{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:51:54Z","timestamp":1791960714365,"version":"4.3.4"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The widespread HIV epidemic in Ukraine is concentrated among people who inject drugs (PWID), making access to sterile injection paraphernalia (SIP) like sterile needles and syringes a critical method of HIV\/AIDS prevention; however, the Russian invasion has threatened to disrupt the operations of syringe services programs (SSPs), creating a risk of HIV outbreaks among PWID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted 10 semi-structured interviews with outreach workers from SSPs. Interviews were purposively sampled to cover three prototypic regions of Ukraine: temporarily Russian-controlled, frontline, and destination. Qualitative results from interviews were then compared against a standardized, nationwide harm reduction database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that the Russian invasion triggered both supply and demand challenges for SSPs. Demand increased for all regions due to client transitions from pharmacies that closed to SSPs, increases in illicit drug use, greater client openness to NGO support, and displacement of clients to destination regions. Supply decreased for all areas (except for remote destination regions) due to battle-related barriers like curfews, roadblocks, and Internet disruptions; diminished deliveries of SIP and funding; and staff displacement. Time series plots of the number of unique clients accessing harm reduction services showed that an initial decrease in service provision occurred at the start of the war but that most regions recovered within several months except for Russian-controlled regions, which continued to provide services to fewer clients relative to previous years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>To ensure continued scale-up of SIP and other HIV prevention services, the SyrEx database should be leveraged to serve as a streamlined harm reduction locator that can inform workers and clients of open site locations and other pertinent information.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1229057","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T15:08:30Z","timestamp":1700752110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Early disruptions to syringe services programs during the Russian invasion of Ukraine"],"prefix":"10.3389","volume":"11","author":[{"given":"Benjamin M.","family":"Nikitin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Bromberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Pykalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Ivasiy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahedul","family":"Islam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Altice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"ref1","volume-title":"Global AIDS Monitoring 2019","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1016\/S0140-6736(19)32229-9","article-title":"Global patterns of opioid use and dependence: harms to populations, interventions, and future action","volume":"394","author":"Degenhardt","year":"2019","journal-title":"Lancet"},{"key":"ref3","author":"Sazanova","year":"2019"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S118","DOI":"10.1016\/j.amepre.2021.05.044","article-title":"Syringe services programs\u2019 role in ending the HIV epidemic in the U.S.: why we cannot do it without them","volume":"61","author":"Broz","year":"2021","journal-title":"Am J Prev Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1080\/10826080600669579","article-title":"Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international evidence","volume":"41","author":"Wodak","year":"2006","journal-title":"Subst Use Misuse"},{"key":"ref6","year":"2016"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.drugpo.2016.12.008","article-title":"Patterns of harm reduction service utilization and HIV incidence among people who inject drugs in Ukraine: a two-part latent profile analysis","volume":"43","author":"Ompad","year":"2017","journal-title":"Int J Drug Policy"},{"key":"ref8","volume-title":"Injection drug use in Ukraine.","author":"Nieburg","year":"2012"},{"key":"ref9","volume-title":"Global Fund Grants in Ukraine.","year":"2022"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.drugpo.2012.01.001","article-title":"Rejuvenating harm reduction projects for injection drug users: Ukraine's nationwide introduction of peer-driven interventions","volume":"23","author":"Smyrnov","year":"2012","journal-title":"Int J Drug Policy"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e25509","DOI":"10.1002\/jia2.25509","article-title":"Operationalizing the HIV prevention cascade for PWID using the integrated bio-behavioural survey data from Ukraine. 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