The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66073

Paul D. Bouey, PhD, MPH¹, Eric P. Goosby, MD¹, Deborah von Zinkernagel, RN, MS¹, Agnes Binagwaho, MD², Abel Kagame, MD³, and Fidele Ngabo, MD³. (1) Pangaea Global AIDS Foundation, 995 Market Street, San Francisco, CA 94103, 415-581-7006, Paulbouey@sbcglobal.net, (2) Bureau de la Premiere Dame, BP 7162, Kigali, Rwanda, (3) Centrale Hopital de Kigali, BP 2593, Kigali, Rwanda

The Rwanda Family Package Project is a capacity-expansion program offering wrap-around care for HIV-infected mothers accessed through mother-to-child transmission (MTCT) projects. The pilot effort is situated at the Kacyiru Health Center, Kigali, Rwanda, and focuses on treatment of STIs and OIs, and use of antiretroviral (ARV) medications for an eligible cohort (CD4<200 or an OI).

Evaluation targets longitudinal monitoring of health status, quality of life (Medical Outcomes Study-HIV [MOS/HIV]), ARV adherence, prevention, and care delivery. Current data describe all women (and willing family members) who receive the HIV test, and HIV-positive clients who receive a baseline medical examination. Follow-up occurs at three-month intervals.

Test data represent 1400 clients (80% female), among whom HIV prevalence is about 12% (85% female). MOS/HIV data exhibit lower functional levels for 10 scales among the HIV-positive group, consistent with patterns from South Africa and Uganda. Past and current OIs are dominated by isosporosis and TB, while past and current STIs are dominated by syphilis and trichomonosis. Karnofsky scores are in the 90-100 range.

These data describe baseline for each client upon entry into this treatment program. Follow-up data will allow the longitudinal monitoring of care for each client and of the success of this local capacity expansion effort. This pilot project also represents a model from which expansion of this effort across the remainder of the country will emerge.

Learning Objectives:

• Attendees will learn about critical variables in the implementation of piloting and evaluating an ARV-based HIV care and treatment program in resource-poor settings.

Keywords: HIV/AIDS, Evaluation

Related Web page: www.pgaf.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.