2024
High rates of deferring antiretroviral treatment for patients with HIV and substance use disorders: Results from a national sample of HIV physicians in Ukraine
Ottesen T, Wickersham J, Lawrence J, Antoniak S, Zezuilin O, Polonsky M, Antonyak S, Rozanova J, Dvoriak S, Pykalo I, Filippovych M, Altice F. High rates of deferring antiretroviral treatment for patients with HIV and substance use disorders: Results from a national sample of HIV physicians in Ukraine. PLOS ONE 2024, 19: e0305086. PMID: 39028735, PMCID: PMC11259278, DOI: 10.1371/journal.pone.0305086.Peer-Reviewed Original ResearchConceptsAntiretroviral therapy prescriptionAntiretroviral therapyCD4 countSubstance use disordersIncreased levels of stigmaNational sampleLevel of stigmaIndependent of risk groupSuboptimal antiretroviral therapyInitiate antiretroviral therapyPopulation of peopleHIV expertsHIV incidenceHIV physiciansHIV treatmentKey populationsTransgender womenAntiretroviral treatmentFeeling thermometerDrinking alcoholSex workersPhysiciansSex partnersPWHRisk groupsIntegrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster randomized controlled trialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized controlled trialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudes
2023
Qualitative exploration of the early experiences of opioid use disorder patients from private clinics after Russia’s invasion of Ukraine in five major cities in Ukraine
Mazhnaya A, Meteliuk A, Pykalo I, Altice F. Qualitative exploration of the early experiences of opioid use disorder patients from private clinics after Russia’s invasion of Ukraine in five major cities in Ukraine. Frontiers In Public Health 2023, 11: 1238188. PMID: 38162610, PMCID: PMC10756895, DOI: 10.3389/fpubh.2023.1238188.Peer-Reviewed Original ResearchConceptsPrivate clinicsOpioid use disorder patientsInvasion of UkraineOpioid use disorderDosage reductionTreatment optionsFull-scale invasion of UkraineHealth system navigationQualitative explorationExperiences of patientsQualitative semi-structured interviewsMOUD treatmentUse disorderPatientsRussia's invasion of UkraineFull-scale invasionDisorder patientsClinicState-funded clinicsSemi-structured interviewsMOUDMOUD deliveryMedication availabilityState-funded facilitiesPatient experienceHigh perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine
Galvez S, Altice F, Meteliuk A, Ivasiy R, Machavariani E, Farnum S, Fomenko T, Islam Z, Madden L. High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine. Frontiers In Public Health 2023, 11: 1231581. PMID: 38098837, PMCID: PMC10720365, DOI: 10.3389/fpubh.2023.1231581.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOpioid use disorderAgonist therapyOAT patientsCOVID-19 pandemicSubstance useTake-home dosingAdditional psychosocial supportHigher perceived stressHigh riskPerceived Stress ScalePsychiatric disordersUse disordersPatientsPatient stressPsychosocial supportCertain subgroupsSevere levelsHigh levelsHealthcare deliveryStress ScalePerceived stressTherapyExtraordinary high levelsDisordersEarly disruptions to syringe services programs during the Russian invasion of Ukraine
Nikitin B, Bromberg D, Pykalo I, Ivasiy R, Islam Z, Altice F. Early disruptions to syringe services programs during the Russian invasion of Ukraine. Frontiers In Public Health 2023, 11: 1229057. PMID: 38074770, PMCID: PMC10702598, DOI: 10.3389/fpubh.2023.1229057.Peer-Reviewed Original ResearchConceptsSyringe service programsHIV prevention servicesHarm reduction servicesService programsWidespread HIV epidemicsSemi-structured interviewsIllicit drug usePreventive servicesHIV/AIDS preventionOutreach workersHIV epidemicReduction servicesClients transitionClient’s opennessHIV outbreakService provisionUnique clientsDrug useInterviewsPWIDHarmServicesNGO supportClientsInjection paraphernaliaDesign, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine
Machavariani E, Bromberg D, Dumchev K, Dvoriak S, Zeziulin O, Morozova O, Esserman D, Pykalo I, Saichuk N, Ivasiy R, Haddad M, Altice F. Design, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine. Contemporary Clinical Trials 2023, 131: 107248. PMID: 37263492, PMCID: PMC10527419, DOI: 10.1016/j.cct.2023.107248.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyMajor depressive disorderCo-occurring disordersAgonist therapyDepressive disorderSpecialty clinicPsychiatric disordersPatient-level outcomesPrevalent psychiatric disordersCluster-randomized trialPoor health outcomesProvider-level dataMDD treatmentTreatment algorithmExperimental armHigh prevalenceDelivery outcomesHealth outcomesSerial surveysClinicPatientsProject ECHOSubstance useMonthsDisordersModelling the impact and cost‐effectiveness of non‐governmental organizations on HIV and HCV transmission among people who inject drugs in Ukraine
Stone J, Trickey A, Walker J, Bivegete S, Semchuk N, Sazonova Y, Varetska O, Altice F, Saliuk T, Vickerman P. Modelling the impact and cost‐effectiveness of non‐governmental organizations on HIV and HCV transmission among people who inject drugs in Ukraine. Journal Of The International AIDS Society 2023, 26: e26073. PMID: 37012669, PMCID: PMC10070931, DOI: 10.1002/jia2.26073.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyHepatitis C virusHCV incidenceHCV infectionHIV/HCV testingHIV/HCV infectionHCV transmission modelNeedles/syringesHCV testingHCV eliminationHCV transmissionAgonist treatmentC virusNew HIVHigh prevalencePWIDHIVCondom useSubstantial detrimental impactInfectionIncidencePreventative impactDrugsCoverage levelsDALYsResponding to health policy recommendations on managing opioid use disorder during Russia's invasion of Ukraine: Divergent responses from the frontline to the west
Ivasiy R, de Leon S, Meteliuk A, Fomenko T, Pykalo I, Bromberg D, Madden L, Farnum S, Islam Z, Altice F. Responding to health policy recommendations on managing opioid use disorder during Russia's invasion of Ukraine: Divergent responses from the frontline to the west. Frontiers In Public Health 2023, 10: 1044677. PMID: 36711398, PMCID: PMC9880308, DOI: 10.3389/fpubh.2022.1044677.Peer-Reviewed Original ResearchConceptsRussia’s invasionMartial lawRegions of UkrainePolicy recommendationsDepth interviewsHealth policy recommendationsEmergency policiesInternal displacementPolicyDistribution policyUkraineHealthcare servicesOpioid agonist treatment programExperienceWarSeries of adaptationsConflictInterviewsLegislationFrontlineCountriesDivergent responsesProvisionDirectorsPractice
2022
Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war
Altice FL, Bromberg DJ, Klepikov A, Barzilay EJ, Islam Z, Dvoriak S, Farnum SO, Madden LM. Collaborative learning and response to opioid misuse and HIV prevention in Ukraine during war. The Lancet Psychiatry 2022, 9: 852-854. PMID: 36244353, PMCID: PMC9806953, DOI: 10.1016/s2215-0366(22)00318-2.Peer-Reviewed Original ResearchExtending a lifeline to people with HIV and opioid use disorder during the war in Ukraine
Altice FL, Bromberg DJ, Dvoriak S, Meteliuk A, Pykalo I, Islam Z, Azbel L, Madden LM. Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine. The Lancet Public Health 2022, 7: e482-e484. PMID: 35358424, PMCID: PMC9818031, DOI: 10.1016/s2468-2667(22)00083-4.Peer-Reviewed Original Research
2021
An expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care
