Site and Background:
The training site will include the Ukrainian Institute on Public Health Policy (UIPHP), which has ongoing relationships with the country’s two largest NGOs that provide HIV, HCV, and TB prevention and treatment in Ukraine – ICP Alliance for Public Health - Ukraine and the All Ukrainian Network of People Living with HIV - the Ministry of Health, Ministry of Prisons, WHO, USAID and CDC. Drs. Altice and Dvoryak have collaborated together since 2005 in these sites, which have served as training sites for numerous pre-and post-doctoral fellows.
In 2005 alone, Drs. Altice and Dvoryak were among the first to train 32 Ukrainian physicians and administrators on the treatment of HIV and opioid dependence when they first introduced buprenorphine into the country as primary and secondary HIV prevention. Since 2011 we have trained numerous Global Health Equity Scholars funded by Fogarty International to conduct research on issues related to urban health, HIV, HCV, tuberculosis, health services, implementation science research and addiction medicine. Many of these trainees have moved to important positions in the Ministry of Health, Clinton Foundation and professional societies within Ukraine. Drs. Altice and Dvoryak collaborate on three active R01 grants from the National Institutes on Drug Abuse.
The first NIH NIDA grant is to conduct implementation research to expand methadone and buprenorphine treatment entry and retention for HIV prevention in Ukraine and to use health services research methods to introduce the integration of extended-release naltrexone into HIV clinical care settings. This study involves decision science, conjoint based analysis and other survey methods, to create a shared decision-making aid. Further research includes implementation science and facilitation to increase HIV prevention entry and retention.
The second NIDA grant is to conduct research with people in the criminal justice system in prison or on probation to expand MAT in the community. This grant collaborates with multiple NGOs in former Soviet Union countries (Moldova, Kyrgyzstan, Armenia and others) to conduct intervention research. In Kyrgyzstan, there is considerable qualitative research underway assessing the within prison risk environment.
The third NIDA R01 uses evidence-based practices to examine the effects of integrating addiction treatment into primary care clinics on health care quality of life and stigma. All of this work has mathematical modeling approaches to support the findings.
In addition, Drs. Altice and Dvoryak have been funded by numerous other international agencies, including USAID, CDC, UNAIDS, Open Society Institute and the Global Fund to conduct research on healthcare delivery systems for people who use drugs, including the development of the first integrated healthcare systems.