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APHA Scientific Session and Event Listing

Joy Amulya, PhD¹, Melissa Edoh, BS², Pamela S. Van Horn, MEd³, and Suresh Subramanian, PhD². (1) Preventive Medicine and Biometrics, University of Colorado School of Medicine, 4200 E. Ninth Avenue, C-245, Denver, CO 80262, 970-443-9426, joy.amulya@uchsc.edu, (2) Arm's Reach Care Program, Power of Love Foundation, 4747 Morena Boulevard, Suite 375, San Diego, CA 92101, (3) School of Education, University of Denver, Room 212, Wesley Hall, 2135 East Wesley Avenue, Denver, CO 80208

Background: Arm's Reach Care (ARC) was developed as part of a “community innovation lab” aimed at introducing innovations for strengthening communities and families to respond to HIV and AIDS in resource-scarce settings. This paper discusses an outcomes evaluation of the ARC model for a community-based network of care and treatment to support in-home treatment and care for HIV-positive children in Lusaka, Zambia. The network integrates family caregivers, community care assistants, and a program nurse. Methods: Longitudinal data collection was carried out on 100 symptomatic HIV-positive children in the program. Evaluation measures focused on descriptive data in five outcome areas: survival rates, linkage to anti-retroviral therapy (ART), incidence and reasons for clinic visits, child health (rates of opportunistic infection, change in initial health status), and family health (rates of testing, incidence of clinic visits). Clinic records data were also compiled for similar children in the same community to allow descriptive comparisons. Results: Evaluation results show program participants had high survival rates, stabilized health, high rates of ART enrollment and adherence, and reduced impact on health clinics due to home management of common conditions. In comparison to clinic records data for similar children, program participants achieved higher levels on all outcomes. Conclusions: The ARC model of in-home care incorporating family caregiver training and community-based support can result in stabilizing children's health and reducing clinic load from the escalation of common conditions. Results suggest it would be beneficial to replace traditional palliative-only models of home-based care in resource-scarce settings with an ARC model.

Learning Objectives: Participants in the session will come away with the following learning

• Recognize the need for innovation in community-based HIV care in resource-scarce settings.
• Identify the elements of the Arm's Reach Care model for in-home HIV care and treatment.
• Assess five areas of impact for participants in the Arm's Reach Care program in Lusaka, Zambia.

Keywords: Community Health, HIV/AIDS

Presenting author's disclosure statement:

Not Answered