As part of the regional information and advocacy campaign «EECA Voices at AIDS 2026», implemented by VirusOFF with the support of the UNAIDS EECA and Asia-Pacific Office, we continue to speak with people whose voices are shaping the HIV response in the region.
AIDS 2026 in Rio de Janeiro became a space where much was said about innovation, medicines, the future of prevention, sustainable financing, the role of communities and human rights. But for Eastern Europe and Central Asia, and especially for Ukraine, these issues are not abstract. They pass through the experience of war, displacement, declining humanitarian support, an exhausted system, barriers to services and the daily work of communities that do not allow people to be left without help.
We spoke about this with Olena Stryzhak, Chair of the Board of the charitable organization “Positive Women”, a well-known activist who represents the voices of women living with HIV in Ukraine and internationally, and who has worked for many years at the intersection of human rights, gender equality, access to health care and community leadership.
Olena participated in AIDS 2026 in Rio, spoke at sessions focused on Ukraine and speaks about the conference without embellishment: about how Ukraine is gradually disappearing from the global focus; about why innovation has little meaning without access; about why human rights are not a separate issue, but part of prevention and treatment; and about how communities continue to work even when funding decreases and needs grow.
Olena, you were in Rio at AIDS 2026, and this was not your first international AIDS conference. What felt different this time — in the tone of the global discussion, in conversations about human rights, the role of communities and financing?
For me, this conference was emotional, but I cannot say it was negative. It was neutral. And that was felt in the number of civil society representatives, and the overall atmosphere depended on that.
Of course, I was very happy to see familiar and dear people with whom we have worked for a long time. Today, the conference is perhaps even the only chance to meet in person once every two years. So I always try to use this opportunity as much as possible.
But I cannot say that there was an event that impressed me very strongly. At previous conferences, there were moments that truly stayed with me and that I still remember. This time, there was nothing like that.
I think this is connected to funding cuts and the overall political situation. In our field, the current situation is not directed toward growth, improvement or development. What is felt more is decline and holding on with the last strength to what we still have. We understand that we have already lost a lot.
But because of our position, we are not in this field by chance. We pull ourselves through and support one another so that we do not stop.
What does the global HIV discussion still often fail to understand about our region — about war, migration, stigma and access to services?
Not only does it fail to understand it — it has almost stopped talking about it.
If we compare it with the 2022 conference, back then Ukraine was being discussed from all sides. There was enormous support. And it was not only in words — it was in actions, in financing, in the reformatting of work. Everything was directed toward supporting people who remained in Ukraine and people who had left.
Over these four years, this has changed dramatically.
The only more or less high-level session dedicated to Ukraine focused on ensuring access to HIV testing and treatment in Ukraine during the war. There, I presented the situation and needs of women living with HIV, as well as the community’s vision for improving services, including the important role of cooperation between the public sector and civil society in ensuring continuity of HIV services. And one moment touched me: almost 80% of the room consisted of Ukrainian delegates. It felt as if we were telling this to ourselves.
Yes, we said important things. Yes, the materials will remain on the conference website, and there was an online broadcast. But among those who do not live in Ukraine, there were mostly people who already support Ukraine: donors, organizers, people who already understand the situation.
And what we are saying is that support is not only emotional presence. If we are talking about supporting Ukraine as a country that continues the HIV response during the war, then this is first of all about financing and real humanitarian support. And there is far less of it now.
When we talk about women and people who have left Ukraine and still continue to need support, almost no one talks about this. This issue is visible only thanks to initiatives working in the region and focusing on migrant women and migrants. Without them, it would not be mentioned at all.
At the conference, there was a lot of discussion about innovation, long-acting medicines and new approaches to prevention. How does this sound from the reality of Ukraine?
It is very good that we continue to talk about innovation, long-acting therapy and new opportunities. And it is important that even during the war Ukraine does not stop and does things that other countries are only beginning to think about.
But this is not enough.
Treatment and testing cannot exist separately from humanitarian support, psychological support, social accompaniment and financial support. These things must happen in parallel.
Ukraine is not stopping. The Public Health Center is already implementing long-acting injectable medicine as pre-exposure prophylaxis (PrEP), in some cities, and we believe that soon we will also have treatment using long-acting medicines. But when you return to reality, you understand that for many women, the needs are of a different nature right now.
