USAID launches Prison-Based, Medication-Assisted Therapy to Combat HIV among Opioid-Dependent Prisoners

Speeches Shim

Tuesday, November 16, 2021
An opioid-dependent prisoner takes his daily dose of liquid methadone as part of medication-assisted therapy at Bucha Prison Colony #85.
Photo: Mykola Dziuba, Coalition of HIV-Service NGOs.

Vadym, 35, grew up in a small town with his mother. As a young person, he was often alone. Vadym found support from friends who suggested that he try drugs, which led Vadym to begin injecting them into himself. Before he realized it, he was opioid-dependent. This dependency ultimately led him to illegal drug dealing that ended with three incarcerations.

Vadym continued injecting drugs during his imprisonment at the Bucha Prison Colony #85 in Kyiv oblast. While he was there, he met with a social worker from the Charitable Organization, 100 Percent Life. Vadym talked to the social worker about his opioid dependency problem. The social worker assured Vadym of confidentiality and offered him several options: visiting self-help groups at the prison; peer counseling sessions; counseling from project’s psychologist; or enrolling in the first medication-assisted therapy (MAT) program for opioid-dependent prisoners that was to be launched at the prison. The social worker also recommended an HIV test, for which Vadym tested positive. Following his diagnosis, Vadym received psychosocial support and was linked to HIV treatment.  

With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), USAID, through its Serving Life project, collaborated with Ukraine’s Ministry of Justice (MOJ) to launch the country’s first MAT program in prisons for people who inject drugs. In December 2019, Bucha prison became the first MAT site and Vadym became the first client. As part of the pilot, Vadym received methadone under the supervision of a health professional to reduce his dependence on opioids. He also received support from social workers who promote good health-seeking behavior, and provide psychological and social support. 

Oleksandr Kaminskyi, a social worker from Serving Life partner 100 Percent Life, provided psychosocial support and MAT adherence counseling. “The MAT pilot is an excellent project that enables our clients to embark on the path of correction. Before the MAT project, they felt doomed to the role of eternal criminal and prisoner, but this project gives them a chance to increase their self-esteem, remember their hobbies, and think about getting a job,” said Oleksandr. 

Vadym was released from prison in June 2020. Because of COVID-19 restrictions, it was difficult for him to travel to the city of Pryluky, where he lived. With his consent, Serving Life social workers met him at the prison and transported to Pryluky, linking him to the MAT site. Vadym continues opioid dependency treatment and visits the MAT site in Pryluky. “I am very grateful to everyone who helped launch the MAT program in Bucha Prison. [It is a] wonderful project which saves lives. After my release, social workers did not leave me, but helped me in my hometown. Thanks to them, I did not return to using street drugs, found a job, and became a productive member of society,” said Vadym.

The MAT pilot began as part of USAID’s Serving Life project, due to successful advocacy activities in 2018 and 2019. As a result, MAT was included in Ukraine’s MOJ-approved comprehensive care package for detainees and prisoners. By November 2020, 35 prisoners were enrolled in MAT and were provided with methadone procured by the NGO Alliance for Public Health using funds from the Global Fund to Fight AIDS, Tuberculosis, and Malaria. With the support from USAID and the Global Fund, the MOJ will scale up MAT in 2021 to four more prison colonies in the PEPFAR-supported regions of Kherson, Zaporizhzhia, and Poltava oblast that will include access for both male and female prisoners.

Last updated: December 03, 2021

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