National roll-out of database for HIV prevention programmes among civil society organizations in Ukraine Olga Varetska ICF “International HIV/AIDS Alliance in Ukraine” XVIII International AIDS Conference July 2010, Vienna, Austria

Most severe AIDS epidemic in Europe –Estimated 1,33% of Ukrainians (age 15-49) living with HIV –101,000 people officially reported with HIV –360,000 people estimated living with HIV Epidemic concentrated among injecting drug users (IDUs): - over 70% of people living with HIV have history of injecting drugs - sexual transmission now occurring among IDUs or their sexual partners –IDUs and their sexual partners focus of HIV prevention efforts. Programmes also for sex workers, MSM, and prisoners Epidemic overview

Coverage of HIV prevention programs in Ukraine

SyrEx is a user-friendly database for tracking: number of individual clients reached Frequency, type and trends of services accessed SyrEx developed to monitor prevention programmes for IDUs and sex workers Also used by organizations working with MSM and prisoners Used by more than 100 NGOs in Ukraine Currently exists in Russian, English version is coming Syr-Ex (Syringe Exchange)database Syr-Ex (Syringe Exchange) database

PC PC literacy Functioning system for client coding (each client is given a card with a code, which will be used as client ID for all services) accurate and timely completion of daily registration forms directly at service provision points Key user requirements

–Client registration –Keeping track of daily records: information on the number of services provided and consumables given out to each client –Compilation of reports –Data transfer (to an upper level) and consolidated analysis SyrEx functions

Coverage of prevention programmes, disaggregated by: sex, age, risk group, geographical area frequency of service access by clients type and quantity of services User defined reports Customizable Reports

1.real-time reporting to donors 2.guiding scale-up of services and mobilization of additional resources 3.data use in managing services to meet changing needs of clients 4.detailed analysis of scope and scale of coverage of prevention programmes i.e. percentage of injecting drug users regularly reached by harm reduction programs Civil society organizations can use SyrEx database for:

Examples of data obtained with the help of SyrEx for 2009 within the national harm reduction programme supported by the GF

Client characteristics

Provision of prevention commodities (per client in 2009) Number of syringes distributed per IDU 114 Number of condoms distributed per IDU 61 Number of condoms distributed per FSW 129 Number of condoms distributed per MSM 117

Average number of visits per client per month to prevention programmes

Frequency of visits of IDUs to Needle Exchange Programmes in 2009 (by month)

Examples of data use at national level Low number of condoms distributed per IDU per year 61 per client (SyrEx) Increase in sexual transmission of HIV associated with drug use In 2009 sexual transmission accounted for 43% of all new HIV infections, versus 36,5% IDU related (data from routine surveillance) Low condom use among IDUs Only 48,3% of IDUs reported condom use during the last sexual intercourse (BSS data) Result Developed new prevention component among IDUs and their sexual partners, aimed at prevention of sexual transmission

More examples of data use 75% of all IDUs clients are male 70% of all clients of harm reduction programs are above 25 Mostly opioid drug users are reached with services (about 90% of all program clients) Yet: female drug users are more vulnerable to HIV than male national behavioral studies indicate increasing proportion of young stimulant drug users emerging (34.5% of all IDUs were stimulant drug users in 2009 compared to 20% in 2005) Result: Reprogramming prevention services for IDUs to include: gender sensitive counseling and services for female IDUs Special group level interventions for stimulant users

Use of databases for monitoring HIV prevention programmes by civil society organizations improves data management and use Enables timely reprogramming of prevention programs to optimize their effectiveness Free distribution of SyrEx (shareware) among national partners to ensure systematic data collection and use SyrEx is being promoted within Eastern Europe and Central Asia Several NGOs in Belarus are using Syrex; NGOs in Kyrgyzstan, Tadjikistan and Kazakhstan expressed interest and were trained to start using SyrEx in near future Conclusions