Innovations in preventing hepatitis B and C and HIV/AIDS in Moldova

This presentation will describe an innovative approach to preventing Hepatitis B and C and HIV/AIDS which has being implemented in the Republic of Moldova where prevalence rates for viral hepatitis are seven times higher than the EU average and HIV and Hepatitis co-infection is common. The approach aims at reducing transmission via all major routes. The problem is simultaneously addressed from five angles and includes an integrated HIV and Hepatitis VCT network; BCC programs to reduce high-risk behavior in the general population and in vulnerable groups; improving blood safety; strengthening laboratory capacity and surveillance; and upgrading infection control in hospital settings. The approach combines sociological and medical expertise to support practical research and data collection efforts to design interventions. National implementation was preceded by pilot tests in all five components. Key achievements included creation of a sustainable VCT network which was implemented through the existing government health system and included government financing through the national health insurance program. To increase demand for VCT services, this was accompanied by a BCC outreach program in the pilot areas. Another result was a first ever National BCC campaign against hepatitis based on the results of a national KAP survey on viral hepatitis and HIV. Since the campaign was implemented by local resources, the added value was capacity building through prior training of journalists, outreach workers, commercial advertising companies, and NGOs. Another innovation is the approach to provide information to vulnerable groups.  It is based on a first-ever survey that combines data on KAP with blood tests to measure the prevalence of both HIV/AIDS and hepatitis B and C. This allows calculations of co-infections and tells about relationship between prevalence and KAP, which can have important implications for high-risk groups worldwide.