. Eighty per cent of all infected people are young. The recent sharp increase in infections outside vulnerable groups and in young women in particular suggests that the coming years will be decisive for addressing the HIV/AIDS epidemic in Ukraine.
Women are more prone to infection due to their biological and social vulnerability. Women now represent 45 per cent of all adults living with HIV in Ukraine. The absolute number of children infected with HIV through mother-to-child transmission (MTCT) continues to increase as there is a 20-30 per cent yearly increase in HIV-infected pregnant women: in 2011, HIV prevalence among pregnant women was 0.47 per cent, the highest in Europe.
According to official statistics from Ukraine’s Ministry of Health, 32,504 children were born to HIV-positive mothers between 1995 and 2012. Among them, 21,916 are HIV negative, 6,735 children under the age of 18 months are awaiting confirmation of their HIV status, while 2,814 are HIV-positive, 752 have AIDS and 287 children have died of AIDS. Despite important progress in preventing mother-to-child transmission (PMTCT), and paediatric AIDS services in many CIS countries including Ukraine, there are serious issues and challenges that remain unaddressed, including early infant diagnosis of HIV.
The analysis of data for most at risk adolescents (MARA) aged 10 to 19, based on data of the behavioural surveillance studies among most at risk populations (IDUs, MSM and FSWs), shows that MARA represent a population group in need of special attention within the frame of the national AIDS response. Risk behaviour among this group starts very early, overlapping risk behaviours are common, while HIV/AIDS knowledge, skills and particularly access to adequate HIV prevention, treatment, care and support services is extremely low – much lower than among their adult counterparts, as this population group faces a wide range of access barriers. Many of the existing prevention and harm reduction services are not targeting MARA, e.g. the national estimate for the access of children living or working on the streets to HIV services is less than 1 per cent .
Current trends of the HIV epidemic prove that more emphasis should be placed on prevention among most at risk adolescents and youth, information outreach to the general public to prevent discrimination of HIV-affected people, children born to HIV-positive mothers survival, care providers capacity building and increasing of quality of existing system of treatment, care and support for those who already affected by HIV/AIDS.
Action: Protecting children and women from HIV/AIDS
UNICEF is assisting the government to address the threat of a full-blown outbreak of HIV/AIDS in Ukraine while at the same time protecting the rights of those infected by:
The Government of Ukraine, in collaboration with civil society partners, developed a Road Map to Universal Access for HIV Prevention, Treatment and Care by 2010, with technical and advocacy support from UNICEF and its UN partners. The document emphasises children and adolescents as an especially vulnerable group and the need to provide them with special consideration in prevention, treatment, care and support.
UNICEF supported the government in developing and implementing the first National Programme Prevention of HIV Transmission from Mother to Child for 2001-2003. Today UNICEF is building the capacity of health care providers. An evaluation of the National Programme in 2007 found that it had helped to reduce transmission by two thirds, from 27 per cent in 2000 to 6 per cent in 2008.
To respond to the needs of children and families affected by HIV, UNICEF has supported community-based Day Care Centre models in Kiev, Odessa, Kherson, Mykolayiv and Krivyi Rig and Autonomous Republic of Crimea. The centres provide HIV-positive children with a place where they can communicate with other children, receive care and prepare for school. Parents receive advice in the Centres on how to care for their children, as well as psychological, legal and social support.
In light of most-at-risk adolescents being at the core of the deteriorating HIV/AIDS epidemic in Ukraine, UNICEF and the Government of Ukraine pursued a new focus vis-a-vis most-at-risk adolescents (MARA) and HIV, thereby covering a major gap in the national HIV prevention response and building a sound database and evidence-based approaches targeting MARA. Knowledge base on MARA was created; strengthened with the understanding of their behaviour, behavioural determinants and service coverage. MARA issues have been included in the 2009-2013 National Programme on HIV/AIDS and the national M&E system.
UNICEF supported the HIV Education interactive programme provided in the juvenile detention facilities.
UNICEF’s pilot project on HIV prevention among injecting drug users has been recognised as a success by the government and is being expanded across the country. 216 needle exchange programmes for injecting drug users are now operating.
UNICEF helped to integrate youth friendly services into primary level paediatric polyclinic services and the Social Services for Family, Children and Youth. Today there is a network of 104 Youth Friendly Clinics operating in the country Some 400 professionals are trained and are currently implementing “youth-friendly” techniques at their workplaces. The quality standards and evaluation criteria for services in youth friendly clinics (YFCs) have been drafted including certification procedure and staff excellence guidance.
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