14th International AIDS Conference Barcelona, Spain — July 7-12, 2002

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. MoOrB1097

BACKGROUND: HIV-antiretrovirals (ARV) are officially prescribed in 10 government and private-not for-profit UNAIDS accredited centers. However, little is known about ARV use in the private-for-profit (PfP)-medical facilities (mf). Midway International in collaboration with Medical Access Uganda Limited (MAUL) and with the assistance from GlaxoSmithKline is evaluating the ARV use in the PfP sector in Uganda

METHODS: A survey to identify PfP-mf prescribing ARV was completed in 3 of 7 selected districts. A questionnaire was used to collect information on the count of PfP-mf prescribing ARV, types and frequencies of ARV regimes, alternative sources of ARV, factors for choosing these alternatives, and drug intolerances. Identified PfP-mf were provided with free CD4 and HIV-viral load count to a maximum of 40 patients per PfP-mf. All lab-tests were done at the Uganda Virus Research Institute.

RESULTS: 21 PfP-mf have so far been identified as having ever prescribed ARV, 17 PfP-mf (~340 patients) were actively prescribing ARV, of which 4 (38 patients) have within 2 months received CD4 and viral load results. At enrolment, 28 patients (74%) had received lab- monitoring for 2 or less times a year, 7 (18%) for 3+ times a year and 3 (8%) were only clinically monitored. The cost of both CD4 and viral load tests by Dec-2001 was150-165 USD per sample. 31 Patients (81%) were on 2 Nucleoside Reverse Transcriptase Inhibitors (NRTI) plus a Non-NRTI or a Protease Inhibitor, of these, 49% were on generic combinations. Alternative sources of ARV were mainly drug donations from relatives abroad and local pharmacies. Differences in drug cost and stock run-outs were the main reasons for alternative source. Commonly mentioned drug intolerances were toxicity and hyper-pigmentation.

CONCLUSIONS: ARV use is common in the PfP sector. Laboratory monitoring costs can limit access to ARV. Stakeholders need to involve the PfP sector in programs providing care to patients on ARV therapy.

Presenting author: Charles Kabugo

1Midway International, Kampala, Uganda.

2Medical Access Uganda Limited, Kampala, Uganda.

3Case Clinic, Kampala, Uganda.

4International Medical Center, Kampala, Uganda.

5GlaxoSmithKline, London, United Kingdom.

6Nsambya Hospital, Midway International, P.O. Box 23186, Kampala, Plot 2683 Tank Hill Rd., Uganda.

020708
MoOrB1097

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.