Yes, we are ready to be involved in innovation processes. We do not reject them. But if a woman needs to get to a hospital, if she needs housing, warmth, food for her children, safety and psychological support, innovation alone does not solve her situation.
Innovation cannot be separated from basic needs. First, we need to cover what a person needs in order to physically reach a service.
You speak about human rights and women’s rights not as a separate advocacy issue, but as part of prevention, treatment and access. How does this work in practice?
At Positive Women, two areas are now quite strongly developed, and they are directly linked to ensuring and protecting human rights in the context of women living with HIV.
The first is the paralegal service, which has been working for the third consecutive year and is funded through HIV programmes. The second is a major area of community-led monitoring.
These are two harmonized areas. On the one hand, we collect information, assess barriers and see where rights are being violated. On the other hand, we overcome these barriers with the help of paralegal workers, and when needed, we involve lawyers or free legal aid at the local level. We also cooperate at the regional level.
But there are many things we cannot overcome quickly precisely because women often lack even the possibility to travel to the place where they can receive help.
Many facilities where medical care used to be provided have been destroyed. Because of this, women have to change location and look for another route. And in this situation, a woman often chooses other priority expenses: feeding her children, paying for housing, renting an apartment, covering basic needs.
Displacement continues. We see the situation in Sumy, Kramatorsk, Sloviansk, Kherson, and in the Dnipropetrovsk and Zaporizhzhia regions. Even our specialists have left three regions over the past month — Sumy, Donetsk and Kherson. They continued working there until the very last moment.
And when women arrive in a new place, they need not only counselling or psychological support. They need humanitarian support. And today there is tens of times less of it. This is the barrier.
A woman chooses not therapy, not testing, not a medical check-up, not what is related to physical or mental health. She chooses basic things that require money.
When we talk about quality of life and human rights, I often say: in Ukraine, many things are now much simpler and harsher. If we take the hierarchy of needs, we are now on the first step — where a person’s basic needs are. And they are not being met.
This is about warmth, electricity, safety and housing. These are things that can be covered, but they require financing.
What prevents women living with HIV from receiving services in a timely and safe way today?
The main thing is absent — safety.
People think first about basic needs, about safety, about children, about housing. Only after that do they think about treatment, prevention and innovation.
We continue to work. Thanks to the Global Fund, processes are continuing; we have submitted an application for the eighth funding cycle; we cooperate with health care facilities, the Public Health Center and coordination structures. If we identify barriers or rights violations, we respond through working groups and coordination councils, and we resolve issues even situationally.
But if we talk about a systemic approach, it is very much lacking now.
In your work, there are very concrete examples of advocacy working not on paper, but in real life. Could you share one of them?
Recently, with the support of UNICEF, we conducted a large study in the Dnipropetrovsk and Odesa regions and saw cases where women were asked to pay for services that should be covered by the Programme of Medical Guarantees through the National Health Service of Ukraine, including childbirth or anesthesia.
We started working through the National Health Service of Ukraine, writing appeals on behalf of women from the regions and raising these cases. We cannot yet resolve everything centrally, but we will act case by case and prevent such practices.
When a gynecologist says, “Send money to my card” for something that is covered by the NHSU guarantees, we will not leave it like that.
In one case, the woman got her money back. And this happened because she wrote a complaint, and we supported her. Without us, perhaps she would not have written it. Perhaps she would not have known about the National Health Service of Ukraine at all.
And when, during a working group meeting, people ask me, “How is this possible? Tell us about it,” I can tell them about this situation and others. If someone thinks these are invented cases, they are very mistaken. Money is being taken for childbirth, for anesthesia and for other services. And we will continue to raise this to stop it.
For me, this is advocacy in action.
The principle “nothing for communities without communities” is often repeated. At what stage should communities be involved so that decisions do not remain beautiful words?
Communities must be involved from the very beginning.
The rhetoric, approaches and position of decision-makers have changed a lot. Earlier, when we talked about advocacy even at the national level, there was a feeling of shared responsibility. We brought a problem that needed to be solved, and we saw that responsibility and action were distributed among different sides.
Now we often hear something different: “You found the problem? You conducted the study? You identified the barriers? Then you advocate for solving it.” Protocols may directly state “advocacy actions” and list two organizations, for example, Positive Women and 100% Life.
