Med school prof battles HIV in Eastern Europe

Yale researchers are tackling the burgeoning HIV epidemic in Eastern Europe.

School of Medicine professor Frederick L. Altice and his research team received a $4.2 million grant this month from the National Institutes on Drug Abuse to conduct studies on the HIV epidemic within the Ukraine and other Eastern European criminal justice systems. Medical researchers and criminal justice partners will collaborate on the proposed research program, dubbed PRIDE (Prison-related Research, Intervention Development and Evaluation), to decrease HIV-related mortality and the concentration of other infectious diseases within the criminal justice system. While Ukraine is home to one of the most volatile HIV epidemics in the world, researchers said that not enough work is being done to combat the issue.

School of Medicine professor Frederick L. Altice and his colleagues on their most recent visit to Ukraine to study HIV.
School of Medicine professor Frederick L. Altice and his colleagues on their most recent visit to Ukraine to study HIV.

According to the study’s project summary, the HIV epidemic has reached an explosive level in Ukraine, due to the prevalence of injection drug abuse and the high incarceration of drug users. Altice’s team has invoked the collaboration of both the medical and legal worlds.

“There has been little leverage of research looking at the criminal justice system to put more than a Band-Aid on the burgeoning HIV epidemic issues,” Altice said.

With the assistance of collaborators in Kazakhstan and Georgia, the study seeks strategies to reduce HIV transmission within prisons and to meet pre-release needs of prisoners with HIV, tuberculosis or drug addictions. The international team composed of medical and legal professionals aims to incorporate behavioral interventions, administer therapy to prisoners during incarceration and aid prisoners with the transition back into the community once their sentence is over.

But this research has a different focus than other HIV studies because of the underserved population it targets, said Ukrainian lead investigator and citizen Sergey Dvoriak.

“This research is addressing a completely different population,” Dvoriak said. “The prisoners have no access to regular medical help or education of the problems. They have no experience for how to work with American researchers.”

Dvoriak, who described the prisoners as stigmatized, discriminated against, and receiving no attention from the Ukrainian government, said they trust Americans and hope that the medical researchers have their best interests at heart. The prisoners are a very dangerous yet vulnerable group, he said.

Although they have plans to help curb the country’s HIV epidemic, the research team is not expecting financial support from the Ukrainian government.

“Our authority is mostly very poor,” Dvoriak said. “We need to convince them that it will be helpful for the system, for the country, and for them.”

The United States’ public policy on the prevention of HIV transmission at least acknowledges the urgency of actively addressing the epidemic, said Connecticut lawyer and member of the research team Michael Lawlor. Recognizing and accepting that there is an issue that needs to be addressed will make the preventative efforts more effective, he said.

With experience in public policy as a member of the Connecticut State House of Representatives covering East Haven, Lawlor will serve as a consultant of the team as it navigates the complicated intersection of public health and criminal justice, he said.

“The AIDS epidemic is a huge problem globally, and you can identify areas where not enough is being done to prevent it,” Lawlor said.

Altice, whose research is grounded in human rights and social responsibility, has been working in Ukraine since 2005 and has also worked in Russia, Malaysia, Indonesia, and Iran on previous projects.

“We are a global entity,” Altice said. “Yale is on board with the notion that these sorts of connections that were previously hindered by borders are no longer there.”

The lessons learned abroad also form an important part of the research, Altice said, because making important discoveries elsewhere will provide us with research tools to address domestic issues.

Ukraine was identified by the United States Agency for International Development in 2006 as a contributor to nearly 21 percent of reported HIV diagnoses in Europe and Eurasia.

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