{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T02:46:57Z","timestamp":1783219617181,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Globally, stark inequities exist in access to HIV treatment and prevention. The eastern European and central Asian region is experiencing the sharpest rise in new HIV acquisition and deaths in the world, with low rates of treatment and prevention services, especially for key and vulnerable populations who face a range of human rights\u2010related barriers to HIV prevention and treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An implementation learning evaluation approach was used to examine the implementation of the Breaking Down Barriers initiative targeting key and vulnerable populations in Ukraine. Between September 2022 and April 2023, researchers conducted 23 key informant interviews with individuals from the Ukrainian government, implementing organizations and human rights experts. Using a concurrent triangulation design, researchers and key informants, in a process of co\u2010creation, sought to describe programme accomplishments, challenges and innovations in implementation, between 2021 and 2023, including periods before and after Russia's February 2022 full\u2010scale invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight rights\u2010based interventions related to HIV were identified in Global Fund programme documents and key informant interviews as making up the core of the Breaking Down Barriers initiative in Ukraine. These included programmes seeking to: eliminate stigma and discrimination; ensure the non\u2010discriminatory provision of medical care; promote rights\u2010based law enforcement practices; expand legal literacy (\u201cknow your rights\u201d); increase access to justice; improve laws, regulations and policies; reduce gender discrimination, harmful gender norms and violence against women and girls; and mobilize communities for advocacy. These programmes received US$5.9 million in funding. Key informants reported that significant progress had been made addressing human rights barriers and scaling up interventions, both before and after Russia's invasion. Programme implementors adopted innovative approaches, including using paralegals, hotlines and other community\u2010led interventions, to ensure that key and vulnerable populations, including displaced individuals, were able to access prevention and care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An implementation learning evaluation approach examining programmes addressing human rights barriers to HIV services, designed as a process of co\u2010creation between researchers, programme implementors, government officials and human rights experts, can provide a robust assessment of programme outputs, outcomes and evidence of impact, despite a challenging operational environment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26328","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T08:15:53Z","timestamp":1721376953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An implementation evaluation of the Breaking Down human rights barriers to HIV services initiative in Ukraine"],"prefix":"10.1002","volume":"27","author":[{"given":"Diederik","family":"Lohman","sequence":"first","affiliation":[{"name":"Consultant  Maplewood New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yevheniia","family":"Kononchuk","sequence":"additional","affiliation":[{"name":"Consultant  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandrina","family":"Iovita","sequence":"additional","affiliation":[{"name":"Community, Rights, Gender Department Global Fund  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhail","family":"Golichenko","sequence":"additional","affiliation":[{"name":"HIV Legal Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Rachinska","sequence":"additional","affiliation":[{"name":"100% Life  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavlo","family":"Skala","sequence":"additional","affiliation":[{"name":"Alliance for Public Health  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Gvozdetska","sequence":"additional","affiliation":[{"name":"Public Health Center  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serhii","family":"Myroniuk","sequence":"additional","affiliation":[{"name":"Public Health Center  Kyiv Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2455-6703","authenticated-orcid":false,"given":"Joseph J.","family":"Amon","sequence":"additional","affiliation":[{"name":"Office of Global Health, Drexel University Dornsife School of Public Health  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Joint United Nations Programme on HIV\/AIDS.UNAIDS data 2023. Geneva Switzerland;2023."},{"key":"e_1_2_11_3_1","unstructured":"UNAIDS. Global AIDS Monitoring 2019: Ukraine.Geneva Switzerland;2019."