Rozanova J, Zeziulin O, Rich KM, Altice FL, Kiriazova T, Zaviryukha I, Sosidko T, Gulati K, Carroll C, Shenoi SV. An expanding HIV epidemic among older adults in Ukraine: Implications for patient-centered care. PLOS ONE 2021, 16: e0256627. PMID: 34591848, PMCID: PMC8483339, DOI: 10.1371/journal.pone.0256627.Peer-Reviewed Original ResearchConceptsStandardized mortality ratioMortality rateCause standardized mortality ratioTime of diagnosisGeneral population ratesLate-stage HIVAge-matched groupHigh mortality ratePatient-centered careIncident HIVHIV diagnosisHIV testingHIV incidenceHIV treatmentHIV epidemicMortality ratioTreatment strategiesGeneral populationHIVMortality trendsAge groupsEECA countriesTreatment programSame calendar yearOlder peopleSuccessful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study
Meteliuk A, Galvez S, Fomenko T, Kalandiia H, Iaryi V, Farnum SO, Islam Z, Altice FL, Madden LM. Successful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study. Journal Of Substance Use And Addiction Treatment 2021, 134: 108619. PMID: 34579978, DOI: 10.1016/j.jsat.2021.108619.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyPrimary care clinicsPrimary care settingOAT coverageAgonist therapyStable patientsCare clinicsSubstance useCare settingsNegative urine drug testsSpecialty addictions treatmentUrine drug testsSymptom Identification ScaleMental health symptomsAddiction treatment clinicsHIV transmissionPrimary careTreatment clinicsOAT patientsBASIS-24PatientsHealth symptomsEmotional labilityAddiction treatmentPilot studyModelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis
Stone J, Degenhardt L, Grebely J, Larney S, Altice FL, Smyrnov P, Rahimi-Movaghar A, Alavi M, Young AM, Havens JR, Miller WC, Hickman M, Vickerman P. Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis. The Lancet Psychiatry 2021, 8: 301-309. PMID: 33640039, PMCID: PMC8255389, DOI: 10.1016/s2215-0366(20)30538-1.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentDrug-related deathsOAT coverageDrug-related harmAgonist treatmentHepatitis C virus transmissionC virus transmissionOverall health benefitsUK National InstituteNational InstituteHIV 0OAT retentionHIV mortalityInjury 3Opioid dependenceMortality outcomesUS National InstitutesHCV-2Overdose deathsSignificant additional effectIntervention effectsDrug abuseHealth benefitsMortalityDeath
2020
Development and Psychometric Evaluation of the PrEP Sexual Expectancies (PSEXS) Scale
Dubov A, Ogunbajo A, Altice FL, Fraenkel L, Distelberg B. Development and Psychometric Evaluation of the PrEP Sexual Expectancies (PSEXS) Scale. AIDS And Behavior 2020, 25: 1192-1198. PMID: 33185775, PMCID: PMC7979444, DOI: 10.1007/s10461-020-03087-7.Peer-Reviewed Original ResearchRapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine
Meteliuk A, Galvez de Leon SJ, Madden LM, Pykalo I, Fomenko T, Filippovych M, Farnum SO, Dvoryak S, Islam ZM, Altice FL. Rapid transitional response to the COVID-19 pandemic by opioid agonist treatment programs in Ukraine. Journal Of Substance Use And Addiction Treatment 2020, 121: 108164. PMID: 33191004, PMCID: PMC7769928, DOI: 10.1016/j.jsat.2020.108164.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyTake-home dosingInterim guidanceShort-term overall mortalityOpioid agonist treatment programPerson clinical encountersOAT deliveryAgonist therapyOverall mortalityCOVID-19 transmissionPatient dropoutOAT patientsNaloxone distributionOverdose educationClinical practiceClinic interactionsTreatment programClinical encountersPatientsCliniciansCOVID-19COVID-19 pandemicOverdosesDosingPrevious yearThe real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine
