Кафедра соціології
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Item Community perspectives on self-testing for HIV and HCV in the WHO European region(2022) Tokar, Anna; Prokhorova, Anna; North, SarahBackground: The landscape of HIV and HCV testing service delivery models continues to evolve alongside the introduction of novel biomedical technologies and evidence-based testing guidelines. At the same time, late diagnoses of HIV and HCV persist in areas of the European WHO region. As part of the range of diverse testing offers, self-testing diagnostics have demonstrated to provided great opportunity to reach and engage key populations according to their specific needs. In 2021, EATG in partnership with the Foundation for Innovative New Diagnostics (FIND) examined country-specific policies, regulations, and practical factors enabling or hindering availability and integration of HIV and HCV self-testing diagnostics as one of the ways to advance early diagnosis and linkage to care in most affected populations, in addition to healthcare provider-initiated testing and testing by trained lay provider. Materials and Methods: An online cross-sectional survey was distributed between July and September 2021 to HIV and HCV-related community organisations within the European region on the availability and cost of self-testing kits for HIV and HCV. Based on the self-reported data on varying levels of self-test kit availability, 7 countries were selected for further qualitative analysis. A socio-ecological approach was used to carry out qualitative semi-structured interviews (SSIs) in English and Russian with key informants to understand community perspectives on self-testing for HIV and HCV in Armenia, Bosnia and Herzegovina, Kazakhstan, Kyrgyzstan, Poland, Slovenia, and the Russian Federation. Results: 70 individual responses from 37 countries in the region to the online survey. For the qualitative SSIs, a total of 18 online interviews (via Zoom, Skype, and Microsoft Teams) were analysed in four Eastern Europe/Central Asian and three Central/Southeastern European countries. Commonly reported barriers HIVST and HCVST included lack of comprehensive information relayed to community, high cost of kits, stigma, and discrimination. Conclusions: To ensure HIVST and HCVST access and uptake by those who benefit the most, a three-prong approach is required. First, at policy-level: introduce a legal framework for HIV and HCV self-testing and monitor how it is implemented in the field. Second, funding for the implementation of self-testing with the full-service cycle and/or needed treatment and reducing the cost of self-testing kits. Third, improving understanding and awareness of the self-testing concept and advantages of self-testing among key populations, local authorities, and healthcare providers.Item Strengthening Community leadership for decentralised access to HIV & HCV testing project. Policy and operational brief : October-December, 2021(2022) Tokar, Anna; Prokhorova, Anna; North, SarahThis policy and practice brief reviews some of the key factors enabling or hindering availability and integration of HIV and HCV self-testing diagnostics as one of the ways to advance early diagnosis and linkage to care in most affected populations, in addition to healthcare provider-initiated testing and testing by trained lay provider. This paper provides a community perspective drawn from a quantitative and qualitative research piece and an online community exchange meeting. It outlines opportunities and challenges from a community perspective to inform planning of self-testing for HIV and HCV service delivery at community level to ease its access to and uptake by those who would benefit from it. The study has been carried out in seven countries: Armenia, Bosnia, and Herzegovina, Kazakhstan, Kyrgyzstan, Poland, Slovenia, and the Russian Federation.Item Strengthening Community leadership for decentralised access to HIV and HCV testing project: Findings from qualitative research among key informants in Armenia, Bosnia and Herzegovina, Kazakhstan, Kyrgyzstan, Poland, Slovenia, and the Russian Federation : October-December, 2021(2022) Tokar, Anna; Prokhorova, Anna; North, SarahThe European AIDS Treatment Group (EATG) is a patient and community-led NGO that advocates for the rights and interests of people living with or affected by HIV/AIDS and related co-infections within the WHO Europe region. Founded in 1992, the EATG is a network of more than 160 members from 45 countries in Europe. Members are people living with HIV/AIDS and representatives of different communities affected by HIV/AIDS and confections. EATG represents the diversity of more than 2.3 million people living with HIV in Europe as well as those affected by HIV/AIDS and confections. In line with EATG’s long-term strategy goal to engage, inform and empower all people living with and affected by HIV in increasing the usage of HIV, viral hepatitis, TB, and STI combination prevention and testing strategies in affected communities; EATG is implemented the Co-Lead project ‘Strengthening Community leadership for decentralized access to HIV and HCV testing’. This project focused on community perspectives of HIV and HCV self-testing. It examined how the concept of self-testing is exercised and understood on the ground beyond policy analysis, which might not be able to address lived experiences and persistent facilitators and/or barriers to self-testing in a specific context. Early HIV/HCV diagnosis continues to be a global health priority, in particular among key populations and Eastern Europe and Central Asia (EECA).[1-3] Despite efforts to promote and increase the uptake of HIV testing in Europe, it is estimated that it takes on average three years from the time of HIV infection until diagnosis, and every second diagnosed HIV case happens at a late stage (53% of people had CD4 cell count less than 350 cells/mm3 at diagnosis) according to the 2019 surveillance data.[4] In the EECA region, this estimate is a bit higher at 56%.[4] Furthermore, it is estimated that approximately 15– 50% of people are unaware of their HIV-positive status across 31 countries of the European Union and European Economic Area (EU and EEA).[5] Eastern Europe and Central Asia remain one of two regions in the world where HIV incidence continues to rise, with a 27% increase in annual HIV infections between 2010 and 2018.[6] Early HCV diagnosis and care also remains a priority for the WHO European Region, where according to estimate one in every 50 persons are chronically infected with HCV (approximately 14 million people). Countries in the EECA region are reported to have an intermediate and high prevalence of HCV antibodies, while the countries of Western and Central Europe - low.[3] Thus, this study prioritized several, key populations groups (i.e., men who have sex with men (MSM), migrants, people who use drugs (PWUD), and sex workers (SW)), countries in Central Europe, Eastern Europe and Central Asia. This study was conducted in the WHO European region with four EECA countries (Armenia, Kazakhstan, Kyrgyzstan, and the Russian Federation), three Central/South Eastern European countries (Bosnia and Herzegovina, Poland and Slovenia).