Publications by authors named "E N Machavariani"

Introduction: People who inject drugs experience poor health and social outcomes which improve with opioid agonist therapies like methadone, yet provider stigma may influence healthcare utilization. In Ukraine, integrating methadone into primary care centers (PCCs) provides an opportunity to examine provider stigma and its impact on patient outcomes.

Methods: This sub-analysis included patients randomized to receive methadone in PCCs as part of an implementation trial in which the control group received methadone in specialty addiction clinics in Ukraine.

View Article and Find Full Text PDF

Purpose Of Review: This review evaluates recent literature to understand the ways in which war disrupts HIV prevention and creates conditions for HIV outbreaks, with a focus on Ukraine. We also examine potential responses that can be deployed to sustain HIV prevention services amid ongoing conflict.

Recent Findings: Recent studies and frameworks suggest that disruptions caused during war are comparable to other emergencies, like natural disasters.

View Article and Find Full Text PDF

Introduction: Ukraine has high HIV prevalence, concentrated among people who inject drugs (PWID), mostly of opioids. Maintenance on opioid agonist therapies (OAT) is the most effective evidence-based treatment for opioid use disorder. As PWID experience high morbidity and mortality from preventable and treatable non-communicable diseases, international agencies recommend integrating OAT into primary care centers (PCC).

View Article and Find Full Text PDF

Background: Opioid use disorder (OUD) significantly impacts individual and public health and exacerbated further by concurrent infectious diseases. A syndemic approach is needed to address the intertwined OUD, HIV, and HCV epidemics, including the expanded use of medications for opioid use disorder (MOUD).

Methods: To identify MOUD scale-up opportunities, we conducted a retrospective cohort study, representing commercially insured persons, and created the OUD care continuum, including HIV and HCV influences in adults (18-64 years) newly diagnosed with OUD in 2019 using Merative MarketSan data.

View Article and Find Full Text PDF
Article Synopsis
  • HIV stigma negatively impacts health outcomes like adherence to antiretroviral therapy (ART) and engagement in HIV care, especially among men who have sex with men (MSM) and transgender women (TGW) in Peru.
  • A study involving 400 MSM and TGW at specialized HIV clinics assessed various factors influencing ART adherence and care engagement.
  • Results showed that while some health factors were associated with good outcomes, stigma did not significantly affect ART adherence or care engagement when LGBTQ-affirming care was provided.
View Article and Find Full Text PDF