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Community-based HIV home testing project in Butuo , Liangshan , Sichuan

Community-based HIV home testing project in Butuo , Liangshan , Sichuan. Humana People to People China. HPP in China .

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Community-based HIV home testing project in Butuo , Liangshan , Sichuan

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  1. Community-based HIV home testing project in Butuo, Liangshan, Sichuan Humana People to People China

  2. HPP in China • Humana People to People China works to create better development opportunities for disadvantaged people through solidary actions, standing shoulder-to-shoulder with those in need, striving for a better tomorrow. • HPP China is currently working with 14 projects in 3 provinces of China (Yunnan, Sichuan and Chongqing) within the sectors of San Nong (Sustainable Rural Livelihoods), Health, Education, Urban Communities, and Volunteer and Leadership Training. We have reached over 2.6 million people since we started projects in 2007.

  3. Our projects in China • Farmers’ Club • YN- Zhenkang, Yuanyang, • CQ- WZ, FD • Community Development • YN- ZK, XM • CQ- WZ • Preschools of the Future • YN-ZK, Shangrila • SC-Butuo • Total Control of the Epidemic - HIV/AIDS, Malaria, TB • TB – Kunming • TCE-Butuo

  4. HPP in Liangshan • CMAP PROJECT (2010.1- 2012.12) cooperated with Butuo Women Federation -- Accumulated number of visited households 21745, total 50514 people (including 6408 households living with HIV/AIDS, 6114 people living with HIV/AIDS, trained accumulated 445 women key persons / village women committee chief) -- Mobilized 1029 people to VCT by township clinics • New Zealand Embassy Total control of epidemic of HIV/AIDS project (2010.8 – 2012.7) -- Accumulated number of visited household 5489, total 26774 people -- Mobilized 603 people to VCT • Preschools of the Future project (2012.8-2013.8) Established 5 preschools covered 256 preschool aged children in Butuo

  5. Project profile Community based HIV home testing project in Butuo • Test the feasibility of community based home-based HIV rapid testing in areas in China with the highest generalized epidemic • Home visit and mobilize 2,400 people to VCT and HIV home testing • Visit 9600 people in 6 townships • 6 months with 4 weeks initial training

  6. Why we start the project • Butuo severe HIV prevalance, in the end of 2011, accumulated reported 8235 people, the infection rate of some township is more than 10% • Promote HIV Voluntary Counseling and Testing • Some villagers need to walk 1-5 hours to the township clinics for HIV test • VCT boost people behavior change, statistics show that 68% of people have changed their behavior after HIV test. • Receive support from local Bureau of Health, CDC etc

  7. Project structure • Butuo project team: • Project Leader- Li Jiancai • Project Manager- Yang Zhengqiang • 2 project officers (locals) • 6 Field officers (3 of them are village doctors) • Technical advisor - US CDC (GAP) • Technical support – Butuo CDC • HPP Kunming project office • HPP Beijing project office

  8. Project location selection • Target 5 townships have never had a HIV screening project • We have 20 months project in Butuo and have some experience in local area • Field officer are trusted by local people • Not lapped with CMAP covered townships

  9. Field Officer training • Invited Butuo CDC to train 6 Field Officers HIV VCT knowledge and practice (7 days training, 1 day practice) • After training, CDC tested 6 Field Officers. All 6 Field Officers passed the exam and got the certificates by CDC. • All the training and work are conducted by national laws and meet related requirements.

  10. HIV test certificate

  11. FO work procedure • a) HIV knowledge education • b) While talking, acquire the family background • c) Pre-test counseling – mobilize the family member to do HIV test • d) When agree to test, do the test • e) Fill the consent form and test registration form • f) Check the result (wait not less than 20 mins) • g) If positive, tell him/her need to do further test in township clinics and record his/her information, FO take him/her to township clinics for further test. • h）If negative, tell the result and HIV prevention knowledge in daily life, and protect one’s family • i）take away all the testing materials

  12. Work principle • Consider all people at risk • Principle of confidentiality • Principle of informed consent

  13. Monitoring and Evaluation • FO Weekly data report • Monthly meeting for data analysis • Monthly telephone meeting - Butuo project team, local CDC, Beijing office and Kunming office • Project staff onsite supervision • Butuo CDC onsite supervision monthly

  14. Data until now Counseling rate: 76.43% Testing rate: 66.26% Infection rate: 2.44%

  15. Data analysis • Reasons for refuse to test after counseling - Fear, don’t want to do the test (most are young people) - Local custom (tested positive will influence marriage) - Some people had tested before and don’t want to test again • Most people would like to do the test and know about HIV test • Positive result analysis 20 positive: • 8 - IDU • 4 - Family member • 3 - Young people with active sexual behavior and multiple sexual partner • 1 - PMTCT • 1 - Migrant worker • 1 - Not clear reason

  16. After test • Result negative: prevention education • Result positive: refer to township clinic, FO will take by himself. Get the final result after one month from township clinics or CDC. Do the first follow up visit with township clinics. Check the positive result with township clinic, avoid double test. Positive case get into township clinic management (CD4 test- twice a year, ARV treatment etc)

  17. Project experience until now • HIV knowledge aware rate improved, and people know the HIV/AIDS • Most of family would like to do HIV counseling and testing • People will do the test and mobilize family member to do the test • Some young people (sex active) don’t want to do the test • Make good use of the identity of local village doctor, village leader, increase the project credibility

  18. Project experience until now Local support from • Village committee • Township clinic • Butuo CDC • Liangshan CDC

  19. Significances Till now: • 20 found HIV positive • Tested 40 pregnant women • Enlarge the HIV screening in the target area • A complement to township clinic HIV test – focus on IDU, pregnant women, home-coming migrant worker, young people etc.

  20. Difficulties and Challenges • Big number of HIV+ • Big number of people under ARV treatment (1373 in the end of 2011, estimate 1800 in 2012) • Distance and time- Farthest village to township clinic is 4 hrs on foot, to county for one day time • Township clinic lack staff – each township clinic has 3 staff • Yi- Ethnic idea about HIV/AIDS • FO capacity training and improvement • Lack of test kits and equipment

  21. Next step • April 2013 - Project conclusion and feasibility analysis • HPP will look for more resources to support the project • Field officer capacity training • Keep working together with local health and CDC department to explore a best work model for local HIV/AIDS prevention and treatment

  22. Thank you!

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