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APHA Scientific Session and Event Listing

Recorded presentation

Wendy Johnson, MD, MPH¹, Florencia Floriano¹, Esperanca Tavede², and Mark A. Micek, MD, MPH³. (1) Health Alliance International, PO Box, Chimoio, Mozambique, 258 (0)82 5010720, wjohnson@teledata.mz, (2) Mozambican Minstry of Health, Chimoio DPS, Chimoio, Mozambique, (3) International Health Program, Department of Health Services, University of Washington, Box 354809, Seattle, WA 98195

Background: HIV treatment scale-up is improving HAART availability for marginalized populations in sub-Saharan African, but small programmatic differences have important consequences. Central Mozambique has two models of treatment delivery, centralized treatment clinics in provincial hospitals and decentralized treatment offered through smaller health centers. All women testing positive in ANC/pMTCT programs near treatment sites are referred to HIV treatment clinics.

Methods: Using routine data collected by treatment centers and pMTCT program sites, we compared on-site vs. off-site, same-city treatment clinics based on the following indicators: rate of referral from pMTCT to treatment, CD4 testing, and proportion of eligible women receiving HAART.

Results: A higher proportion of women referred from pMTCT programs to onsite clinics enrolled for care than those referred to off-site, nearby clinics (77.0% vs. 28.3%, OR 8.46, p<.001). Once registered, there was no significant difference in the percent of eligible women receiving HAART (off-site 33.3% vs. onsite 41.3%, p=.61), however on-site treatment centers obtained CD4 counts on a lower proportion of enrollees (66.1% vs. 80.6%, OR=.47).

Conclusion: Pregnant women face significant barriers in accessing definitive HAART treatment. Decentralizing treatment to health centers with ANC/pMTCT provides better access to treatment centers but still showed low rates of providing HAART to eligible pregnant women.

Learning Objectives:

• 1. Recognize challenges in providing HAART to eligible pregnant women in Central Mozambique.
• 2. Identify the advantages and disadvantages of centralized vs. decentralized treatment clinics for HIV positive pregnant women.

Keywords: Women and HIV/AIDS, International Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation