3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

EXPANSION OF HIV/AIDS CARE AND TREATMENT PROGRAMS IN 5 COUNTRIES IN SUB SAHARAN AFRICA

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. MoOa0206

Nash D.¹, Hoos D.¹, Rosenthal M.¹, Musick B.², Fraser Chanpong G.³, Reed K.⁴, Casey S.⁵, Hawken M.³, Macharia D.⁴, Lima J.⁶, El Sadr W.^1
1Columbia University, Mailman School of Public Health, New York, United States of America, ²Indiana University, Indianapolis, United States of America, ³Columbia University Tanzania, Dar Es Salaam, United Republic of Tanzania, ⁴Columbia University South Africa, East London, South Africa, ⁵Columbia University Rwanda, Kigali, Rwanda, ⁶Columbia University Mozambique, Maputo, Mozambique

INTRODUCTION: Expansion of HIV care and treatment is a global priority. Funded via PEPFAR, the Multicountry Columbia Antiretroviral Program (MCAP) supports HIV care and treatment programs and sites in 5 sub-Saharan African countries (Kenya, Mozambique, Rwanda, South Africa, and Tanzania) since February 2004 with the goal of rapid enrollment of HIV-infected patients.

METHODS: Data from patients enrolled at 16 facilities through December 2004 were compiled using a variety of methods depending on the country and facility. Demographics and antiretroviral therapy (ART) status were assessed for patients enrolled through September 2004, and from October– December 2004.

RESULTS: Through December 2004, 9,456 patients (69% female) enrolled in MCAP-supported sites. Of these, 43% (4,061/9,456) were prescribed ART. Among the 4,061 patients receiving ART, 10,498 ART prescriptions were dispensed during October-December 2004. Females comprised 69% of those enrolled in care and 67% of those on ART; however among those enrolled, a slightly greater proportion of males received ART care (47% vs. 43%). Children age 0-14 years (n=1,056) comprised 12.4% of those enrolled and 8.4% of those on ART; 29.6% of enrolled children had started ART. During the period October-December 2004, 3,328 new patients were enrolled, 1,355 (41%) of whom were placed on ART. Of 2,681 patients placed on ART through September 2004, 240 (8.9%) didn’t receive ART during October-December 2004. Reasons were loss to follow-up (5.0% [150/2,681]), death (2.0% [54/2,681]) and stopping ART (1.9% [51/2,681]).

CONCLUSIONS: Rapid enrollment of patients can be successfully accomplished, even at sites without prior experience. Programs were able to enroll women and children, possibly reflecting HIV testing in antenatal clinics. A greater proportion of men were on ART, suggesting a more advanced stage of disease. Collection of information on response to ART, adherence, loss to follow-up, and deaths is an important priority in order to improve the efficiency and quality of programs.

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