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Analyzing USG Emergency Plan Multi-Country ART Program: Scale-Up from 2004-2007

This analysis aims to evaluate the quantity and quality of HIV care and treatment programs supported by the US Government across Emergency Plan focus countries. The objective is to publish simple, informative results in a medical or public health journal. The program's success and challenges will be shared to inform the medical community and the public. The analysis will track patients enrolled in HIV care, on ART, and service quality indicators. The proposed title is "Scale-Up of Antiretroviral Therapy by Emergency Plan Multi-Country Partners: 2004-2007," with authorship by the Emergency Plan Multi-Country ART Partner and Agency Group. Contact John Aberle-Grasse for further details.

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Analyzing USG Emergency Plan Multi-Country ART Program: Scale-Up from 2004-2007

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  1. Plans for Analysis of USG Emergency Plan Multi-Country ART Program John Aberle-Grasse CDC, Global AIDS Program U.S. Department of Health and Human Services

  2. Analysis Proposal • Analyze the “quantity” and “quality” of HIV care and treatment programs supported by the USG multi-country partners across the 15 Emergency Plan focus countries • Publish “simple” description of results in a prominent medical or public health journal, submitted in approximately 9-12 months

  3. Analysis Rationale • The Emergency Plan ART program is very large and complex and should be monitored and evaluated to assess progress both in scale-up and service quality • Program success (and challenges) should be published to inform the medical and scientific community and the US public that supports the program

  4. Analysis Rationale • Track 1.0 grantees (4) and the Department of Defense and Family Health International provide direct ART services across multiple countries to over 1/3 of patients in the Emergency Plan • This large (relatively) standardized ART program data and reporting represents a unique and significant opportunity to describe the extent and quality of HIV care and treatment being supported by the USG

  5. Proposed Title and Authorship • Working title- Scale up of Antiretroviral therapy by Emergency Plan Multi-country partners: 2004-2007 • Authorship- Emergency Plan Multi-country ART Partner and Agency Group

  6. Analysis • Based on recommendations by the US Office of the Global AIDS Coordinator Adult Treatment Technical Workgroup for description of USG-funded HIV care and treatment programs • Describe services provided between Track 1.0 program start up in 2004 through Sept 30, 2007

  7. Analysis • Quantity of Program (scale up) Calculate quarterly- FY04Q4 to FY07Q4 • Patients ever enrolled in HIV care • Patients currently in HIV care • Patients ever started on ART • Patients started on ART during quarter • Patients currently on ART • Facilities providing ART

  8. Analysis • Quality of Program- (cohort) • Proportion alive and on ART (6, 12, 24 mos) • Including transfer in, excluding transfer out • Median difference in CD4 from start • Proportion with undetectable viral load (<400 cells/µl) • Proportion started on 2nd line ART • Proportion not on ART (6, 12, 24 mos) • Died • Stopped • Lost to follow up • Of those enrolled in HIV care, proportion on care at 12 months

  9. Administration of analysis • Task Force to guide and move analysis • Include participants from USG agencies and grantee partner groups • Contact John Aberle-Grasse at this meeting, or phone, or email • The USG work group includes: • CDC GAP: Tedd Ellerbrock, Laura Porter, Seymour Williams, Hong-Ha Truong, John Aberle-Grasse • USAID: Robert Ferris • HRSA: Jin Park • DoD: To be determined

  10. Analysis- Proposed time table

  11. Thoughts for Discussion • Do partners support this proposal? • Have quarterly data from Track 1.0 partners, is data for DoD and FHI readily available? • What disaggregation? (sex, age, country, partner, facility type) • How best do we “simplify” and present multi-country, multi-partner “quality” analysis? • Additional analysis of more detailed issues and data subsets • Other thoughts?

  12. For more information contact: John Aberle-Grasse CDC GAP 1600 Clifton Rd, MSE 30 Atlanta, GA 30333 404.639.6201 Email: JAberleGrasse@cdc.gov

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