Dr. Michael Grillo: If we find all HIV-positive people, we will have a chance to overcome the virus by 100%

HIV/AIDS is one of the most difficult problem of humanity. Today, Ukraine is a leader in Europe in terms of spread of HIV epidemic. According to estimates of international experts, about 240,000 people live with HIV in Ukraine. According to statistics, every day in our country 8 people die of AIDS. More than 100,000 people are not aware of their HIV-positive status, and only one in two knows about the diagnosis.

In 66% of cases in Ukraine, HIV infection is obtained through unprotected sex, and 20% through intravenous injection of drugs. Experts note that if HIV is diagnosed on time, it is possible to ensure a high-quality life if the patients start their antiretroviral therapy promptly.

On May 21, Kyiv hosted an international conference on perspective development of HIV/AIDS and tuberculosis prevention in the Armed Forces of Ukraine. The event was organized by International HIV/AIDS and Tuberculosis Institute, an NGO, in partnership with the US President's Emergency Plan for AIDS Relief (PEPFAR) in Ukraine and the region.

The event was attended by Dr. Med. Eliot J. Pearlman, MPH&TM, MPA (COL RET), Head of the Board of International Institute for HIV/AIDS and Tuberculosis, Dr. Michael Grillo, PhD, MS, Branch Chief and Director of Prevention, Education and Training, Mr. Sten Ito, DHAPP Ukraine desk officer, Lieutenant Colonel Serhii Lytovka (Medical Service), Chief of Central Public Health and Epidemiological Department of Ministry of Defense of Ukraine as well as other representatives of Medical Service of the Armed Forces of Ukraine and Preventive Medicine Service of Ministry of Defense of Ukraine.

We talked with Dr. Michael Grillo about the plans for project implementation in Ukraine.

- You said that PEPFAR is undergoing changes in general and in Ukraine in particular. What changes should we expect and what plan will you follow in Ukraine?

-  Our previous activity, indeed, shows results not as high as we would like. Analyzing the available data, we came to the conclusion that we need to change the course of action. In the past, we have focused mainly on the purchase of equipment, and now, in the framework of the US President's Emergency Plan for AIDS Relief, we plan to use targeted HIV testing strategies such as partner notification and social networks associated with positive clients since we know studies suggest these strategies will give us better yield.  This will have a two-fold benefit by providing health benefits, living a normal life for those living with HIV and if they remain on medications and are virally suppressed they will not transmit HIV to others which is a huge prevention benefit.

While implementing our activities in other countries, we have seen that suppression of virus in the human body and a healthy lifestyle allow a person with HIV-positive status to lead a normal lifestyle, work, start a family and do not feel any restrictions. Treatment that reduces the viral load allows them to avoid further transmission of virus, which means that if we find all HIV-positive people we will treat them, and then we will have a chance to significantly reduce incidence rates which will decrease transmission of HIV allowing us to gain epidemic control.  .

I also hope that we will be able to establish cooperation with the Ministry of Health of Ukraine and create a collaborative system in this way.

- Are there any deadlines for project implementation? How long will it last?

- We do not have a specific date for project completion. We will continue to move forward with program implementation and support the military HIV program.  My responsibility is to continue to support and implement the activities under PEPFAR.

- Is it planned to evaluate the medical and laboratory equipment in the Armed Forces of Ukraine in the framework of the project, and verify the equipment relevance?

- We have not yet discussed with the Ukrainian military leadership the specific measures we will implement, whether this be tests for HIV detection in the blood serum, or clinical tests for service members and their family members/partners in the event of HIV/AIDS detection. The purpose of our meeting today is to identify the Ukraine's needs and find the ways to accomplish the tasks in order to implement the decisions we made.

- You mentioned that testing each and everyone is not cost-efficient. The rate is low, and tracking what happened with a person after confirmation of his/her HIV-positive status is currently impossible the way the military is structured. Are there any ideas about how exactly we will be searching for HIV-positive people, and which population will you test at first?

- This is exactly what we will discuss with Ukrainian military leadership. However, I will emphasize that testing should be targeted and directed. It is necessary to clearly specify who should take the test and where is the highest risk of infection. Also, I hope that we will be able to establish cooperation with the Ministry of Health of Ukraine and then the Ministry of Health will be able to test those at highest risk for HIV, and our work will focus on countering the epidemic across the specific groups of military populations where we will test the particular people with the most likely positive indicators for HIV. We plan to test the most at risk individuals as a result of communication with experts from the Ministry of Defense of Ukraine on the basis of their observations and statistics.

- What problems do you encounter in Ukraine? Does the armed conflict in Eastern Ukraine affect your work?

The conflict in Eastern Ukraine does not affect our work. Regarding the difficulties we face in Ukraine while performing our work, I cannot single out any special challenges. As in all other countries, we have communication problems due to the language barriers but this not a major barrier that we cannot overcome. When messages are transmitted from person to person, the information often is distorted. As a result, the message reaches the endpoint with a completely different context. Thus, our main challenges are misunderstanding these distorted communications. One way to overcome these language barriers is to have in person meetings so that we can be sure we are communicating effectively with the military and all other organizations, ministries and agencies

Additionally, our work is complicated by the fact that in Ukraine the HIV positive patients are not treated in the military system. Our work is most successful in those militaries where treatment is included in the process of military service.

