175836 Family-focused integrative care of trauma and HIV/AIDS with Rwandan families

Monday, October 27, 2008: 1:00 PM

Mary Fabri, PsyD , Marjorie Kovler Center for the Treatment of Survivors of Torture, Chicago, IL
The 1994 genocide in Rwanda left a legacy of trauma and HIV/AIDS. In an initial assessment conducted in 2005 by Women's Equity in Access to Care & Treatment (WE-ACTx), 65% of 912 women responding to the Harvard Trauma Questionnaire (HTQ) met the criteria for Post Traumatic Stress Disorder. Additionally, 76% of 819 women screened positive with depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) during a primary care visit. The high levels of psychological distress signal a strong need to address the mental health of women in a post-conflict society, many who are living with HIV/AIDS. This presentation will describe a family-focused integrative model of care that includes peer advocates, trauma counselors, a psychologist, nurses, and physicians working together to provide medical, mental health, and social services to more than three hundred women and their families living with HIV/AIDS in Kigali, Rwanda. 35% of the families are single parent households and 17% are child-headed households. A peer advocate or trauma counselor assesses the psychological functioning and social needs of the family by conducting home visits. In addition to the residual trauma of the genocide and living with HIV/AIDS, poverty related issues such as hunger are prevalent with 43% of the families reporting eating one meal a day. Other traumatic events such as domestic violence and sexual abuse are also being identified. Home visit assessments allow the treatment team to identify non-medical obstacles to care with psychosocial interventions and promote adherence to treatment.

Learning Objectives:
1. List the mental health components of integrated HIV care for women with HIV in low resource countries. 2. Articulate the components of integrated HIV care providing wrap around services. 3. Describe the human rights basis of integrated HIV care for women.

Keywords: HIV/AIDS, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the consulting psychologist for this program and have provided input on the development, implementation, and maintenance of the family-focused mental health components spending approx. 3 mos./year in Rwanda.
Any relevant financial relationships? No

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.