Access to HIV-prevention in female sex workers in Ukraine between 2009 and 2017: Coverage, barriers and facilitators

Abstract

The provision of comprehensive prevention services is vital for reducing the high burden of HIV amongst Ukrainian female sex workers (FSWs). To identify barriers and facilitators that influence access to HIV prevention amongst this population between 2009 and 2017, we developed a literature-informed conceptual framework and conducted a document analysis to identify the components of the Ukrainian prevention package (PP). Using the Integrated Bio Behavioural Surveillance Surveys, we then conducted descriptive analyses to explore PP coverage from 2009 to 2017 and the influence of factors, identified by our conceptual framework. After increasing over four years, a drop in PP coverage was observed from 2013 onwards. Being a client of a non-governmental organisation, street and highway solicitation, non-condom use, and knowledge of HIV may influence access to HIV prevention in the Ukrainian context. Future interventions should consider barriers and facilitators to HIV prevention and the multiple structural levels on which they operate.

Modes of HIV transmission among young women and their sexual partners in Ukraine

“…The current study adds to the literature, suggesting a significant association between injecting drug use, unprotected sex, and heterosexual transmission to non-drug-injecting women. Our findings highlight the need for tailored prevention interventions for serodiscordant couples and bridge populations (non-drug-using sexual partners of PWID), considering the complex interplay between HIV risks, IPV, STI, non-disclosure of HIV and IDU, and combined IDU- and HIV-related stigma to effectively address the unique challenges faced by PWID and their partners in Ukraine and beyond [ 37 ]. Additionally, such intervention could benefit from bottom-up approaches nested around lived experiences of AGYW in Ukraine to account for unstable socio-ecological environments (i.e., the ongoing war or pandemics) [ 37 – 40 ].…”

Untitled

“…The current study adds to the literature, suggesting a significant association between injecting drug use, unprotected sex, and heterosexual transmission to non-drug-injecting women. Our findings highlight the need for tailored prevention interventions for serodiscordant couples and bridge populations (non-drug-using sexual partners of PWID), considering the complex interplay between HIV risks, IPV, STI, non-disclosure of HIV and IDU, and combined IDU-and HIV-related stigma to effectively address the unique challenges faced by PWID and their partners in Ukraine and beyond [37]. Additionally, such intervention could benefit from bottom-up approaches nested around lived experiences of AGYW in Ukraine to account for unstable socio-ecological environments (i.e., the ongoing war or pandemics) [37][38][39][40].…”

Untitled

“…The current study adds to the literature, suggesting a significant association between injecting drug use, unprotected sex, and heterosexual transmission to non-drug-injecting women. Our findings highlight the need for tailored prevention interventions for serodiscordant couples and bridge populations (non-drug-using sexual partners of PWID), considering the complex interplay between HIV risks, IPV, STI, non-disclosure of HIV and IDU, and combined IDU-and HIV-related stigma to effectively address the unique challenges faced by PWID and their partners in Ukraine and beyond [37]. Additionally, such intervention could benefit from bottom-up approaches nested around lived experiences of AGYW in Ukraine to account for unstable socio-ecological environments (i.e., the ongoing war or pandemics) [37][38][39][40].…”