Data show that non-injecting drug use is as important in HIV transmission as injecting drug use. Stimulants and New Psychoactive Substances (NPS) are the most commonly used non-injectable drugs in Ukraine, and because of their effects, they can increase sexual stamina and subsequent risky sexual behaviors, and therefore exacerbate the risks of sexual transmission of HIV and HCV. Although progress has been made in reducing infections and improving the lives of people already living with HIV, people using new psychoactive substances/stimulants (NPS/stimulants) are among the hardest to be reached out with prevention and treatment services, proper information, and harm reduction disposals. As a co-sponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and in line with its mandate, the United Nations Office on Drugs and Crime (UNODC) in Ukraine has supported national partners and civil society organizations to ensure the uninterrupted provision of HIV prevention, treatment and care services, reaching over 200,000 people since 2022.
The Office has organized a series of studies and interventions (see Frame 'Addressing the Drugs Problem') to address the HIV and harm reduction service needs of people who use drugs (PWUD), people in prison, refugees and internally displaced persons (IDPs), while increasing support to minimize risk behaviors, particularly those caused by the use of NPS and stimulants.
Based on the needs assessment on access to HIV services for PWUD during the period of hostilities in Ukraine, UNODC’s programme has already addressed evidence for certain interventions, technologies and approaches with PWUD in particular people who use NPS/stimulants in Ukraine and the region (read our webstory). Through cost, impact and policy analysis, the Office developed community-based mechanisms, survivor-centred approach and multi-sectoral cooperation to reduce unmet need for services and risk behaviors, while enhancing an innovative pilot engagement mechanism model to enroll NPS/stimulant users in all stages of HIV prevention and treatment, as well as related substance abuse treatment.
Based on WHO/UNODC/UNAIDS recommendations, UNODC implemented in 2022 and 2023 a core set of interventions (web-based awareness raising, motivational counselling, demonstration and promotion of human resource videos, referral to HIV testing and drug counseling) and designed innovative awareness-raising tools (8 e-guides, 10 e-learning videos and 1 e-manual in the form of a wiki-based website, chat/group). Focusing on local assistance, UNODC promoted awareness-raising activities to educate drug users and people living in closed environments about HIV and drug-related information, treatment and services, as well as to improve the outreach and information skills of government HIV services and addiction treatment services. An evaluation carried out in 2023 in Dnipro and Odessa on harm reduction and treatment outreach interventions among NPS/stimulants users, showing a decrease in risky NPS use by injection and an increase in psychological and social well-being.
UNODC’s responses to HIV among PWUD, including for people who use NPS/stimulants, promotes core interventions, such as expanded voluntary counseling and testing and earlier access to HIV treatment in the Ukrainian emergency context, which can reduce HIV incidence among PWUD and consequently community levels of HIV transmission. This also reduces drug-use related morbidity and mortality, including overdose, as well as key non-health indirect effects such as reducing crime when linked to drug use. The Office in Ukraine also supports the country's national policy environment to scale up programmes providing combined prevention, treatment and care services, including outreach services, which can improve the risk environment, reduce stigma and lower the risk of HIV infection. In addition to the benefits of combating the epidemic, it is highly desirable, from a public health and human rights perspective, to reduce problematic policing practices in order to improve well-targeted HIV interventions among PWUD.
UNODC’s interventions in Ukraine and the region are evidence-based, rights-respecting and cost effective. They reflect UNODC's commitment to achieving the Sustainable Development Goals, in particular Goal 3, as well as the UNAIDS Global Strategy to End AIDS by 2030 and the UNAIDS Fast-Track Strategy 2021-2026. There is an urgent need to expand combined prevention and treatment services for PWUD, which are cost-effective even at moderate levels of intervention impact, and very cost-effective at higher levels of efficacy, and which are crucial for the future of the national and global response to HIV.An "AIDS-free generation" will only be possible if HIV prevention, treatment and care services are extended to people who use drugs, including NPS/stimulants.
1. Global AIDS Strategy 2021-2026 — End Inequalities. End AIDS. | UNAIDS
Further Information
In line with the Global UNAIDS Strategy and its mandate, the UNODC works to support countries in the achievement of the Sustainable Development Goals in particular, SDG Target 3.3 to end AIDS by 2030, SDG 5 to ensure gender equality, SDG 10 to reduce inequalities, SDG 16 to ensure access to justice and SDG 17 to foster partnerships across sectors, including civil society and community-based organizations.
May 2024 - The Government adopted the 'Strategy on drug policy of Ukraine until 2030' aiming towards a more people-centred and human rights-oriented approach to drug policy. The current drugs situation in the country requires comprehensive responses across dimensions of security, health and social policy, law enforcement, taking into account scientific, environmental, socio-political, technological, and international aspects.
UNODC key interventions:
2024 - UNODC’s latest report assessed benefits and limitations of the pilot model mechanism related to the outreach activities and their effective impacts on NPS and stimulants users.
August - December 2023 - UNODC carried out the "Analysis of the effectiveness of outreach interventions to reduce harm among persons who use new psychoactive substances/stimulants in Ukraine" in Dnipro and Odesa, selected as UNAIDS Fast-Track Cities within the Initiative to accelerate action in major cities to prevent the AIDS Epidemic as part of the UNAIDS Strategy "Acceleration: Ending the AIDS Epidemic by 2030". UNODC developed the NPS and stimulants users’ treatment guideline and implemented and scale-up activities following 2022 interventions in web outreach, motivation counselling, HR videos demonstration and promotion, referral to HIV testing and addiction counselling. UNODC also started preparatory work to organize a training event on TreatNet Family Skills.
October 2023 - UNODC held a consultative roundtable bringing together representatives of the Ukrainian Ministry of Health, the Supreme Court of Ukraine, the Anti-Drug Department of the National Police, the US Center for Disease Control and Prevention and UNAIDS Ukraine, to discuss the ways to incorporate evidence-informed responses, based on health and human rights-centered approaches to optimize public health and prevention of drug use disorders and trafficking.
September 2023 - UNODC supported national advocacy efforts to amend a Ministry of Health Order “on approval of Tables of small, big, and especially big sizes of drugs, psychotropic substances and precursors in illegal circulation”.
June - July 2023 - UNODC conducted a SOS II level for NGOs across Ukraine and a SUD management during pregnancy training with the Centre for Public Health (MoH).
April 2023 - UNODC organized the session ‘Understanding the UNODC-WHO Stop Overdose Safely (S-O-S) Initiative’ at the 27th Harm Reduction International Conference.
March - December 2023 - UNODC completed the pilot scheme for supporting CSOs in the provision of web-based and regular outreach, testing referral to HIV T&C, and addiction counselling service to engage NPS users to HR and HIV/drug use related services. The pilot scheme was supported by National Institute of Social Research, the Center for Public Health of the Ministry of Health of Ukraine.
July - December 2022 - UNODC completed a study to assess the needs and identify the barriers to access HIV services for people who use new psychoactive substances/stimulants during the period of hostilities in Ukraine. UNODC piloted an innovative mechanism of engagement of new psychoactive substances/stimulants users to HIV prevention/treatment and related drug dependence treatment.
2021 - UNODC regional programme office for Eastern Europe commissioned the report on the influence of NPS/stimulants use on key population access to HIV-related services in Ukraine. The report was done during COVID-19 time and described the difficulties and barriers impeding access to HIV services for NPS/stimulant users.