Building HIV services around people's lives: Five years of Community Action for HIV Control in Ukraine

Over the past five years, the Community Action for HIV Control (CAHC) project has worked alongside community organizations across Ukraine to make HIV services easier to access, more responsive to people's needs, and better connected to the continuum of HIV care.

Working in 15 regions of the country, the project helped more than 210,000 people learn their HIV status. For more than 5,500 of them, the result was life-changing: They learned they were living with HIV, and 95% were successfully linked to HIV care and treatment. Through its network of partner organizations, CAHC became an important part of Ukraine's HIV response, accounting for between 15% and 25% of new HIV case detection across project-supported regions.

Yet numbers tell only part of the story. Behind every test, referral, and linkage to care was a person navigating their own set of challenges: loss, displacement, isolation, addiction, poor health, uncertainty, or simply not knowing where to turn for help.

The project was designed with those realities in mind. Through community organizations, social workers, peer support, digital tools, outreach, and integrated services, CAHC sought to make HIV care not only available, but truly accessible to the people who needed it most.

Meeting people where they are

One of CAHC's core principles was simple: Service providers should not wait for people to come to them. Instead, services should reach people where they are, whether that means a city park, a digital platform, a community organization, or a trusted social network.

For Oleg, a 50-year-old man from a small town in Zhytomyr region, that first step happened at a community event organized by CF Let Your Heart Beat. There, he met Yurii, a social worker who offered HIV testing in a welcoming, judgment-free environment. Oleg had considered testing many times before but always postponed it, concerned that in a small town there was little privacy. This time, he agreed to test and later entered HIV care with Yurii's support. 

And for some, the first step happened without even leaving home. In Kyiv, one man, who had long suspected he might be living with HIV but avoided testing out of fear, ordered a self-test through TestVdoma. Launched under CAHC, the platform allows people to order HIV self-testing kits free of charge and test in the privacy of their homes. The man’s result was positive. What followed was not only treatment for him, but prevention for his partner, who later tested negative and began taking PrEP. Their experience was one of nearly 40,000 self-testing journeys supported through TestVdoma over the course of the CAHC project.

Turning a first contact into a pathway to care

As CAHC's experience often showed, the most important outcome of a first interaction is not always the test result itself. Leonid's story illustrates this well. When he first met Viktoriia, a social worker with CO Charitable Society Network 100 Percent Life Dnipro, his HIV test was negative. What stayed with him, however, was the supportive conversation that followed, and he left with her phone number saved in his contacts.

Months later, worsening health symptoms and severe pain near his liver prompted him to call her again. Follow-up testing revealed both HIV and hepatitis C. Faced with two life-changing diagnoses, Leonid found himself relying on the same trusted connection he had formed earlier. With Viktoriia's support, he was linked to care, started treatment, stopped using drugs, and eventually found work.

Not every first contact happened face-to-face. GoPoruch, an online appointment platform launched under CAHC, offers people a convenient way to connect with HIV services. In Kyiv Region, one woman used the website to schedule HIV testing but ultimately decided not to come, held back by fear and stigma. Even so, she kept the social worker's phone number. When her health eventually began to deteriorate, she knew exactly who to call. Her HIV test was positive, and further examinations revealed advanced HIV infection and tuberculosis. She was urgently linked to medical care and treatment.

Whether that first connection happened in person or online, it often remained available long after the initial interaction, helping people find their way back when they were ready to take the next step.

Looking beyond HIV

People do not always come looking for HIV services. Often, they come looking for answers.

Serhii thought he already knew what was wrong. After undergoing hepatitis C testing elsewhere, he came away believing he had tested positive. Looking for clarity, he contacted Kateryna, a social worker with CO 100 Percent Life. Lviv, one of CAHC's partner organizations. 

When they met, hepatitis C was the only thing on his mind. But Kateryna suggested multitesting, explaining that it could provide a more complete picture of his health. The results told a different story. The diagnosis Serhii expected was not confirmed. Instead, the test revealed HIV. With Kateryna's support, he was referred for confirmatory testing and connected to care the same day.

Another pathway to care began for Sofiia in Cherkasy Region. Social workers from CO 100 Percent Life. Cherkasy first contacted her after learning that her husband had recently received an HIV diagnosis. This approach proved highly effective across the project, with index and social network testing accounting for 38% of all HIV cases identified through CAHC. When Sofiia agreed to be tested, her HIV result was negative. The visit, however, revealed another important health issue: hepatitis C. The organization helped connect her to health care providers and support her preparation for treatment.

Together, their stories show why looking beyond a single diagnosis often opens the door to more effective care. Throughout CAHC, integrated testing and coordinated support helped identify important health needs that might otherwise have gone unnoticed.

Delivering HIV services in wartime

War has changed nearly every aspect of life in Ukraine, including access to health care. Displacement, financial hardship, disrupted support networks, and ongoing uncertainty often push health concerns into the background, making HIV prevention, testing, and care harder to access.

Yet throughout the war, CAHC and its partner organizations continued delivering and adapting services, ensuring that support remains available when people needed it most. Maryna's story brings this reality into focus.

After fleeing her destroyed home with her two children, Maryna was focused on survival. Finding safety, rebuilding daily life, and caring for her family left little room to think about her own health. When she came to a mobile outreach site to collect food and basic hygiene supplies, she met a social worker from CO 100% Life Dnipro Region. What began as a conversation during humanitarian assistance led to HIV testing, linkage to care, and ongoing support at a moment when she needed all three.

“I thought it was the end. That my children would be left without me. But you showed me it wasn't a sentence. It was a chance. And I will live,” Maryna recalls.

While stories like Maryna's underscored the importance of maintaining HIV services during wartime, the changing realities of war also required new approaches. In 2025, the CAHC project launched targeted work with veterans, recognizing the growing need to ensure that HIV services remained accessible to people transitioning from military service back to civilian life. Across nine regions of Ukraine, more than 5,000 veterans received HIV testing through CAHC-supported services, and 45 learned they were living with HIV.

What made the difference

Over five years, people found their way to HIV services under CAHC through many different doors. They ordered a self-test, booked an appointment online, connected through a peer recruiter, followed the recommendation of a friend or partner, met a social worker during outreach, walked into a community center, noticed a poster on a bus, or sought help for an entirely different concern. No two journeys looked exactly alike. 

Yet the stories shared a common thread. People reached HIV services through options that fit their needs, circumstances, and readiness to engage. Creating and expanding those pathways was one of CAHC's defining strengths, made possible through service delivery approaches tailored to the needs and realities of the people they served.

Although the project closes this month, its impact will continue through the knowledge, partnerships, and local capacity built through collaboration with partner NGOs across Ukraine. The expertise, service models, and practical solutions developed through CAHC will remain part of Ukraine’s HIV response for a long time to come.