How Ukrainian refugees with HIV overcome difficulties: experience of treatment in Poland

There are 260,000 people living with HIV in Ukraine. According to UNHCR, the war has displaced more than six million Ukrainians from their homes, with the main destination being Poland, where 1.6 million Ukrainians have sought refuge through temporary protection programs. Amid problems with housing, employment and education, people with HIV face another pressing dilemma: access to the antiretroviral (ARV) drugs needed to suppress the virus on a daily basis.

Anna Ariabinska , a prominent Ukrainian HIV activist, representative of Positive Women and head of Fundacja HelpNowHUB, shared the experiences of Ukrainian refugees with HIV for New Eastern Europe, where a major report by Lily Hyde was published. The report was made during a mission trip from the Public Health Alliance, where the author documented the organization’s initiatives in response to the war in Ukraine.

In Poland, where discussions about HIV remain scarce, conservatism prevails, rejecting sex education and LGBT rights. The absence of preventive programs targeting high-risk populations perpetuates the stigma surrounding the disease. Shockingly, only four individuals in Poland have publicly disclosed their HIV-positive status, underscoring the stark contrast with the advocacy efforts in Ukraine, exemplified by activists like Ariabinska. Ariabinska laments the lack of awareness among the general population in Poland, likening the situation to a regression to the 1990s compared to Ukraine.

Moreover, differences exist between the HIV treatment regimens in EU countries and Ukraine. Poland has enacted legislation to ensure that Ukrainian refugee patients maintain uninterrupted access to familiar ARV medications. Additionally, adaptations such as extending take-home medication supplies and facilitating the exchange of patient information with Ukrainian health facilities have been implemented. As a result, Poland now provides ARV treatment to over 3,000 Ukrainians, according to the National AIDS Center.

However, the psychological barriers to treatment present significant challenges. Many refugees are hesitant to disclose their health status due to fears of stigma and cling to the hope that their displacement is temporary, delaying or neglecting treatment adherence. Struggling with depression and the upheaval of social structures like family and work, they may prioritize other concerns over their health, leading to lapses in daily treatment adherence.

But activists continue their work abroad as well – Anna has leveraged her experience in Ukraine to establish the inaugural self-help group catering to HIV-positive individuals and members of vulnerable communities in Poland. “I really missed live meetings and the sense of community,” she adds. “And people come from all over Poland, at their own expense, so I see it’s not just me who needs it.”