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Program Updates Herby Derenoncourt, MD, MPH Deputy Chief of Party / AIDSRelief Martine Etienne-Mesubi, MPH, DrPH Direct

Program Updates Herby Derenoncourt, MD, MPH Deputy Chief of Party / AIDSRelief Martine Etienne-Mesubi, MPH, DrPH Director Health Programs, IHV/AIDSRelief. Providing Treatment, Restoring Hope. Who we are. Catholic Relief Services (CRS)

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Program Updates Herby Derenoncourt, MD, MPH Deputy Chief of Party / AIDSRelief Martine Etienne-Mesubi, MPH, DrPH Direct

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  1. Program Updates Herby Derenoncourt, MD, MPHDeputy Chief of Party / AIDSReliefMartine Etienne-Mesubi, MPH, DrPHDirector Health Programs, IHV/AIDSRelief Providing Treatment, Restoring Hope

  2. Who we are • Catholic Relief Services (CRS) • University of Maryland School of Medicine – Institute of Human Virology (IHV) • Futures Group (FG) • Catholic Medical Mission Board (CMMB) • IMA World Health (IMA)

  3. Where Do We Work? 34 4 7 18 29 226 Local Partner Treatment Facilities (LPTF)+ 150satellite sites 14 98 19 3 0

  4. AIDSRelief Model

  5. The AIDSRelief Approach Maintain the 1st line regimen For a natural lifetime Ensure durable viral suppression Building program capacity to support optimal adherence Patient follow up and engagement in care Reinforce and fund the community health treatment supporter as a vital therapeutic intervention for continuous community health

  6. Cum-Ever vs. Current on ART by Quarter Enrolled – 481,122

  7. Enrolled, Ever & Current on ART by Population Group(June 30, 2010) Adult Females Adult Males Pediatrics Enrolled HIV Care Cum-Ever on ART Current on ART

  8. Percent Pediatrics Active on ARTJune 30, 2010

  9. Adjusted Retention Rates (95% CI) by CountryJune 30, 2010

  10. Reason for Attrition by Country June 30, 2010

  11. On Treatment Viral Suppression in Randomly Selected Patients 2007 – 2009 89.23% overall viral suppression 11

  12. % of Patients receiving a baseline CD4 count at ART start by year A higher percentage of patients receive a baseline CD4 count over time

  13. Median CD4 at ART start by year We are enrolling healthier cohorts of patients over time N=81,813 (66%) with baseline CD4 count

  14. Median CD4 at ART start by Country Notice the healthier cohort of patients in some countries

  15. 5 year survival curves of ART Patients* by gender Significant difference was observed between males and females. Retention among adult females was significantly better than males.

  16. Survival curves of mortality by Country 50%of all deaths (5 countries) occur within 3 months of ART start When looking at median time to death by country Uganda: 5 months after ART start. Rwanda: 3 months after ART start. Kenya: 3 months after ART start. Tanzania: 3 months after ART start. Nigeria: 2 months after ART start. N=10,385 deaths

  17. Adherence Support and Percentage LTFU within first 12 mos. of AIDSRelief (Guyana, Haiti, Kenya, Nigeria, Rwanda, Tanzania,Uganda, Zambia) Etienne,M.,Hossain,B., Burrows,L.,Redfield,R.,Amoroso,A;2010.Situational analysis of varying models of adherence support and loss to follow up rates; findings from 27 treatment facilities in eight resource limited countries. Tropical Medicine and International Health vol 15 suppl. 1 pp 76–81

  18. Tiered Programs and Five year follow-up

  19. Current strategies • Targeting the mortality rate • 7.4% mortality rate • Focus on targeted interventions that will begin to improve the mortality rate

  20. Thank You

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