# Presentation: 521085

## Slide 1

## ICOHRTAVinnitsa, Ukraine

**Joseph Schumacher, Ph.D.**
- U. of Alabama at Birmingham
**Nataliya Vlasova**
- STEPS Clinic, ICOHRTA grantee

## Mission

- To further clinical, operational, and health services research capacity with respect to treatment and prevention of substance abuse, as well as prevention and control of related epidemics of human immunodeficiency virus (HIV) infection, sexually transmitted diseases (STD), and tuberculosis (TB) in Vinnitsa, Ukraine.

## Description

- International, clinical, operational, and health services research training award
- Supported by the Fogerty International Center at National Institutes of Health
- Goal to increase research capacity in Ukraine in drug addiction and related diseases (e.g., HIV/AIDS, TB, HCV)
- Five year budget ($250k / year): 48% training, 20% infrastructure, 15% consulting, 12% travel & 5% supplies/equipment
- Department of Epidemiology at UAB SOPH
- Sten Vermund (former PI), Nalini Sathiakumar (PI)

## Our Partners

- Pirogov National Medical University, Vinnitsa, Ukraine
- Regional Narcological Dispesary, Vinnitsa, Ukraine
- US - Ukraine Foundation, Kiev, Ukraine
- The National Development and Research Institute, New York, USA

## Training Overview

- In country Spring Symposium
- Summer Institute in Birmingham
- Long-term Fellowships
- Pilot Study Grants
- Individualized Mentorship
- Short-term Training/Education
- Large Grant Efforts

## Trainee Profile:Kostyantyn Dumchev, MD, MPH

- Spring and Summer Institute participant
- Long-Term Fellow
- MPH degree in epidemiology
- Mentored in drug addiction research
- Pilot study on epi.of HIV among IDU’s
- NIDA R01 Project Coordinator

## Trainee Profile:Nataliya Vlasova

- STEPS Clinic Executive Director
- Spring Symposium and Summer Institute Participant
- Mentored in alcohol addiction and treatment research
- Pilot study found standard medical detoxification plus Twelve Step outpatient treatment more effective at reducing alcohol use and depression than standard care only
- Humphrey Fellowship at John Hopkins U.

## Accomplishments

- 214 trained in 4 Spring Symposiums
- 26 trained in 4 Summer Institutes
- Six small grants awarded
- Three long-term fellowships awarded
- Ethical review board established in country
- NIDA R01 awarded

## Research projects

- A school-based educational intervention  to reduce HIV risk
- Hospital versus outpatient alcohol abuse treatment
- Predictors of HIV status in IDUs
- Predictors of HCV status in IDUs
- Adolescent sexual and drug risk behavior
- Surgical care doctors' attitudes toward the patients who inject drugs
- Feasibility of antiretroviral therapy
- HIV status influence on further drug using
- HIV prevalence, knowledge and behavior among female sex workers
- Soft Tissue Infections in IDUs
- Short term efficacy of CBT intervention in Narcological Dispensary

## Capacity Building

- Ethics Committee at Pirogov University
- Research courses to be incorporated in to new public health curriculum at Pirogov
- Trainee involvement in development / participation in new research
- Research Institute at Pirogov
- On site UAB coordinator

- Pirogov Medical University, Vinnitsa, Ukraine

## Challenges

- Bureaucracy, especially money transfer
- Language
- Limited research experience in country
- Limited computer and internet resources
- Cultural differences
- Sustainability and “brain drain”

## Solutions

- US Ukraine Foundation relationship for $
- Simultaneous translation
- Basic research training, simple designs/studies, research institute
- Computers in grants and internet hook up
- Cultural sensitivity and empowerment
- Integration of Research Institute, “pay off” to trainees

## Lessons Learned

- Involvement of stakeholders in decision making
- Establishment of an in-country leadership committee and employment of field-based representatives

## Lessons Learned (continued)

- Assessment of commitment to return home as major consideration during the selection process
- More time is needed for the maturity of the research network
- Supplemental funding/new grants will be needed to address new training needs and infrastructure challenges
- Creative incentives for mentors needed

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