Farnum SO, Makarenko I, Madden L, Mazhnaya A, Marcus R, Prokhorova T, Bojko MJ, Rozanova J, Dvoriak S, Islam Z, Altice FL. The real‐world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine. Addiction 2020, 116: 83-93. PMID: 32428276, PMCID: PMC7674222, DOI: 10.1111/add.15115.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyOAT discontinuationAgonist therapyTreatment retentionIndependent predictorsHIV epidemicCost-effective HIV prevention strategyMethadone maintenance treatment patientsObservational longitudinal cohort studySpecialty addictions treatmentBuprenorphine maintenance treatmentHigh dosageHIV prevention strategiesLongitudinal cohort studyOpioid-dependent peopleTreatment discontinuationCohort studyMaintenance treatmentMale sexTreatment patientsPrevention strategiesDiscontinuationYounger ageCenter settingAddiction treatment
2019
Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study
Tan J, Altice FL, Madden LM, Zelenev A. Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: a modelling study. The Lancet HIV 2019, 7: e121-e128. PMID: 31879250, PMCID: PMC7289179, DOI: 10.1016/s2352-3018(19)30373-x.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyNew HIV infectionsHigh HIV burdenHIV infectionMinistry of HealthOAT coverageAgonist therapyHIV burdenHIV incidenceBuprenorphine maintenance therapyPublic Health CenterMaintenance therapyHIV outcomesHIV prevalenceHIV transmissionMedication procurementHIV epidemicHealth centersHIV preventionTreatment goalsPWIDOAT expansionDisease controlSexual riskInfectionCost‐effectiveness of expanding the capacity of opioid agonist treatment in Ukraine: dynamic modeling analysis
Morozova O, Crawford FW, Cohen T, Paltiel AD, Altice FL. Cost‐effectiveness of expanding the capacity of opioid agonist treatment in Ukraine: dynamic modeling analysis. Addiction 2019, 115: 437-450. PMID: 31478285, PMCID: PMC7015766, DOI: 10.1111/add.14797.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentOpioid use disorderOAT coverageAgonist treatmentGross domestic productOpioid use initiationOpioid addiction epidemicOAT accessHIV epidemicUse disordersAddiction epidemicCapita gross domestic productPay thresholdsTreatment demandUse initiationAddiction treatmentIncremental costBaseline capacityTreatmentPotential peer effectsDomestic productTreatment spilloversEpidemicPeer effectsCoverage levelsDual motivational model of pre-exposure prophylaxis use intention: model testing among men who have sex men in Ukraine
Ranjit YS, Dubov A, Polonsky M, Fraenkel L, Rich KM, Ogunbajo A, Altice FL. Dual motivational model of pre-exposure prophylaxis use intention: model testing among men who have sex men in Ukraine. AIDS Care 2019, 32: 261-266. PMID: 31288547, PMCID: PMC6937373, DOI: 10.1080/09540121.2019.1640845.Peer-Reviewed Original ResearchTreating opioid dependence with extended-release naltrexone (XR-NTX) in Ukraine: Feasibility and three-month outcomes
Makarenko I, Pykalo I, Springer SA, Mazhnaya A, Marcus R, Filippovich S, Dvoriak S, Altice FL. Treating opioid dependence with extended-release naltrexone (XR-NTX) in Ukraine: Feasibility and three-month outcomes. Journal Of Substance Use And Addiction Treatment 2019, 104: 34-41. PMID: 31370983, PMCID: PMC8215516, DOI: 10.1016/j.jsat.2019.05.008.Peer-Reviewed Original ResearchConceptsOpioid use disorderOpioid agonist treatmentXR-NTX injectionXR-NTX treatmentXR-NTXUrine drug testingOpioid useExtended-release naltrexoneMonths of treatmentThree-month outcomeHealth-related qualityAdverse side effectsSymptoms of depressionOpioid dependenceAgonist treatmentLife scoresTreatment optionsIndependent factorsSide effectsUse disordersPeriod of observationDrug useStimulant useTreatment motivationDrug testing