Grant: Project Grant - Priority Announcement: Population and Public Health

Political conflict erupted in Ukraine in 2014, leading to 1.5-million internally displaced persons and over 13,000 conflict-related deaths. Amidst this backdrop, Ukraine has had growing HIV and HCV epidemics. The ongoing conflict in Ukraine may exacerbate these sexually transmitted and blood-borne infection (STBBI) epidemics-including HIV, HCV, and other STI. Conflict and its consequences-including population movement, disruption in the health care system and economic impact-have the potential to undermine epidemic control. Important changes in the HIV epidemic have already been seen in this conflict. The Ministry of Defense reports increased HIV among military personnel since 2014, and evidence indicates movement of HIV viral lineages out the conflict zone to other parts of the country, following the movement of internally displaced persons. Conflict's impact on transmission dynamics of non-HIV STBBI is under-researched, but given common risk factors for transmission, is important to examine. Many factors within the military environment might contribute to risks of STBBI acquisition and transmission. Young age, consistent income, high risk-tolerance, exposure to trauma, deployment away from home and limited access to health services, tend to place military personnel at higher risk for STBBI. As such, there is a particular need to quantify STBBI burden among military personnel, identify missed opportunities in prevention and treatment, and explore how this unique population might contribute to broader transmission dynamics in the country. With our multidisciplinary team, including colleagues from the Ukrainian Institute for Social Research and the Ministries of Defense and Health, we aim to understand the burden of STBBI among military personnel in the setting of conflict and to examine the extent to which unmet prevention needs of military personnel contribute and sustain STBBI epidemics in Ukraine.