# Adapting and coping during the war in Ukraine: lived experiences of older adults with HIV and their healthcare providers

> **NIH NIH R21** · YALE UNIVERSITY · 2022 · $186,656

## Abstract

Since the war in Ukraine began on February 24, 2022, experts have warned of possible collapse of the HIV care
system and a loss of decades of hard-earned gains in high-priority areas like HIV and addiction care. Older
people with HIV require tailored intervention for linkage and re-linkage to HIV care. Our parent R21 grant focuses
on tailoring Peer Navigation to OPWH in Ukraine to create PROST (Peer-Run Optimal Strategy for Treatment
or “To your health” in Ukrainian), and pilot test it to (re-) engage OPWH in HIV care. To date, using the ADAPT-
ITT framework, we adapted FHI PN manual to build PROST PN for Ukrainian OPWH. Our remaining aims include
a pilot RCT of PROST vs. treatment as usual (TAU) to measure acceptability and feasibility; and using the data
from the pilot to conduct dyadic analyses of peers and beneficiaries to understand shared decision-making and
linkage to care outcomes. As the war in Ukraine is ongoing, it is essential to understand how OPWH and HIV
and other healthcare providers cope and add to PROST PN manual a chapter based on this knowledge for how
PN may help OPWH (re) link to HIV care during humanitarian crisis. Phone interviews we conducted in Kyiv in
April 2022 suggest that HIV and addiction care doctors remain in post during the war, and OPWH do not evacuate
due to sentimental attachment to home, fear of moving to a strange place, mobility limitations, having few
resources and nobody to support them in evacuation, caregiving responsibilities for frail family or pets, and desire
to stay close to their trusted HIV and other healthcare providers. In this Administrative Supplement, we propose
to develop a chapter for the PROST manual on OPWH Peer Navigation during humanitarian crisis, based on
analyses of lived experiences of OPWH and their clinicians in Kyiv. In-depth interviews with a purposive sample
of 25 OPWH and HIV, addiction, and 10 mental healthcare providers in Kyiv will examine what is involved in
surviving and giving and receiving HIV care in humanitarian crisis. Findings will inform the questions added to
Wave 4 of the longitudinal survey of 123 OPWH participants in Kyiv. Wave 3 completed just before the war offers
an opportunity to understand changes in OPWH's physical and mental health, social support, risky behaviors,
and participation in HIV and other healthcare since the war began. Our Community Working Group (CWG)
comprising OPWH and clinicians in Ukraine will guide the inclusion of findings into the new chapter of PN manual.
Feasibility is high as our collaboration with EIPHP, CWG, Kyiv AIDS Center, and Kyiv Addiction Treatment Clinic
stays robust. All colleagues are well, all clinicians remain in post and physically in Kyiv. We continue weekly
Zoom team meetings to discuss ongoing fieldwork and strategic plans. We can interview and survey OPWH
entirely by phone (and process payments for their time online). Drawing on Ukrainian colleagues' partnerships
with the Ministry of Health of Ukraine, Ukrainian ...

## Key facts

- **NIH application ID:** 10614174
- **Project number:** 3R21AG072961-02S1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Julia Rozanova
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $186,656
- **Award type:** 3
- **Project period:** 2021-06-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10614174

## Citation

> US National Institutes of Health, RePORTER application 10614174, Adapting and coping during the war in Ukraine: lived experiences of older adults with HIV and their healthcare providers (3R21AG072961-02S1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10614174. Licensed CC0.

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