152352 An Integrated Approach to ARV Delivery: IPPF's experience in the Dominican Republic

Monday, November 5, 2007

Jessica Halverson, MPH, LMSW , International Planned Parenthood Federation/Western Hemisphere Region, New York, NY
Jane Galvao, PhD , International Planned Parenthood Federation/Western Hemisphere Region, New York, NY
Magaly Caram, PhD , International Planned Parenthood Federation/Western Hemisphere Region, New York, NY
Aleisha Rozario, MPH , Jhpiego, Lilongwe, Malawi
Background: PROFAMILIA, IPPF's Member Association in the Dominican Republic, piloted a one-year project to introduce comprehensive HIV/AIDS treatment and care into two of its sexual/reproductive health (SRH) clinics. At the time, most Dominicans in need of antiretroviral (ARV) treatment had no access.

Design/Methods: The treatment approach rested on seven key elements: staff training, a multi-disciplinary team approach, pre- and post-test counseling, laboratory tests, support groups, and monitoring treatment adherence. IPPF conducted evaluation via case studies and focus groups, review of service statistics, and implementation of pre- and post- knowledge, attitude, and practice (KAP) surveys.

Results: After one year, PROFAMILIA was providing services to more than 165 HIV-positive clients, with 67 receiving ARV treatment and an adherence rate of 95%. KAP analysis indicated improvements in staff knowledge and attitudes. Focus groups identified numerous health and psychosocial benefits to providing HIV treatment and care in an integrated clinical setting.

Conclusion: Multi-sectoral partnerships, one-on-one staff training and supervision, multidisciplinary team approach, and empowering clients through self-run support groups all proved to be critical elements of this model. Programmatic challenges included long-term sustainability concerns, including staff time, funding, and continuous access to ARVs. Both clinics are now in the Dominican National AIDS Care Network, and the government will also replicate PROFAMILIA's model of care.

Learning Objectives:
At the conclusion of this presentation, participants will be able to: 1) Identify key elements for implementing comprehensive HIV treatment and care services; and 2) apply similar methods for integrating HIV/AIDS services in sexual/reproductive health (SRH) care settings.

Keywords: Service Delivery, International

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.