Preliminary report on the provision of HIV care to war refugees living with HIV who are migrating from Ukraine - data from ECEE Network Group


BACKGROUND: The armed conflict in Ukraine resulted in humanitarian crisis with over five million people migrating to neighboring countries and ten million being displaced within Ukraine. The HIV epidemic in Ukraine is the largest in Europe with approximately 130 000 adult people on ART, half of them being women, and 2700 children. It is important to understand the impact of war on continuum of HIV care for displaced people and the impact on national HIV programs, especially in countries from Central and Eastern Europe (CEE).
METHODS: The ECEE Network Group consists of 47 experts in infectious diseases from 24 countries, actively involved in patients' care. The group was established in 2016 to endorse and disseminate the standards of care for HIV and hepatitis. In March 2022, an online survey (28 questions) was created on MonkeySurvey® and disseminated by group members.
RESULTS: 22 (75.9%) centers from 14 countries (Bulgaria,Croatia, Czech Republic, Estonia, Georgia,Greece, Hungary, Latvia,Lithuania,Malta,Poland, Republic of Moldova, Romania,Slovakia) were admitting war refugees from Ukraine as of 31 March 2022 and completed the survey. Most centers (86%) organized promptly providing access to ARVs on the same day, for 30 days or longer in 77% of the centers. Continuation of ART was manageable with brand or generic drugs in 64% centers, whereas 36% were switching ART (Table). 81.8% of respondents indicated that increased workload with could affect local HIV care.

CONCLUSIONS: CEE countries receiving war refugees implemented prompt measurements to provide continuity of HIV care including universal healthcare insurance, waiving most administrative requirements, providing same day doctor''s consultations and ART disposal. Barriers identified were lack of medical documentation, language barrier (shortage of translators) and psychological trauma. Our study identifies gaps which should informs international stakeholders on how to assist countries in delivering undisrupted HIV care to war refugees from Ukraine.