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2024.104319"},{"key":"e_1_2_11_5_1","unstructured":"UNAIDS. Key populations atlas [Internet]. [cited 2024 Apr 27].https:\/\/kpatlas.unaids.org\/dashboard"},{"key":"e_1_2_11_6_1","unstructured":"United Nations High Commissioner for Refugees. Ukraine refugee situation [Internet]. [cited 2024 Apr 27].https:\/\/data.unhcr.org\/en\/situations\/ukraine"},{"key":"e_1_2_11_7_1","unstructured":"International Organization for Migration.Ukraine internal displacement report: general population survey round 8.Geneva:International Organization for Migration;2022."},{"key":"e_1_2_11_8_1","unstructured":"WHO World Bank European Union Delegation to Ukraine US Agency for International Development's Mission in Ukraine.Priorities for the health system recovery in Ukraine: joint discussion paper.Geneva:World Health Organization;2022."},{"key":"e_1_2_11_9_1","unstructured":"Coercion and control: Ukraine's health care system under Russian occupation\u2014PHR [Internet]. [cited 2024 Apr 27].https:\/\/phr.org\/our\u2010work\/resources\/coercion\u2010and\u2010control\u2010ukraines\u2010health\u2010care\u2010system\u2010under\u2010russian\u2010occupation\/"},{"key":"e_1_2_11_10_1","unstructured":"WHO European Region.WHO Country Office in Ukraine 2022 Report.Ukraine;2023."},{"key":"e_1_2_11_11_1","unstructured":"WHO surveillance system for attacks on health care | Index [Internet]. [cited 2024 Apr 27].https:\/\/extranet.who.int\/ssa\/Index.aspx"},{"key":"e_1_2_11_12_1","unstructured":"UNAIDS.SITREP: UNAIDS\u2019 response to the crisis in Ukraine.Geneva Switzerland;2022."},{"key":"e_1_2_11_13_1","unstructured":"Council on Foreign Relations.War threatens Ukraine's progress curbing HIV\/AIDS [Internet]. [cited 2024 Apr 27]. Think Global Health.https:\/\/www.thinkglobalhealth.org\/article\/war\u2010threatens\u2010ukraines\u2010progress\u2010curbing\u2010hivaids"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-023-00855-1"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(22)00125-4"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00214-6"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2215424120"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-023-00578-0"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100490"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100582"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104062"},{"key":"e_1_2_11_22_1","unstructured":"ILGA Europe RFSL Gender Stream TGEU.Briefing Note: securing access to border crossings for vulnerable LGBTI people in the context of the war in Ukraine. 2022."},{"key":"e_1_2_11_23_1","unstructured":"Global Fund.Breaking Down Barriers: A Global Fund initiative to advance the right to health: frequently asked questions. (cited 2024 Jun 7) Available athttps:\/\/www.theglobalfund.org\/media\/1213\/crg_breakingdownbarriers_qa_en.pdf"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0219-z"},{"key":"e_1_2_11_25_1","unstructured":"Global Fund.Ukraine Progress Assessment Global Fund Breaking Down Barriers Initiative. 2023."},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-018-0136-9"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/02255189.2020.1838887"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cptl.2018.03.019"},{"key":"e_1_2_11_29_1","volume-title":"Determination of applicability of human research regulations guidance: policy","author":"US Centers for Disease Control and Prevention","year":"2010"},{"key":"e_1_2_11_30_1","unstructured":"National Institutes of Health Office of Intramural Research. Program evaluation vs. research: do I need to submit for an exemption or IRB approval?2023."},{"key":"e_1_2_11_31_1","unstructured":"Legalife\u2010Ukraine.Plans of legislative changes to fight stigma and criminalization of vulnerable groups in Ukraine [Internet]. [cited 2024 Apr 27].https:\/\/legalifeukraine.com\/en\/articles\/plans\u2010of\u2010legislative\u2010changes\u2010to\u2010fight\u2010stigma\u2010and\u2010criminalization\u2010of\u2010vulnerable\u2010groups\u2010in\u2010ukraine\/"},{"key":"e_1_2_11_32_1","unstructured":"100% Life.Progress Update and Disbursement Request Form. 2023."},{"key":"e_1_2_11_33_1","unstructured":"Pepfar USAID 100% Life GNP+ ICWWA UNAIDS.The People Living with HIV Stigma Index 2.0. Ukraine; 2020."},{"key":"e_1_2_11_34_1","unstructured":"100% LIFE. Sub\u2010Recipient Report Period: 2020\u20132022. UNAIDS. Global AIDS Monitoring 2022. Ukraine; 2022."},{"key":"e_1_2_11_35_1","unstructured":"CairnsG.HIV services in Ukraine resilient but starting to feel the strain. AIDSMAP. (cited 2024 Jun 7) Available from:https:\/\/www.aidsmap.com\/news\/oct\u20102023\/hiv\u2010services\u2010ukraine\u2010resilient\u2010starting\u2010feel\u2010strain"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T13:18:06Z","timestamp":1722518286000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":34,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/jia2.26328"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26328","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26328"}}