- Do you observe positive changes in other countries you work with?

- Yes, we have positive developments in many of the countries we are working in, especially in our African countries. We test, care for, and treat our military members, their families and the civilians in the surrounding areas.  As a result, we are able to track and monitor our clients and provide them with exceptional military health care.  By ensuring our clients are on treatment and virally suppressed we keep them healthy so they can continue to serve their country and be active participants in their communities.  As I said, our strategy is changing as we are much more patient focused. My hope is that we can bring these positive changes to Ukraine as well. 

- People living with HIV most often become victims of discrimination. We know that you arrange training and education events that deal with stigma and discrimination. Will you provide such training in Ukraine?

- We plan to talk about this with the Ukrainian military leadership in the next few days. In our opinion, Ukraine no longer needs to just purchase equipment, now we prefer that the Ministry of Defense of Ukraine purchase the equipment and, in turn, we strive to get an opportunity to conduct training activities. Knowledge transfer is more important than transfer of property. Discrimination is a problem that exists in many countries. Everything takes time, including the change of thinking.

Last year we arranged a training event on discrimination and stigma for Medical Service personnel across the Ukrainian Ministry of Defense. It focused on the problem related to HIV. In addition, I recently read an article in the The New York Times describing the unfair treatment of women and sexual harassment in the military. I really want to acknowledge the existence of these problems, and want us to take the necessary steps to eradicate them. If we talk about discrimination against people leaving with HIV, we should first turn to the policy and find out what the policies are and how they may be interpreted as discriminatory. In some countries, military personnel leaving with HIV are not allowed to participate in military operations and deploy to war zone even if their condition is stable and they take antiretroviral therapy. Because of this policy the military personnel try to avoid testing, hide their disease and are not interested to confirm their status, positive or negative. At the same time, if you allow the personnel with positive HIV status to serve in the military, deploy overseas for peacekeeping operations, allow them to perform certain tasks in the war zone, of course, without their direct participation in military operations on the battlefield, then, they will stop being afraid. It is important to convey the information to all people that their life will not change significantly with the timely detection of virus and proper treatment. People living with HIV can have a normal lifestyle and they do not transmit the virus.

So, we want the guideline documents or policy be enacted that allow the service members with positive HIV status to continue their service, provided that he or she follows a healthy lifestyle, monitors the health status and has a suppressed virus load.

Policy focused on positive attitude towards people with a positive status that allows for military service in the Armed Forces of Ukraine and participation in military operations and deployments will generate a society that is not afraid of testing, not afraid to reveal a positive status as well as society that knows exactly that it is necessary to make step by step decisions to defeat the illness.

Thus, changing the attitude of society towards HIV, we will change the attitude towards our people's health in general. This will give a chance to stop HIV forever in Ukraine and all over the world.

Dr. Eliot J. Pearlman organized an international conference

Director of NGO "International Institute for HIV / AIDS and Tuberculosis" Eliot J. Pearlman organized an international conference "On the Future Development of Directions of HIV / AIDS and Tuberculosis Prevention in the Armed Forces of Ukraine", which took place today in Kiev.

Also, the representatives of the PEPFAR project (US President's Emergency Plan for AIDS) have provided assistance in organizing of this conference. Participation in the event was taken by: Dr. Michael Grillo, the head of the Division of DHAP's National Programs, Sten Ito, the representative of the DHAPP Program and the Chief of the Central Sanitary and Epidemiological Department of the Ministry of Defense of Ukraine Lieutenant Colonel of the Medical Service Lytovka Serhii.

The head of the Central Sanitary and Epidemiological Department of the Ministry of Defense of Ukraine Lieutenant Colonel of the Medical Service Lytovka Serhii said that the conference was organized by the PERFAR program. This is a program of the President of the United States and is aimed at reducing the incidence of HIV / AIDS, tuberculosis and viral hepatitis worldwide.

During the conference, the participants discussed the promising directions of HIV / AIDS prevention among servicemen of the Armed Forces of Ukraine. Lytovka Serhii thanked the international partners for their cooperation and provided opportunities for additional training of specialists to fight with the HIV / AIDS epidemic. In particular, he noted:

"This program was actually suspended in 2013. In 2014, when armed aggression and mass mobilization began, the Central Sanitary and Epidemiological Department of the Ministry of Defense of Ukraine revealed a large number of soldiers who were infected with hepatitis. We appealed to our US partners with a proposal to reinstate the program and they agreed. Thanks to the collaboration, a general voluntary testing was carried out, measures were taken to inform the personnel on the prevention of AIDS and sexually transmitted infections. And the measures taken today give the results. "

It is important to note that the PEPFAR project is undergoing changes in implementation.

