472. METHODS. RESULTS. BACKGROUND. Access to care by seroconvertors: MDP 301 Trial.
Access to care by seroconvertors: MDP 301 Trial
The HIV Prevention Research Unit (HPRU) of the Medical Research Council conducts research focusing mainly on female controlled HIV prevention options. Over the past 7 years the HPRU as conducted 5 large phase III clinical trials assessing different interventions for HIV prevention and enrolled over 7000 women. The trials were conducted at 7 community based research sites in the Durban and surrounding areas. Given the high HIV prevalence and incidence in our setting, every effort was made to integrate HIV prevention with treatment and care.
MDP 301 Trial Referral Process
Uptake of HIV Related Care Among Seroconvertors—Implications for VOICE or future HIV prevention trialsSharika Gappoo*, Sarita Naidoo, Yuki Sookrajh, Neetha Morar and Gita RamjeeHIV Prevention Research Unit, Medical Research Council, South Africa
Lost contact /LTFU
Access to HIV related care in resource poor settings can be attributed to the unavailability of efficient health services, financial constraints, stigma and other social barriers to care. Although South Africa has an established ARV Treatment programme, at the end of 2007 less than 31% of adults and children requiring ARV therapy were receiving it.
To help facilitate the referral process of trial participants to accessing care, the HPRU established a Memorandum of Understanding (MOU) with the Provincial Department of Health (DoH) and its associated service providers. This MOU was intended to help trial participants to access care related to HIV/AIDS, reproductive health and psychosocial care.The Referral process included:Counselling HIV positive participants at sites and then referring them for ongoing care to a public health service provider.Provision of a referral letter by the attending clinician or counsellor.Maintaining and updating a Referral log to include the details of the service providers closest to the trial sites.This sub-study examines the outcomes of the referrals provided to participants for HIV related care for 2 trials- -- HIV prevention trial: MDP 301- A randomised controlled trial testing Pro 2000 (05% and 2%) microbicide gel in 4 countries in Africa. -- 1 HIV treatment trial: SPARTAC- (Short Pulse Antiretroviral Therapy at HIV Seroconversion).
Refused to access care
Enrolled in treatment Trial
These 11 women joined the SPARTAC trial and are currently receiving care through this project
Many did not take up referrals due mainly to denial, stigma and other commitments (work, caring for children, etc.)
For most women it took several counselling sessions and a lot of encouragement before they eventually attended local clinics
SPARTAC Trial Referral Process
Access to care by participants: SPARTAC Trial
Total enrolled in SPARTAC Trial
N = 87
Not Enrolled in
Previously enrolled in
National ARV Programme but discontinued
Some participants are still in denial of their HIV status or still feel healthy and don’t see the urgency to attend.
Of the 12 eligible for ARVs (CD4<200 copies/ul)-
11 are currently on long term treatment
Reasons for not attending follow up include: Time and cost constraints. Some do not have treatment supporter that can attend treatment classes with them
Acknowledgements: The participants of MDP and Spartac trials, The HPRU staff that contributed to the data, The Microbicides Development Programme (MDP) is a partnership of African, UK and Spanish academic/government institutions and commercial organisations.,
MDP is funded by the British Government Department for International Development (DIFD) and the UK Medical Research Council. MDP trial ISRCTN number is: ISRCTN64716212, The Clinical Trials Unit: SPARTAC Team; Welcome Trust: Subcontract Agreement Protocol No.:09