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Introduction Co‐located treatment for HIV and opioid use disorder has been shown to improve care outcomes for HIV‐positive people who inject drugs (PWID) in Ukraine. However, patients continue to be stigmatized for both HIV and substance use. This study aimed to assess whether co‐located care for HIV‐positive PWID receiving opioid agonist treatment (OAT) services in Ukraine is associated with less stigma and better perceived quality of HIV services. Methods This cross‐sectional study enrolled 191 HIV‐positive PWID who received OAT services at three healthcare facilities providing substance use treatment (OAT only) and at four facilities that provided co‐located care (both OAT and HIV treatment) in six regions in Ukraine during July‐September, 2017. Primary outcomes were HIV stigma (Berger scale), substance use stigma (Substance Abuse Stigma Scale) and intersectional stigma (both stigma forms above 75th percentile). Secondary outcome was quality of HIV care, a composite score based on a package of received services. Linear and ordinal regressions were used to assess the predictors of selected outcomes. Results Study participants were 75% male, mean age 40 ± 7 years; 47% received co‐located care, and 10.5% had both high HIV and substance use stigma. Co‐located care was neither associated with HIV nor substance use stigma but it was linked to better quality of HIV care (adjusted odds ratio: 4.13; 95% CI: 2.31, 7.54). HIV stigma was associated with suicide attempts (adjusted beta (aβ): 5.90; 95% CI: 2.05, 9.75), and substance use stigma was linked to poor mental health (aβ: −0.26; 95% CI: −0.44, −0.08) and lower likelihood of receipt of services from non‐governmental organization (NGO; aβ: −6.40; 95% CI: −10.23, −2.57). Conclusion One in ten people with HIV in this cohort who received OAT services experienced high levels of both HIV and substance use stigma, which was associated with poorer mental health and less NGO support. Co‐located HIV and OAT services were linked to better perceived quality of HIV care, but did not seem to reduce stigma for this key population. Stigma interventions for PWID, possibly delivered involving NGOs, may be an approach to mitigate this challenge.

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Introduction: Congenital Talipes Equinovarus is one of the most common congenital deformities of foot and ankle. Ponseti method of serial manipulation and once weekly casting has claimed a success rate of 95 %. However, modification of the Ponseti method in terms of duration with twice weekly casting can shorten the time immobilized in plaster with increased parents compliance. Materials and Methods: A randomized comparative study was carried out for total 64 patients (100 clubfoot) attending the Outpatient department of Orthopaedics, Silchar Medical College and Hospital from 1 st June, 2017 to 31 st May, 2018. 32 patients each in Standard Ponseti group and Accelerated Ponseti group were allotted according to computer generated randomisation plan. The method of manipulation was similar in both the groups with once weekly casting in Standard Ponseti group and twice weekly casting in Accelerated Ponseti group. The initial and final Pirani scores, number of casts required for correction, treatment time in plaster, rate of tenotomy and relapse of deformity in the Standard and Accelerated Ponseti groups were recorded and compared using paired and unpaired t-test methods as required.Results: The two groups did not differ with respect to their initial and final Pirani scores. The mean number of casts required was 5.92 + 1.09 in Standard Ponseti group, and 6.09 + 1.11 in Accelerated Ponseti group (p-value = 0.4203). However, there was significant difference in the treatment time in plaster with mean treatment time of 41.42+7.62 days(range -28 to56 days) in Standard Ponseti group and 21.13 +3.94days(range-14 to 31 days) in Accelerated Ponseti group with p-value < 0.05. 41 out of 48 feet in Standard Ponseti group and 46 out of 52 feet in Accelerated Ponseti group required percutaneous tenotomy. Relapse of equinus and adduction deformity was seen in 3 feet each in Standard and Accelerated Ponseti groups on follow up. Conclusion: Accelerated Ponseti method of twice weekly casting has similar results as Standard Ponseti method with the advantage of earlier correction of the deformity and better parents compliance.