243192 Community involvement approach strengthens antiretroviral retention rates in Inhambane: Recommendations for best practices

Monday, October 31, 2011

Joana Falcão, LPsy , Technical Services, Pathfinder International Mozambique, Maputo, Mozambique
Ana Deise, LPsy , Pathfinder International Mozambique, Maputo, Mozambique
Bibi Aly, LPsy , International Center for AIDS Care and Treatment Programs Mozambique (ICAP)/ Columbia University, Maputo, Mozambique
Guideon Baul, MD , Hospital Rural de Chicuque, C.P., Inhambane, Mozambique
Susan White, MPIA, MPH , Program Systems Unit, Pathfinder International, Watertown, MA
Issues: Antiretroviral therapy (ART) became available in Mozambique in 2005. With increased access to ART, high rates of loss to follow-up (LTFU) are threatening program outcomes. According to the Ministry of Health's national data, the LTFU rate was 15% in 2009 and 18% by December 2010.

Description: In partnership with the International Center for AIDS Care and Treatment Programs Mozambique, Pathfinder International has been implementing a community involvement approach to addressing LTFU since February 2009. The program trains people living with HIV (PLHIV) volunteers as peer educators (PEs) to conduct home visits to defaulters and other vulnerable patients, and implement community sensitization activities to promote an enabling environment for ART adherence and retention. All PEs work with the support of community leaders (CLs) and community-based organizations (CBOs), receiving regular training updates, including HIV/ART/Tuberculosis, positive prevention, adherence, and community mobilization.

Lessons learned: Program data show as much as a 5% drop in global LTFU rates since implementing the PLHIV–PE approach. One health facility in Inhambane showed a decrease in overall LTFU from 25% in June 2009 to 20% by December 2010. Integration of PLHIV as PEs into existing CBO and CL programming increased the program's retention rate.

Recommendations: Programs challenged by high LTFU rates may benefit from this integrated PLHIV–PE program strategy. The authors recommend replicating this effective approach in other HIV care and treatment facilities.

Learning Areas:
Program planning
Provision of health care to the public

Learning Objectives:
1. Design community-based approaches to HIV treatment programs. 2. Define the role that PLHIV peer educators can have in planning and implementing effective ART programs.

Keywords: Adherence, Community-Based Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-author on this abstract therefore I will be able to present on behalf of the first author who is unable to travel to the US.
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.