16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

PROJECT HEART: INITIATING CARE AND ARV TREATMENT FOR OVER 45,000 PEOPLE IN 22 MONTHS IN FOUR AFRICAN COUNTRIES

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAb0201

Marlink R.¹, Adjorlolo-Johnson G.¹, Anglaret X.², Bolton C.³, Boni-Ouattara E.⁴, Bulterys M.⁵, Buono N.⁶, Dabis F.², Ellerbrock T.⁷, Essombo J.⁴, Fullem A.⁸, Gavitt C.⁹, Giddy J.¹⁰, Ginsburg A.¹, Giphart A.⁹, Grundmann C.¹¹, Havlir D.¹², Hawkins S.¹¹, Hirschhorn L.⁸, Holst H.¹⁰, Hurkchand H.⁶, Kline M.¹³, Lyons C.¹², Maharaj S.⁶, McCullough R.¹¹, Neluheni T.⁶, Nolan M.¹⁴, Nwanyanwu O.¹⁵, Oguda L.¹¹, Reid S.³, Schimana W.⁹, Seyler C.¹⁶, Sinkala M.¹⁷, Spensley A.¹¹, Stringer E.¹⁸, Stringer J.¹⁸, Swai M.¹⁹, Tanoh A.⁴, Tindyebwa D.⁹, Toure S.²⁰, Wahl A.¹, Wiktor S.²¹, Wilfert C.¹, Project HEART Implementation Teams
¹ Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, California, United States, ² Institut de Sante Publique, Epidemiologie et Development (ISPED)/University of Bordeaux, Bordeaux, France, ³ Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia, ⁴ Elizabeth Glaser Pediatric AIDS Foundation, Abidjan, Cote D'Ivoire, ⁵ Centers for Disease Control, Lusaka, Zambia, ⁶ Elizabeth Glaser Pediatric AIDS Foundation, Johannesburg, South Africa, ⁷ Centers for Disease Control, Atlanta, Georgia, United States, ⁸ John Snow Inc., Boston, Massachusetts, United States, ⁹ Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania, United Republic of, ¹⁰ McCord Hospital, Durban, South Africa, ¹¹ Elizabeth Glaser Pediatric AIDS Foundation, Washington D.C., United States, ¹² University of California, San Francisco, San Francisco, California, United States, ¹³ Baylor College of Medicine, Houston, Texas, United States, ¹⁴ Centers for Disease Control, Abidjan, Cote D'Ivoire, ¹⁵ Centers for Disease Control, Pretoria, South Africa, ¹⁶ University of Bordeaux/Elizabeth Glaser Pediatric AIDS Foundation, Abidjan, Cote D'Ivoire, ¹⁷ Lusaka District Health Board, Lusaka, Zambia, ¹⁸ University of Alabama, Birmingham, Lusaka, Zambia, ¹⁹ Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of, ²⁰ ACONDA, Abidjan, Cote D'Ivoire, ²¹ Centers for Disease Control, Dar es Salaam, Tanzania, United Republic of

BACKGROUND: In March 2004, with PEPFAR/CDC funding, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) initiated Project HEART (Help-Expand-ART-for-Children-and-Families), a program to provide HIV/AIDS Care and Treatment (C&T) services to children and adults in Côte d’Ivoire, South Africa, Tanzania and Zambia. As of December 2005, 22 months into the program, we surpassed the goal for people on ART for the entire five year period of our initial application.

METHODS: We present program data from four EGPAF C&T supported country programs, including 64 sites. The data presented are cumulative from program inception. A comprehensive, family-based approach was developed and implemented. ART used followed national treatment guidelines, which all involved NNRTI-containing triple therapy as a first-line regimen.

RESULTS: Currently, there are 38,213 active individuals in the care and treatment program. 7133 (15.7%) of patients who started on ART are no longer on the program including 2396 (5.3%) known patient deaths, 2673 patients transferred, lost to follow-up or dropped-out of the program (5.9%) and 2064 (4.6%) patients whose status were unknown.

CONCLUSIONS: The number on treatment is high, despite many challenges across settings, including uptake of pediatric patients; patient follow-up; management of toxicities/OIs and providing basic HIV care to the large number of patients either on treatment or not yet eligible for treatment. The number of children on ART needs to increase to meet existing needs. Many treatment sites have reached capacity, emphasizing the need to train both primary care facilities and non-physicians for management of HIV/AIDS C&T.

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2006-08-13
ThAb0201

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