Alexei injected drugs for over 15 years before opioid substitution therapy (OST) changed his life. He has now not injected drugs for the past three years, after starting an OST programme at the Psychiatry–Narcology Clinic in Minsk, Belarus.
“I had to do unimaginable things to find at least U$ 50 per day to sustain my heroin addiction,” said Alexei. “Since becoming a client of the methadone programme, I have not injected drugs, have completed my studies, got a job at the local factory and started a family. Thanks to this programme, I am still HIV-negative and I have my life back.”
Belarus aims to sustain and scale up its HIV prevention programme for people who inject drugs. Today, more than 1000 people who used to inject drugs are enrolled on the OST programme, which is available at 18 sites. Clients go every day to a participating health clinic to take a dose of methadone, which helps to treat their addiction to opiates.
About 30% of the people enrolled are living with HIV, and OST is used as a key tool to enhance their adherence to antiretroviral therapy. People who are HIV-negative rely on the programme to avoid HIV infection, as the virus can be transmitted through unsafe injecting.
Evgeny Golubitskiy, a psychiatrist/narcologist and head of the OST programme at the Minsk Oblast Narcology Clinic, said that the people who have graduated from the programme at his clinic are successfully managing their addiction to drugs, which has a positive impact on their overall health. In addition, he said that only one client had become infected with HIV in over four years of the programme.
According to a study conducted in Belarus, each dollar invested in OST programmes will produce a US$ 6 return. By treating people who inject drugs, savings are made with respect to possible HIV treatment, crime and unemployment. Research also shows that the employment rate among people receiving OST has jumped from 26% to 54% since the programme’s implementation.
“The results of the OST programme are clear and positive,” said Vasily Zharko, Minister of Health of Belarus. “We plan to continue these services by gradually increasing financing and support from the state’s budget."
Belarus plans to double the number of people receiving OST, to 2000, by the end of 2015. The target for 2020 is to have 10% of the 75 000 people who inject drugs in the country on the programme.
During his first official trip to Belarus, Vinay Saldanha, UNAIDS Regional Director for Eastern Europe and Central Asia, visited the OST programme at a health clinic in Minsk and learned that it also provides psychological and social support.
"The harm reduction programme in Belarus, including opiate substitution therapy, is impressive," Mr Saldanha said. “The OST programme in Belarus is saving lives and preventing the spread of HIV among clients.”