"It is not possible to test everyone for HIV / AIDS year by year. Today, our main task is finding for the most vulnerable audience, which will allow to localize the epidemic, suppress the level of viral load on a person and promote its healthy life without discrimination. such events as this conference contribute to direct communication. This allows us to clearly hear the problems of your audience and understand the needs for addressing the HIV / AIDS epidemic" - shared the goal of the project head of PEPFAR team Michael Grillo.

The PEPFAR project in Ukraine will be implemented by NGO "International Institute for HIV / AIDS and Tuberculosis", headed by Colonel US Army Medical Service (retired) Eliot J. Pearlman. The Institute effectively implements projects to counter the spread of HIV / AIDS, tuberculosis and other diseases in Ukraine since 2002.

"We have experience in Ukraine and implementation of projects on counteraction to the spread of diseases for HIV / AIDS and tuberculosis. Now we have a number of mandatory tasks that will enable us to overcome the HIV / AIDS epidemic in Ukraine and help stop the spread of the disease in the world ", said Eliot J. Pearlman in his speech.

Among such tasks are the following:

  • Increase awareness of the Ukrainians and personnel of the Armed Forces of Ukraine regarding illness, risk of infection and encouragement for testing in order to identify their own status (preventive testing, counseling, establishing bilateral communication between military and civilian AIDS services).
  • Establishment of cooperation with the Ministry of Defense for the identification of persons and groups vulnerable to illness, organization of educational campaigns aimed at promoting healthy lifestyles, awareness raising among risk groups regarding the importance of identifying an infection in the early stages of the disease (organization of trainings for medical personnel of the Armed Forces of Ukraine).
  • Establishing a Health Center - platform for sharing knowledge and conducting activities to promote disease prevention and control statistics. Equipping the center with the necessary gadgets for processing and analyzing information and statistics on HIV in Ukraine.

Також під час заходу виступили з доповідями представники медичної служби ЗС України та Служби превентивної медицини Міністерства оборони України, які поділились власними спостереженнями в рамках регіону відповідальності з метою формування єдиної політики з профілактики захворювання на ВІЛ/СНІД та подальшого подолання епідемії.

Also during the event, the representatives of the Medical Service of the Armed Forces of Ukraine delivered their reports, which shared their own observations within the region of responsibility in order to formulate a common policy on the prevention of HIV / AIDS and to further overcome the epidemic.

Tender!

NGO "International Institute for HIV / AIDS and Tuberculosis" announces a tender for choosing an organization to provide logistic services for the implementation of activities planned under the project "Assistance to Armed Forces of Ukraine: Continuing the glorious traditions of DHAPP".

Task: organization and assistance in holding an event for 15-17 people in Odessa from 10 to 12 July.

The service should include:

1) Transport services

2) Organization of accommodation of participants

3) Provision of food to participants:

4) Lease of halls: 1 conference room for 17 persons (2,5 days)

5) Rental equipment: 1 projector

6) Purchase of stationery and other equipment necessary for carrying out of the event: Notepads, folders, pens, badges

7) Printing: b / w and color

8) Solving current organizational issues on-site during the event.

Payment terms - 80% prepayment.

Deadline for submission of applications: until 18:00 on June 28, 2019. Proposals received after the deadline will not be considered. Orders (offers) send by post, courier, e-mail, or fax. Any questions regarding the tender should be sent only in writing form by e-mail.

Contacts of the International Institute of HIV / AIDS and Tuberculosis : 01015 Kiev, Ukraine, vul. Staronavodnitskaya, b.13-a, office 35, tel / fax: +38 044 374 28 52, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

NGO "International Institute for HIV / AIDS and Tuberculosis": 01015 Kiev, Ukraine, vul. Staronavodnitskaya, b.13-a, office 35, tel / fax: +38 044 374 28 52, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

International AIDS candlelight memorial

The World Health Organization was identified every third Sunday of May as the International AIDS candlelight memorial. In 2019 this day falls on May 19th.

International AIDS candlelight memorial was launched to disseminate as much information as possible to prevent the disease. As more attention can be drawn to this problem, as more people can be saved. In addition, this project was implemented in order to attract the attention of the authorities to the social protection of HIV-infected people.

For the first time it took place in 1983 in San Francisco (USA). At that time, only a few thousand cases of illness were registered in the world, and about HIV / AIDS was nothing to known. Then the people who personally touched this tragedy became the organizers of the action of the memory of those who died because of AIDS.

It is important to recall that AIDS is one of the most difficult problems of humanity. According to the WHO, in 2015, 36.7 million people were infected with HIV and 1.8 million of them - children. The vast majority of people living with HIV live in low and middle income countries. It is estimated that 2.1 million people in the world have become infected with HIV this year. At least 35 million people have died due to HIV-related causes.

Today, Ukraine remains the leader in Europe in terms of the spread of HIV infection. According to international experts, about 240,000 people live in Ukraine with HIV. And only every second knows about his diagnosis. According to statistics, every day in our country 8 people die of AIDS. Experts note that despite the serious international support the epidemic can not be stopped.

However, the main tool for prevention is knowledge abought disease, ways of infection and the factors contributing to it. 

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