Research
The Brown University Ukraine Collaboration is a joint venture between the Brown University Center for AIDS Research (CFAR) and HIV, tuberculosis (TB) and health service providers in Ukraine through the support of the Elena Pinchuk ANTIAIDS Foundation. The collaboration engages the resources of Brown University to work with Ukrainian health providers to address the challenges of the HIV/AIDS and TB epidemics for children, women and their family members in Ukraine.
individuals in Ukraine are infected with HIV and AIDS according to the World Health Organization
AIDS related deaths occurred in Ukraine in 2019 according to UNAIDS.
of people who inject drugs have HIV in Ukraine according to UNAIDS.
HIV/AIDS is a crisis in Ukraine. The World Health Organization estimates that about 360,000 individuals in Ukraine are infected with HIV and AIDS including up to 20,000 children and 190,000 women. A large percentage of these people are young adults and over the next ten years as these young people become ill with AIDS and TB, it will be a tremendous stress on an already strained healthcare system. Furthermore, as this population moves into peak reproductive years, the potential for vertical transmission to children will increase and the need for prevention and treatment of HIV in children will also increase. In conjunction with the HIV/AIDS epidemic, the burden of TB is very high in Ukraine. Ukraine is listed among the top countries in the world for incidence of tuberculosis with high rates of multi-drug resistant tuberculosis (MDR).
In light of recent developments in Ukraine, Brown University researchers and their local partners have created Friends of Ukraine RI, and organization dedicated to providing immediate disaster relief to Ukrainians.
Ukraine is geographically the second largest country in Europe and has a population of approximately 45 million people. It became independent in 1991 with the dissolution of the former Soviet Union. This marked years of difficult transition for Ukraine and the country struggled with high inflation, a long recession and lasting detrimental effects on its health care system.
HIV/AIDS is a crisis in Ukraine. The World Health Organization estimates that about 360,000 individuals in Ukraine are infected with HIV and AIDS including up to 20,000 children and 190,000 women. A large percentage of these people are young adults and over the next ten years as these young people become ill with AIDS and TB, it will be a tremendous stress on an already strained healthcare system. Furthermore, as this population moves into peak reproductive years, the potential for vertical transmission to children will increase and the need for prevention and treatment of HIV in children will also increase. In conjunction with the HIV/AIDS epidemic, the burden of TB is very high in Ukraine. Ukraine is listed among the top countries in the world for incidence of tuberculosis with high rates of multi-drug resistant tuberculosis (MDR).
Nonetheless, the biomedical tools available to fight HIV and AIDS are outstanding. Antiretroviral therapy, which has been available in Ukraine since 2005, has dramatically decreased death rates and complicating infections. Antiretroviral therapy has also decreased the rate of tuberculosis among individuals with HIV. Treatment and prevention of opportunistic infections, which occur with high frequency in HIV and AIDS, is enormously effective. There are a number of Centers in Ukraine that focus on HIV and AIDS among children. Of particular note is the Children’s Hospital in Kyiv, which has been noted for its ability to provide state-of-the-art care for children with HIV. However, significant challenges remain to provide excellent TB care and HIV and AIDS care in other regions of Ukraine: less than 25% of people who have HIV and qualify for treatment are actually on antiretroviral treatment, leaving a tremendous gap in needed antiretroviral medicine coverage. These people are at high risk of becoming ill, many with tuberculosis which poses a health risk to everyone. We are collaborating with the ANTIAIDS foundation to help women and children with HIV to gain access to medicines and lifesaving support as they battle for their health.
The overall goals of the Brown Ukraine Collaboration are:
Specific goals include:
The Brown University Ukraine Collaboration is currently undertaking a number of research projects in Ukraine in partnership with local organizations.
Collaborators: Bogomolets National Medical University, Kyiv, Ukraine, Dr. Vasyl Petrenko; Ukrianian Institute on Public Health Policy; Boyarka Oblast TB Hospital, Boyarka, Ukraine
This is a mixed-methods study designed to better understand poor treatment outcomes among MDR-TB patients in Ukraine and predictors of those outcomes. Efforts are also being made to build the laboratory capacity at Boyarka hospital to enable DNA extraction from sputum samples, which will eventually allow molecular epidemiology studies.
Collaborators: Kyiv City Pediatric TB Hospital in Puscha Vodytsia, Ukraine; HIV Center, Children’s Specialized Hospital OKHMATDIT, Kyiv, Ukraine
Researchers at Brown are collaborating with Ukrainian colleagues to evaluate the state of the TB and MDR-TB epidemics in pediatric patients in Ukraine. Concurrently, this project will assess the lab capacity of Ukraine’s TB hospitals in the interest of incorporating Ukraine into a multi-site research project investigating novel pediatric diagnostic techniques, which is being led by TB researchers at Harvard.
