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RMI HIV Program Update and Overview Date: June 14, 2009

RMI HIV Program Update and Overview Date: June 14, 2009. By Republic of the Marshall Islands Dr. Zachraias Zachraias Chief of the STI and HIV Program. Background. The estimated population of RMI is 52,700 people (2007).

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RMI HIV Program Update and Overview Date: June 14, 2009

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  1. RMI HIV Program Update and Overview Date: June 14, 2009 By Republic of the Marshall Islands Dr. Zachraias Zachraias Chief of the STI and HIV Program

  2. Background • The estimated population of RMI is 52,700 people (2007). • The Republic of the Marshall Islands (RMI) consists of 29 atolls and five islands in the Pacific Ocean between Hawaii and Australia. • >70% of total population residing on the two urban atolls (Majuro and Kwajalein). • From 1984 through 2008, 18 HIV/AIDS (11 HIV and 7 AIDS) and one infant cases have been reported in RMI. (2008) • There are many unreported cases of HIV oversea in USA, Guam and elsewhere. • In 2008, there are four new confirm HIV cases and one two month old baby girl who died few days after diagnose established.

  3. Background . Currently, the RMI cumulative reporting number is 18 adult cases and one infant case. (exclude 2009 case in Ebeye). • Currently there are five HIV cases residing in Majuro the Capital City of Marshall Islands. (exclude 2009 case in Ebeye). • Two are on ARV treatment for more a year and two just started last month and one will start soon. • After numerous attempt in sending blood samples for the confirm HIV cases to Honolulu for CD 4 and viral load, all five patients finally have a baseline CD 4 and viral load test available.

  4. 1. Situation of HIV care and treatment

  5. 4. Existence of a central unit to manage and coordinate HIV/AIDS care and treatment

  6. 4. PMTCT AND PEP HIV/AIDS PROTOCOL

  7. 7. Partnership and /or coordination between public clinical services, peer support groups and CBOs/NGOs for continuum of care for PLWHs

  8. 8. Supply management system for selection, distribution and use of ARV drugs 9. Patient monitoring system (linked to drug supply)

  9. Total HIV Case by Sex & 10 Years Interval

  10. HIV/AIDS Cases by Status

  11. HIV/AIDS Cases by Mode of Transmission

  12. Cases by Staging.

  13. HIV Cases by Age-Distribution:

  14. HIV Cases by Status

  15. 10 years interval Case by status case of staging Mode of transmission

  16. Unknown age. Age Distribution

  17. HIV and STI Epidemiological situation: an example of slide (1) • (1) : the use of graphs or charts can be added to the template. Additional slides may be added if deemed necessary. • (*)Can be specific disease or STI syndromes (urethral discharge, vaginal discharge,…) • [**]:Can be reported cases or prevalence of infections documented by SGS or other special surveys.

  18. Challenges Merging HIV and STD program into one management is overwhelming and sometime difficult to address multiple tasks. (Pro and Con) Clinical manager is wearing too many hats and responsible for multiple activities. ( lack of human resource/manpower) Delay in line of communication with the hierarchy level. Shortage of ARV at one point in time. Lack of Counselors to do home or follow up visit.

  19. Challenges • Limited number of CBOs or NGO involving with awareness activity for the HIV and STD. • HIV CTR is only conducted at the Hospital setting for example at the program and ANC. • Absenteeism (staffs and other professional) • Lack of nurses from the relevant clinics such as TB and inpatient are not train to do CTR. • Different reporting database system are use throughout the three MOH bureaus. 1. Majuro Hospital. 2. Ebeye Hospital. 3. Outer Islands Health Care Service. • Lack of knowledge and skill on the database system or surveillance system.

  20. Future programme priorities Upgrading the clinical skill and knowledge of the clinicians and nurses on the current management of the HIV and AIDS. Maintain the availability of the ARV supply in the Republic of the Marshall Islands through the cooperation and assistance of SPC, AETC, and Ryan White program. Expand the HIV CTR to other clinical service like TB program or inpatient wards and also to the Community Health Center like Laura clinic and YTYIH and etc. Negotiate with the PLWHA to involve or participant with the HIV Care Team Committee.

  21. Future programme priorities Upgrading the database and surveillance system for the HIV and STD program by training all the staffs both for Majuro and Ebeye for Epi Info system and excel program. Hire more nurse and coordinator and counselor to the HIV program to expand the human resource capacity. (Global Fund) Maintain the monitoring system and drug inventory to avoid shortage of ARV supply. Constant and frequent follow up with the hierarchy for any urgent issues or matter that pertain to the operation of the program.

  22. The End Thank and Komol tata!!!

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