Natalia Zapolska Since 2015, I have worked in the HIV field, focusing on prevention projects for key populations and support for people living with HIV (PLHIV) in non-governmental organizations. Currently, I serve as the Chief Specialist in HIV Management and Response at the Public Health Center.

Introduction:
Ukraine is adopting the experience of countries like Australia, Canada, and Switzerland, where safe injection facilities have successfully operated for years. These centers provide secure conditions for injections, medical supervision, and access to psychological and social support. This approach has reduced overdose rates and improved access to substitution therapy programs. Since 2019, Ukraine has been actively implementing HIV prevention programs among key populations, including people who inject drugs. One innovative measure is the introduction of safe injection rooms, which help reduce overdose risks and the spread of infections, such as HIV. However, the ongoing war has complicated access to medical services, posing additional challenges to the healthcare system.

Methods:
Ukraine has adopted the practices of countries with successful harm reduction programs. Safe injection facilities offer secure environments, medical supervision, and consultations, reducing overdoses and improving access to healthcare services like substitution therapy.

Results:
Despite the war, harm reduction efforts, such as in Sumy, show positive outcomes: fewer overdoses, a reduction in infected syringes in public areas, and more people accessing substitution therapy and other social services.

Year Number of Materials/Services Provided Number of Unique Clients
2022 242,282 2,800
2023 344,118 3,339
2024 241,650 1,803
Conclusions:
In wartime, creating and supporting safe injection rooms is essential to reducing harm among drug users, preserving public health, and stabilizing healthcare systems. Local authority support, international partnerships, and regulatory adaptations are key to ensuring the success of these initiatives.