So: you found it yourselves — you advocate for it yourselves.
I am not against it. If this is what you want, then we will do it this way. I immediately write letters, raise issues and do advocacy work. But we will keep doing this until those who make decisions take responsibility.
Because we do not approach them for no reason. We do not just write recommendations: these are for non-governmental organizations, these are for authorities, these are for international organizations. Each side has its own responsibility.
It has become much more difficult. Even letters may not be answered now, or responses may come much later. But we continue.
“Nothing for us without us” is not a slogan. It means that as long as we keep striking the rock, we will have something. And we will still achieve what we need.
If we return to AIDS 2026: what was the main signal from the conference for Ukraine and the EECA region for you?
For me, the key thing is that we do not stop. We continue. Whether there is money or not, this is already part of our life.
And this is probably the strength of communities. We came from the grassroots. We know the need. We have already learned something, and we continue to do our work — with money or without money. This is the key thing.
You also mentioned that an important part of the conference for you was the presence of women and the return of a strong women’s voice to the global level.
Yes. For me, one of the most important and joyful things was seeing that women living with HIV have again reached the level where they are co-organizers of major sessions, where there are many of them in the overall audience, and where there is a strong space in the Global Village. I attended the session “Women Know What Works,” organized by ICW Global in partnership with Posithiva Gruppen. The event was dedicated to community-led approaches to addressing internalized stigma among women living with HIV, access to mental health services, and the impact of HIV criminalization on women’s rights, dignity and well-being. I saw how many women were in the Women’s Networking Zone. There were always people there, always movement, representatives from different continents and countries, different sessions and a very rich programme.
For me, that was key: to see that so many women continue this work, do not stop, and each in her own place implements what she has planned — with money or without money.
I am very glad that the international community of women living with HIV has again reached the international level. For me, this is the greatest joy, because I have been part of this process for a long time.
You are quite critical of the gap between how the conference space looks and what is happening in people’s real lives.
Yes. Sometimes it seemed to me that the whole conference should have gone into the Global Village and asked communities there what they needed.
Not just develop policies and say how strongly everyone supports communities, but help through real actions. For me, real actions mean concrete provision of resources.
And we will explain the design of services ourselves. We will say ourselves what we need. This is exactly “nothing for us without us”: come in and ask what we need, how to fix what needs to be fixed.
If we want to stop the epidemic, we need to approach this comprehensively. It is not enough simply to provide medicines and have them available. A package of services is needed.
If we are talking about women, we need to understand what is needed so that a woman does not fall out of the system, seeks help, gets tested and does not come only at a late stage when the situation is critical. Social accompaniment is needed for this.
You also spoke about the responsibility of pharmaceutical companies. What exactly struck you?
When I entered the exhibition area, at first I thought it was some kind of television show: screens, lights, huge presentation spaces.
And I thought: are you serious? What is all this for? To tell everyone how great you are? But this is done at the expense of the price of your product.
I am not saying that pharmaceutical companies do not help. But if we talk about the HIV field, for example, we currently have no funding from pharmaceutical companies. There was one grant last year, and it ended.
And for us, even 25,000 euros is very significant money. With those funds, we were able to provide humanitarian support to women in 12 regions of Ukraine. We were able to provide psychological and psychiatric support — things for which others do not provide funding.
We can say what money is needed for. We can say what works. Because a woman who is in a difficult situation will not think about therapy in the way the system expects her to. First, she needs help to survive, stabilize and receive support.
Perhaps this conference showed that pharmaceutical companies should focus not only on presenting themselves, promoting products and increasing visibility, but also on directing resources from profits toward real benefit — to communities that are now going through harsh times without the resources needed to continue their work.
If you had to formulate in one sentence the message from Ukraine, from women living with HIV and from EECA communities to global leaders after AIDS 2026, what would it be?
Go to communities and ask what we need.
Don’t tell us what is better for us. Ask us. Support us with real action. Because we know the needs, we know the barriers, and we know what works.
And if the world truly wants to stop the epidemic, this cannot be done only with medicines, innovations or conference statements. It can only be done comprehensively — through access, trust, rights, financing, social accompaniment and communities that must be at the centre of decisions from the very beginning.
