Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109940

Mardge Cohen, MD, Medicine, The CORE Center of Cook County Hospital, 2020 W. Harrison Street, Chicago, IL 60612, 312-572-4551, mcohen@corecenter.org, Kathryn Anastos, MD, Women Interagency HIV Study, Montefiore Medical Center, 3311 Bainbridge Avenue, Bronx, NY 10467, and Anne-christine D'Adesky, Journalist, Global AIDS Issues, 3345 22nd street, San Francisco, CA 94110.

Background: Rwandan associations of widows and women raped during the 1994 genocide issued an international call to facilitate antiretroviral (ARV) treatment for women with HIV becoming symptomatic in late 2003.

Methods: Women's Equity in Access to Care and Treatment for HIV/AIDS Initiative (WE-ACTx), a U.S. NGO met with Rwandan Women's Associations and Rwandan Treatment and Research AIDS Center in April 2004 to address the health needs of women with HIV. The National Institute of Health funded the Rwandan Women's Cohort (RWIZA), a joint effort by U.S. and Rwandan investigators, to study the interaction of violence, disease progression and toxicity of ARVs as women begin ARVs.

Results: Stigma, shame, poverty, hunger, reliving the trauma from genocide, and transportation costs were identified as obstacles to HIV testing/treatment. A government supported clinic utilizing the infrastructure of the Rwandan women's associations and clinical and financial assistance of WE-ACTx began July 2004 to overcome these barriers. By January 2005, 800 patients had been evaluated; over 300 had been started on ARVs. Median CD4 cell count was 241; median body mass index was 21.4. The World Food Program provides nutritional support for 300 families. Interview and clinician training for baseline and 6 month study visits was completed and enrollment for the RWIZA study of 1000 women begins March 1, 2005.

Conclusions: A decentralized empowerment model of HIV care/services that links government services to existing women's NGOs and relies on training/active participation of HIV positive women provides a sustainable infrastructure for rapid scale up of HIV treatment.

Learning Objectives: