260213 Reaching and linking substance abusing vulnerable women in South Africa to HIV testing and care after PEPFAR

Wednesday, October 31, 2012 : 8:50 AM - 9:10 AM

Wendee M. Wechsberg, PhD , Substance Abuse Treatment Evaluations and Interventions, RTI International, Research Triangle Park, NC
Tracy Kline, PhD , Stat Epi, RTI International, Durham, NC
William A. Zule, DrPH , Substance Abuse Treatment Interventions and Evaluations, RTI International, Research Triangle Park, NC
J. Ndirangu , Substance Abuse, RTI International, Research Triangle Park, NC
Jessica Hopkins, MPH , Substance Abuse Treatment Evaluations & Interventions Research, RTI International, Durham, NC
Rachel Middlesteadt-Ellerson, BA , Substance Abuse Treatment Evaluations & Interventions Research, RTI International, Durham
Issues: PEPFAR has been the greatest resource in South Africa for HIV testing and treating with ARVs. However, because of the lack of targeted outreach endeavors, these large scale efforts have had limited success reaching vulnerable drug users. Drug using women are at extremely high risk and among those who test HIV+ less than 20% initiate treatment. In a recently completed NIH trial in Pretoria, 63% of drug using female sex workers tested HIV+ and 32% of other drug using women tested HIV+. Yet many were unaware of available HIV care options or how to access services. Further, they often felt stigmatized. Description: A newly awarded NIDA-funded study plans to reach similar women in a prospective, geographically clustered, randomized two-group design to compare the standard HIV testing and referral methods in a large PEPFAR-funded program with an enhanced woman-focused HIV prevention intervention along with referral, tracking and ART retention for HIV+ women. Lessons Learned: Since the award, PEPFAR in South Africa has changed its priorities and partners have moved into technical assistance, leaving reach, test, and referral to health care linkages in question. Therefore, health departments and local organizations are still working at filling in the gaps to create a network that assures linkages to care and treatment for vulnerable people. Study trials must adjust and test the realities of real on-the ground practice. Recommendation: Strategic planning for vulnerable women who have the greatest rate of HIV is essential.

Learning Areas:
Administer health education strategies, interventions and programs
Diversity and culture
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Explain issues in South African regarding HIV and women. 2. Describe an international community-based trial.

Keywords: Women and HIV/AIDS, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I have more than 25 years experience in the field and have a PhD in the content area.
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.