Аутрич медсестры в проектах снижения вреда: повышение уровня доступности медицинской помощи для потребителей наркотиков

Двинских Наталья Александровна; Шульга Людмила Александровна; Ботвин Сергей Павлович

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Журнал

Контроль над табаком и общественное здоровье в Восточной Европе

2012

Область наук

Фундаментальная медицина

Ключевые слова

ПОТРЕБИТЕЛИ ИНЪЕКЦИОННЫХ НАРКОТИКОВ / МЕДИЦИНСКАЯ ПОМОЩЬ / АУТРИЧ МЕДСЕСТРЫ / INJECTION DRUG USERS / MEDICAL CARE / OUTREACH NURSES

Аннотация научной статьи по фундаментальной медицине, автор научной работы — Двинских Наталья Александровна, Шульга Людмила Александровна, Ботвин Сергей Павлович

BACKGROUND: Injection drug users (IDU) remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of 'outreach nurses' was piloted by All Ukrainian Harm Reduction Association (UHRA) with support from ICF International HIV/AIDS Alliance in Ukraine. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average). For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93) during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of 'outreach nurses' to the package of services they provide.

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Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users1ICF International HIV/AIDS Alliance in Ukraine

BACKGROUND: Injection drug users (IDU) remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of 'outreach nurses' was piloted by All Ukrainian Harm Reduction Association (UHRA) with support from ICF International HIV/AIDS Alliance in Ukraine. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average). For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93) during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of 'outreach nurses' to the package of services they provide.

Текст научной работы на тему «Аутрич медсестры в проектах снижения вреда: повышение уровня доступности медицинской помощи для потребителей наркотиков»

Dvinskykh N, Shulga L, Botvin S (2012) Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users Tobacco Control and Public Health in Eastern Europe 2 (Supplement 1, 2nd conference 'Economics, sociology, theory and practice of public health'):s61. doi:10.6084/m9.figshare.92825

Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users

Dvinskykh, Natalya; Shulga, Liudmyla; Botvin, Sergiy

BACKGROUND: Injection drug users (IDU) remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers.

Harm reduction projects in Ukraine partially address this problem by providing regular testing for HIV and sexually transmitted infections for their clients, and by referring them to medical institutions, where IDU can get free treatment for sexually transmitted infections, tuberculosis, and antiretroviral therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved.

METHODS: During 2011, the new approach of 'outreach nurses' was piloted by All Ukrainian Harm Reduction Association (UHRA) with support from ICF "International HIV/AIDS Alliance in Ukraine". The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home.

RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average). For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93) during the same period of time.

CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of 'outreach nurses' to the package of services they provide.

KEY WORDS: injection drug users, medical care, outreach nurses

ABOUT THE AUTHORS: Dvinskykh Natalya, ICF "International HIV/AIDS Alliance in Ukraine", Dvin-skykh@aidsalliance.org.ua

Shulga Liudmyla, ICF "International HIV/AIDS Alliance in Ukraine", Shulga@aidsalliance.org.ua

Botvin Sergiy, AUCO «All-Ukrainian Association of Public Health», botvin_s@i.ua

This paper was received 03.04.2012, accepted 15.04.2012, published 10.07.2012.

Аутрич медсестры в проектах Снижения Вреда: повышение уровня доступности медицинской помощи для потребителей наркотиков

Двинских Наталья Александровна, Шульга Людмила Александровна, Ботвин Сергей Павлович

УДК 616-083:613.83 Шульга Людмила Александровна, Национальный

Университет «Киево-Могилянская Академия»,

КЛЮЧЕВЫЕ СЛОВА: п°требители инъекционных МБФ «Международный Альянс по ВИЧ/СПИД в

наркотиков, медицинская помощь, аутрич мед- Украине», Shulga@aidsalliance.org.ua

сестры

Ботвин Сергей Павлович, ВБО «Всеукраинская ОБ ,АВТОРАХ: ДвинскихдНаталья Алекс;ангдровна, ассоциация общественного здоровья»,

1\л С >/ IV Л лмг л\и п I I I ■ ■ л А п I т 1^ п/% О 1/111/I I |Л П п

МБФ «Международный Альянс по ВИЧ/СПИД в Украине», Dvinskykh@aidsalliance.org.ua

botvin_s@i.ua

Аутріч медсестри в проектах Зменшення Шкоди: підвищення рівня доступності медичної допомоги для споживачів наркотиків

Двінських Наталя Олександрівна, Шульга Людмила Олександрівна, Ботвін Сергій Павлович

КЛЮЧОВІ СЛОВА: споживачі ін'єкційних нарко- Шульга Людмила Олександрівна, Національний

тиків, медична допомога, аутріч медсестри Університет «Києво-Могилянська Академія»,

„ МБФ «Міжнародний Альянс з ВІЛ/СНІД в

про АВТ0РІВ: Двінських Наталя Олександрівна, Україні», Shulga@aidsalliance.org.ua

менеджер з надання технічної допомоги, МБФ

«Міжнародний Альянс з ВІЛ/СНІД в Україні», Ботвін Сергій Павлович, ВБО «Всеукраїнська

Dvinskykh@aidsalliance.org.ua асоціація громадського здоров'я», botvin_s@i.ua

2012, Vol.2, Supplement 11 Tobacco control and public health in Eastern Europe

2nd conference ‘Economics, sociology, theory and practice of public health’ conference proceedings | s61

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