Publications by authors named "T M Fomenko"

Article Synopsis
  • Ukraine experiences a significant HIV epidemic predominantly among people who inject drugs, especially opioids, but has notably increased the use of opioid agonist therapies (OAT) between 2014 and 2021.
  • A biobehavioral survey conducted on opioid-dependent people who inject drugs (PWID) in 2020-2021 revealed improvements in HIV diagnosis, care, and treatment compared to a prior survey from 2014-2015.
  • The study highlights that any interaction with the OAT system—regardless of ongoing treatment—enhances HIV care engagement and treatment outcomes, demonstrating the positive impact of this approach on the overall HIV care cascade.
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Purpose: This paper seeks to explore and understand what constitutes successful opioid agonist therapy (OAT) programs from the views of Ukrainian OAT providers in their context-specific accounts. Prior to the ongoing war the Ukrainian addiction treatment system made great strides to expand its OAT program and increase the number of patients. Since the beginning of the war there has been much alarm that those hard-earned successes will be destroyed.

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Background: The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown.

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Russia's invasion of Ukraine on February 24, 2022, followed by Ukraine's Martial law, has disrupted the routine delivery of healthcare services, including opioid agonist treatment (OAT) programs. Directors (chief addiction treatment physicians) of these programs in each region had flexibility with implementing a series of adaptations to their practice to respond to war disruptions like mass internal displacement and legislation updates allowing more flexibility with OAT distribution policies and take-home dosing regulations. We conducted 8 in-depth interviews with directors from seven regions of Ukraine to describe their experiences providing OAT during a specific time during the war and the local crisis-response approach under the emergency policy updates.

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