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Are HIV treatment services provided free of charge and what to do if healthcare providers solicit payment for such services?

In Ukraine, a special Law of Ukraine “On preventing diseases caused by human immune deficiency virus (HIV) and on legal and social protection of people living with HIV” is in action. This law provides for state guarantees of testing to detect HIV infection (Article 4), and for the right to free provision of antiretroviral drugs and medications to treat opportunistic infections (Article 15).

What you need to consider 

Starting from April 1, 2021, medical care for HIV is provided under the state-guaranteed benefit package “Diagnostics, treatment and follow-up services for people with HIV (and suspected HIV).” To receive the services, one needs to select any healthcare facility contracted by the National Health Service of Ukraine (NHSU) for the provision of such services. Alongside AIDS Centers, these can be oblast and city hospitals for communicable diseases, TB care facilities, drug treatment centers, and other healthcare settings.

Medical services delivered free of charge to people living with HIV or with suspected HIV based on their medical needs, include:

  • Testing for human immune deficiency virus and counseling at every stage of testing;
  • Required laboratory tests, including:
  • Total blood count;
  • Complete urinalysis;
  • CD4 Cell count;
  • Plasma HIV RNA (viral load) testing;
  • Proviral DNA and HIV serology;
  • Cord blood investigations;
  • PCR in children for early HIV diagnostics;
  • Testing for HBsAg, HCV antibodies;
  • Blood chemistry profile (creatinine, transaminase, glucose);
  • CrAg test;
  • Urine LF-LAM test for TB;
  • Testing for sexually transmitted infections;
  • Other laboratory tests based on the needs of the patient.
  • Full medical follow-up of HIV-positive people (counseling, examination, administration of antiretroviral therapy, treatment of opportunistic infections and monitoring of progression of HIV-infection);
  • Patient referral for secondary (specialized), tertiary (highly specialized) medical care, other healthcare services;
  • Blood testing of infants born to HIV-positive mothers;
  • Medical follow-up of infants up to 18 months of age born to HIV-positive mothers with diagnosis at the stage of confirmation;
  • Counseling of families and relatives of people living with HIV.

In Ukraine, antiretroviral drugs must be accessible to every person with HIV and provided free of charge.

For the full scope of outpatient care services please access the NHSU website and select the specification under the relevant benefits package.

Conduct of a patient in case of solicitation of payment for medical services in a health facility or in case of refusal to provide the medical service.

  •  First of all, approach the chief physician of the healthcare facility, preferably with a written report (complaint), demanding to remedy the violation of right to free medical care under the relevant benefit package, referring to availability of public funding received by the healthcare facility for provision of such services. The complaint must be duly registered, with an incoming registration number assigned.
  • If these efforts were not successful, you need to file a written report (complaint) to the municipal or oblast health department complaining about absence of response by the chief physician and demanding to remedy the violation of the right to healthcare. The healthcare department must duly register the complaint and respond to it. In fact, this is usually enough to correct the situation. If the client remains unsatisfied, he/she can approach the National Health Service of Ukraine (NHSU) and submit a complaint using the online form on the NHSU website. 
  • If a healthcare provider unreasonable refuses to provide medical care or solicits payment for the services covered by the NHSU under the Program of Medical Guarantees, this is a breach of the contract between the National Health Service and the facility. Usually, NHSU does not ignore such messages and may take measures up to terminating public funding provided to the healthcare facility. Therefore, the administrations of health facilities try to avoid such complaints and prevent conflicts.
  • The client has the right to file a complaint in court.