Professor Frederick Altice from Yale University presented at the 2019 NDARC Seminar Series on Thurs, 17 October 2019.
This presentation examined the implementation strategies used in scaling up OAT in the Ukraine, home to Europe’s most volatile HIV epidemic.
Ukraine is home to Europe’s most volatile HIV epidemic with HIV prevalence among adults being 1.2%, driven mostly by people who inject drugs (PWID) and their sexual partners. Treatment with opioid agonist therapies (OAT) with methadone or buprenorphine, if adequately scaled to need, is the most cost-effective strategy to prevent new HIV infections. In this presentation, we will introduce implementation science strategies using the validated framework – Promoting Action in Research Implementation in Health Services (PARiHS) – to define and overcome the barriers to scale-up by assessing the evidence for use of OAT, context and an active facilitation strategy. Understanding the context is assessed through qualitative, quantitative and mixed methods research, using a multi-level framework assessing patient-, clinic-, healthcare setting and policy barriers. A review of OAT scale-up and the interventions used will be reviewed from the introduction of OAT through to the present.
Dr. Altice is a Professor of Medicine, Epidemiology and Public Health at Yale University where he serves as the Director of Clinical and Community Research, the Community Health Care Van and the HIV in Prisons Program. As a clinician, he is board-certified in both Infectious Diseases and Addiction Medicine. As a researcher, his interests are focused on the interface between infectious diseases, including HIV, tuberculosis, viral hepatitis, and substance use disorders. Specifically, he is interested in both prevention and treatment issues and has been at the forefront of both behavioural and biomedical intervention research activities. He is also interested in creation of novel prevention and treatment programs for the treatment of HIV, viral hepatitis, tuberculosis, and substance use disorders in vulnerable populations, including people who inject drugs, criminal justice populations, men who have sex with men and both female and transgender sex workers.
Dr. Altice has spent considerable time devoted to developing and studying integrated systems of care, including integrating medication-assisted therapies such as methadone, buprenorphine, and extended-release naltrexone into managing co-morbid conditions, including people living with or at risk for HIV, HCV, tuberculosis, and mental illness. In more recent years, given the many successful prevention and treatment interventions available, he has increasingly become involved in implementation science to find improved ways to disseminate research and evidence-based practices and ensure that they are implemented using best-practices. Dr. Altice is currently leading studies in Ukraine, Eastern Europe, Central Asia, Malaysia, Indonesia, Peru, and the United States.