Feasibility and Preliminary Effectiveness of a Data-to-Care Intervention for HIV-Positive People Who Inject Drugs in Ukraine

A Pilot Cluster-Randomized Trial

Bibliographic Data

ID22420941
AuthorsKostyantyn Dumchev (0000-0003-2862-4977, National University of Kyiv-Mohyla Academy, corresponding author), Brian Weir (Johns Hopkins University, corresponding author), Khushee Prasad (Johns Hopkins University, corresponding author), Shannon Fuller (0000-0001-6070-8172, Johns Hopkins University, corresponding author), Farren Rodrigues (Johns Hopkins University, corresponding author), Julia Burlaka (0000-0002-7053-8178, University of North Carolina at Greensboro, corresponding author), Olena Makarenko (Ukrainian Institute of Public Health Policy, corresponding author), Tetiana Kiriazova (0000-0002-8480-6591, Ukrainian Institute of Public Health Policy, corresponding author), J Owczarzak (0000-0003-2380-5533, Johns Hopkins University, corresponding author)
Year2026
Publication date2026-07-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS and Behavior (JOURNAL)
Journal identifiersISSN: 1090-7165 • E-ISSN: 1573-3254
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s10461-026-05224-0
PMID42455468
OpenAlexW7168414388
LanguageEN
References cited32

Antiretroviral therapy (ART) interruptions are common among people who inject drugs (PWID) and contribute to viral rebound, disease progression, and onward transmission. Data-to-Care (D2C) strategies, which use routine health data to identify and re-engage people living with HIV who have fallen out of care, are widely used in high-income settings but rarely evaluated in low- and middle-income countries. We piloted a Ukrainian Data-to-Care (UD2C) intervention integrated into the national HIV Medical Information System among HIV-positive PWID recently out of care. Four specialized HIV clinics were randomized to UD2C or care as usual (CAU), with 40 participants enrolled per clinic (n = 160). UD2C combined an optimized data query to identify out-of-care patients with multidisciplinary, acuity-based case management. Recruitment, data extraction, and intervention delivery were feasible across all clinics. Because recruitment required clinic attendance, the pilot assessed UD2C's post-linkage care component rather than its re-engagement function. The primary analysis accounted for clinic-level clustering using cluster-robust standard errors. Median ART coverage during follow-up was higher in UD2C than CAU (97% vs. 89%; adjusted rate ratio 1.15, 95% CI 0.87-1.51); this difference was significant in the model-based sensitivity analysis but not in the primary clustered analysis. Viral suppression was achieved or maintained more often in UD2C than CAU (58.8% vs. 28.8%; adjusted odds ratio 4.6, 95% CI 1.76-12.1). The UD2C model was feasible to implement and evaluate using a cluster-randomized design and showed promising improvements in longitudinal viral suppression. A fully powered definitive trial is warranted to confirm effectiveness and inform national scale-up. The trial is registered at www.clinicaltrials.gov as NCT05821413.

Health care · Health psychology · Human immunodeficiency virus (HIV) · Intervention (counseling) · Odds · Odds ratio · Public health · Randomized controlled trial · Viral load · HIV Research and Treatment · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions

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