Collaborators: HealthRight International, Director: Halyna Skipalska
This is a mixed-methods project designed to identify risk factors for HIV and other STIs among vulnerable youth and develop interventions to decrease those risks. HealthRight International has been implementing a STEPS program which educates homeless and at-risk youth on topics ranging from basic hygiene and reproductive health to HIV information, violence management and correct condom use. The goal of these efforts is to identify areas that can augment the existing programs and make them more effective.
Collaborators: Karsten Lunze, MD, MPH, DrPH (Boston University); Jeffrey Samet, MD, MA, MPH (Boston University); Timothy Palen Flanigan, MD (Brown University
This project aims to examine the double stigmas of HIV and substance use as a barrier to treatment integration among HIV-infected people who inject drugs (PWID) in Ukraine. This pilot study will leverage the expertise of research groups at Brown University and Boston University and a partner team in Ukraine and will lay the foundation for the development and evaluation of a subsequent stigma intervention.
Collaborators: Bogomolets National Medical University, Kyiv, Ukraine, Dr. Vasyl Petrenko; Kyiv City Pediatric TB Hospital in Puscha Vodytsia, Ukraine; HIV Center, Children's Specialized Hospital OKHMATDIT, Kyiv, Ukraine, Ukrainian Institute on Public Health Policy
This project aims to retrospectively examin autopsy and clinical data of children who have died in Ukraine in an effort to identify all TB-related deaths in children. The second aim of this project is to evaluate the potential for enhancing TB diagnosis in children with a prospective study.
Collaborators: Robert Paul, PhD (University of Missouri, St. Louis); Timothy Palen Flanigan, MD (Brown University); Omowunmi Aibana, MD, MPH (The University of Texas); Ukrainian Institute on Public Health Policy
This project aims to provide capacity building for integration of mental health into HIV/MDR-TB treatment in Ukraine. The goal is to improve treatment adherence and patient outcomes among individuals infected with HIV/MDR-TB. The results of this project with help to inform strategies for closing the mental health gap in Ukraine and other regions of the world.
Projects completed by the Brown University Ukraine Collaboration include:
Collaborators in Ukraine: AIDS Center, L’viv, Ukraine
From June to August, 2013, a study was conducted at the L’viv AIDS Center's integrated ART and opioid replacement therapy program for HIV-infected injecting drug users, with a specific focus on the beliefs and impressions of the Center's healthcare staff on the efficacy of their integrated treatment approach. This study included interviews with the L’viv AIDS Center's healthcare staff as well as a comprehensive chart review for all patients enrolled in the Center's integrated program.
Collaborators in Ukraine: Bogomolets National Medical University, Kyiv, Ukraine, Dr. Vasyl Petrenko; Ukrainian Institute on Public Health Policy; Boyarka Oblast TB Hospital, Boyarka, Ukraine
A retrospective review of treatment outcomes among drug sensitive TB patients in Kyiv Oblast revealed that patients with HIV infection, patients who abuse alcohol, and patients with smear-positive TB at baseline were at greater risk of poor treatment outcomes. Nevertheless, the data also reveal that these patient characteristics, alone, are not sufficient to cause the high rates of poor treatment outcomes among TB patients.
Collaborators in Ukraine: Bogomolets National Medical University, Kyiv, Ukraine, Dr. Vasyl Petrenko, Anna Radysh, Viacheslav Krasuik
This study sought to determine beliefs and fund of knowledge about vaccines and vaccinations in medical students at Bogomolets National Medical University. The Collaboration and its partners created a 30-question survey, which was administered in June 2014 to 463 medical students in their clinical (third through sixth) years at Bogomolets. The written survey contained questions regarding vaccine safety, contraindications, beliefs in the need to vaccinate, and the adequacy of vaccine education at the students’ medical school.
Ukraine is becoming a more inclusive society that is working hard to accommodate people with special needs and challenge the stigma associated with TB, HIV and other diseases. Ukraine has to overcome the legacy of the Soviet Union, where it was state policy to institutionalize people with disabilities, orphans, and other vulnerable groups. Once institutionalized, they were out of the public eye and their lives were rarely discussed in the media. The Brown University Ukraine Collaboration is happy to partner with the UCU School of Journalism to help young reporters give a voice to people whose stories have been muted for so long. Young journalists wrote 22 stories from different parts of Ukraine ranging in topics from commercial sex to the elderly.
The Elena Pinchuk ANTIAIDS Foundation was established in 2003 by Elena Pinchuk (Franchuk) as the first Ukrainian private foundation to address HIV/AIDS in Ukraine. The Foundation has had many successful campaigns and works in collaboration with UN agencies, the Clinton Foundation, and the Elton John Foundation, among others. Read more about the Elena Pinchuk ANTIAIDS Foundation work in Ukraine.