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Reflections on Outcomes Achieved:. Your Work; Your Successes!. June 10 – 23, 2000. HAETC staff visited American Samoa CNMI FSM Guam Palau RMI To understand HIV/AIDS in the Northern Pacific. The HAETC Team Learned. Diabetes, Hypertension, Coronary heart disease, TB

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reflections on outcomes achieved

Reflections on Outcomes Achieved:

Your Work; Your Successes!

june 10 23 2000
June 10 – 23, 2000
  • HAETC staff visited
    • American Samoa
    • CNMI
    • FSM
    • Guam
    • Palau
    • RMI
  • To understand HIV/AIDS in the Northern Pacific
the haetc team learned
The HAETC Team Learned
  • Diabetes,
  • Hypertension,
  • Coronary heart disease,
  • TB
  • Demanded most of the medical and public health resources
  • However…
slide7

Had active HIV positive patients at that time.

  • Health professionals were eager to:
    • Prevent new infections
    • And care for HIV positive patients
throughout the region
Throughout The Region
  • There was interest in
  • Developing laws regarding HIV disease,
  • Establishing hospital and outpatient policies/procedures,
  • Reviewing confidentiality issues
  • Understanding/acquiring meds for
    • PEP,
    • Pregnant women,
    • and OI
guam in june 2000
Guam in June 2000
  • Guam had the largest number of HIV/AIDS cases in the US Pacific Islands.
  • 135 cases:
    • 23 people living with AIDS;
    • 73 known to be living with HIV;
    • 38 deaths due to HIV
guam in june 200012
Guam in June 2000
  • First pediatric case in 2000 was a child < 5
  • Chamorros and Micronesians comprised the majority of HIV cases
cnmi in june 2000
CNMI in June 2000
  • Saipan reported 29 HIV positive people
    • 2 perinatal cases
    • 5 people living with AIDS.
  • There were an estimated 300 infected with HIV
  • There was one HIV positive man in Saipan who visited most of the jurisdictions speaking about HIV. He made a positive impact
palau in june 2000
Palau in June 2000
  • There were two known cases of HIV in Palau – both were deceased
  • No known HIV+ people living in Palau at that time.
  • Testing was offered to people with:
    • STD’s,
    • TB,
    • Blood donors,
    • People seeking physical exam,
    • Pregnant women
yap in 2000
Yap in 2000
  • Yap had two HIV+ people.
    • A man who worked and was infected off-island (and who died in 2000)
    • Infected a woman who became pregnant.
      • The woman was 30 years old,
      • It was her third pregnancy.
      • The baby was born and at the time of the visit, 3 months old.
yap in 200019
Yap in 2000
  • They found that the woman was HIV positive in prenatal screening in September 1999.
  • Yap routinely tested all
    • pregnant women,
    • alien workers,
    • students at physicals,
    • and any donated blood.
pohnpei in 2000
Pohnpei in 2000
  • HIV testing had commenced in May 2000
  • Testing was anonymous and required client consent.
  • HIV testing was offered
    • with premarital exams,
    • at student physicals,
    • to food handlers,
    • and to pregnant women.
  • Donated blood was not screened.
kosrae in 2000
Kosrae in 2000
  • No known HIV cases in Kosrae at that time.
  • It was reported that 13 years previously
    • a Kosraean man was diagnosed on the U.S. mainland,
    • And came home to Kosrae to die.
  • There was some social discomfort with this situation
chuuk in 2000
Chuuk in 2000
  • The team was unable to visit Chuuk at that time,
  • But met with representatives in Pohnpei.
  • There were 3 known HIV cases,
  • One person had come home to Chuuk to die,
rmi in 2000
RMI in 2000
  • Doctors told the team that there had been 9 HIV cases among the Marshallese (excluding foreigners and military).
rmi in 200028
RMI in 2000
    • 3 were diagnosed in California,
    • 3 in Guam,
    • and 3 in Hawaii.
    • None were presently in RMI.
  • HIV medications were not accessible, but the medical staff was enthusiastic about providing care
american samoa in 2000
American Samoa in 2000
  • There were no known HIV cases
  • There had been 6 cases of patients with end-stage AIDS -- all of who had died.
    • The most recent patient died in 1998.
  • There was an infrastructure for HIV/AIDS prevention
    • Fara Utu, RN,
    • Led a very active HIV/AIDS Program
visit ideas
Visit Ideas
  • Provide HIV information via clinical conferences,
    • To Jurisdiction-based clinicians
    • And support a network of region-wide HIV clinicians to share ideas about patient care,
    • You have built a network of clinicians and trainers spanning a vast area…
visit ideas continued
Visit Ideas, continued
  • Provide clinical assistance with PEACESAT conferencing to give clinicians access to any needed information
visit ideas continued36
Visit Ideas, continued
  • Provide one-week mini-residencies for clinical care information
in 2000 vs 2008
In 2000 vs 2008

Written universal precautions protocol?

American Samoa:

CMNI:

2000 – No

FSM; Chuuk:

FSM; Kosrae:

FSM; Pohnpei:

2008 – Yes

FSM; Yap:

Guam:

Palau:

RMI:

in 2000 vs 200839
In 2000 vs 2008

Written testing/counseling protocol?

American Samoa:

CMNI:

2000 – No

FSM; Chuuk:

FSM; Kosrae:

FSM; Pohnpei:

2008 – Yes

FSM; Yap:

Guam:

Palau:

RMI:

in 2000 vs 200840
In 2000 vs 2008

Written perinatal protocol?

American Samoa:

CMNI:

2000 – No

FSM; Chuuk:

FSM; Kosrae:

FSM; Pohnpei:

2008 – Yes

FSM; Yap:

Guam:

Palau:

RMI:

in 2000 vs 200841
In 2000 vs 2008

Written PEP protocol?

American Samoa:

CMNI:

2000 – No

FSM; Chuuk:

FSM; Kosrae:

FSM; Pohnpei:

2008 – Yes

FSM; Yap:

Guam:

Palau:

RMI:

in 2000 vs 200842
In 2000 vs 2008

Best Practices HIV treatment information:

American Samoa:

CMNI:

2000 – No

FSM; Chuuk:

FSM; Kosrae:

FSM; Pohnpei:

2008 – Yes

FSM; Yap:

Guam:

Palau:

RMI:

in 2000 vs 200843
In 2000 vs 2008

Recognition of HIV Signs/Symptoms:

American Samoa:

2000 – No, 2008 – Yes

CMNI:

2000 – No, 2008 – Yes

FSM; Chuuk:

2000 – No, 2008 – Yes

FSM; Kosrae:

2000 – No, 2008 – Yes

FSM; Pohnpei:

2000 – No, 2008 – Yes

FSM; Yap:

2000 – No, 2008 – Yes

Guam:

2000 – Yes, 2008 – Yes

Palau:

2000 – No, 2008 – Yes

RMI:

2000 – No, 2008 – Yes

in 2000 vs 200844
In 2000 vs 2008

Regional HIV Trainers now available:

CMNI:

Dr. James Hofschneider

FSM; Chuuk:

Dr. Yoster Yichiro

Eleanor Sos, RN, NP

FSM; Pohnpei:

Dr. Elizabeth Keller

Nancy Lynn Edwards RN NP

Mercedes Gilmete

FSM; Yap:

Dr. James Edilyong

Palau:

Dr. Selaima Lalabalavu

RMI:

Dr. Zachraias Zachraias

Dr. Chocho Thein

thank you
Thank You!
  • We’re excited about the next steps.
  • But we’ll need your guidance over the next few days and next few months to help us understand your needs.