AEGiS-15IAC: How can MTCT-Plus program improve existing HIV care in the hospital?

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

How can MTCT-Plus program improve existing HIV care in the hospital?

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10202)

Phanuphak N, Chotnopparatpattara P, Chaithongwongwatana S, Santarattiwong P, Kriengsinyot R, U-prasitwong J, Sirisakyot W, Teeratakulpisarn S, Thisyakorn U, Thaithammayanont P, Limpongsanurak S, Phanuphak P
Thai Red Cross AIDS Research Centre, Bangkok, Thailand

ISSUES: MTCT-Plus program introduces practical model of family-centered, multidisciplinary care for HIV-infected patients. While most university hospitals have existing HIV clinics, this model of care may still benefit them by formally organizing the already available services in the hospitals.

DESCRIPTION: Chulalongkorn hospital is one of the oldest and largest university hospitals in Thailand. Before MTCT-Plus program started in February 2003, adult and pediatric HIV clinics were run separately by internists and pediatricians. Obstetricians ran pMTCT program. Currently, the hospital is having "Family Clinic" every Tuesday which provides services to 91 MTCT-Plus families (198 patients). Pediatrician sees patients in the morning while internists/general practitioner/obstetricians see patients in the afternoon. Pediatric clinic, adult clinic, and pharmacy are in the same building but on separate floors. PLWA group, social worker, and counselor are available in the same clinic.

LESSONS LEARNED: 1. University hospital is not as good demonstrating site for new program as it seems to be. Space and time for clinic is hard to find since everyone is so busy. 2. Family-centered, multidisciplinary model of care needs more than the availability of specialists in each discipline. 3. Set up new clinic with new protocol was seen as "burden" to other hospital staff rather than the way to improve patient care.

RECOMMENDATIONS: 1. Don't rely the readiness and success of MTCT-Plus program on the size of the hospital. 2. Be flexible with the protocol. Keep in mind you are doing the best for your patients and everything will be easier. 3. Ask for commitment from everyone involved. Always give positive encouragement to the team. 4. Better HIV care and treatment model can be and should be set up even in complex setting of university hospitals. Next generation of doctors and medical students should made familiarized to MTCT-Plus program as model of care for chronic diseases.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Thailand, Hospitals, University, Ambulatory Care Facilities, Health Services Needs and Demand, Physicians, Health Services Accessibility, Personnel, Hospital, Adult, Humans, Child

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B10202