MSH Presents at 2015 International AIDS Society Conference

MSH Presents at 2015 International AIDS Society Conference

 {Photo credit: MSH staff.}MSH staff at IAS2015 included: Dr. Ndulue Nwokedi, Deputy Project Director, Pro-ACT; Dr. Ginika Egesimba, Senior Clinical Advisor, TB/HIV, Pro-ACT; Emmanuel Nfor, Principal Technical Advisor, SIAPS; Dr. Andrew Etsetowaghan, Clinical Advisor, PMTCT, Pro-ACT.Photo credit: MSH staff.

Management Sciences for Health (MSH) presented seven abstracts at the 8th International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) in Vancouver, Canada, July 19-22, 2015.

The abstracts highlighted innovative models and tools to improve HIV and AIDS prevention, care, and support services used by three MSH-led projects: Prevention Organizational Systems AIDS and Treatment (Pro-ACT) and Community-Based Support for Orphans and Vulnerable Children in Nigeria (CUBS, completed in 2014), both funded by The US President’s Emergency Plan for AIDS Relief (PEPFAR) and US Agency for International Development (USAID); and the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS). Below are summaries of the seven abstracts.

Cameroon

Strengthening Supply Chain for Women and Newborns

In Cameroon, unmet need for antiretroviral therapy (ART) among HIV-positive pregnant women stands at 66 percent. Ensuring the availability of ART commodities is essential for preventing the spread of the disease through mother-to-child transmission (PMTCT). Emmanuel Nfor of SIAPS presented the poster (Addressing the Unmet Need for ART among Women and Newborns in Cameroon by Strengthening the Supply Chain of PMTCT Commodities, PDF).

Nigeria

Early infant diagnosis: The SPEEiD Model

[The SPEEiD Model improves logistics for early infant diagnosis of HIV in Nigeria.] {Photo credit: MSH staff}The SPEEiD Model improves logistics for early infant diagnosis of HIV in Nigeria.Photo credit: MSH staff

Dr. Ndulue Nwokedi, deputy project director for Pro-ACT, presented an oral abstract and poster (Improving Dried Blood Spot Transport Logistics for Early Infant Diagnosis in Nigeria: ) about Pro-ACT’s unique dried blood spot transport model for early infant diagnosis (EID) of HIV in Nigeria, called the SPEEiD Model. This model utilizes national postal service routes to reduce costs (by 30 percent), and to reduce the turnaround time between sample collection and return of EID results to 28 days or less (compared to 3 to 6 months previously).

Co-authors included Andrew Etsetowaghan and Chima Gabriel.

Task shifting for Tuberculosis screening

Ginika Egesimba, Emmanuel Nwabueze, Abdulraheem Abubakar, Joy Kolin, and Andrew Etsetowaghan's poster (Effective use of task shifting for TB screening among PLHIVs in Rural Clinics in Northern Nigeria) focused on Pro-ACT’s use of the World Health Organization’s four tuberculosis (TB) symptom screening criteria, and its effectiveness in excluding TB for patients declared non-TB suspects before commencement of TB prophylaxis.

The finding also supports task shifting; non-clinicians were provided with training in TB screening.

Optimizing retention in rural clinics

[Integration of ART services can improve access to care for PLHIV in rural settings.] {Photo credit: MSH staff}Integration of ART services can improve access to care for PLHIV in rural settings.Photo credit: MSH staff

Very few hospitals in Nigeria have fully integrated all of their HIV care and services. Stand alone HIV care and services, e.g. separate laboratory, pharmacy, and clinic days, can lead to patient stigmatization and attrition. Integration of ART services and an innovative retention calendar improves access to health care for people living with HIV (PLHIV), and reduces work load for health care workers.

Emmanuel Nwabueze, Nwokedi Ndulue, Med Makumbi, Ginika Egesimba, Andrew Etsetowaghan, and Nneka Onuaguluchi authored the poster (Optimizing Retention of PLHIVs in Rural HIV Clinics in North Central Nigeria: Experience and Challenge).

Combination prevention interventions for female sex workers

[Combination prevention interventions can be tailored to address HIV prevention needs of female sex workers in remote rural areas.] {Photo credit: MSH staff}Combination prevention interventions can be tailored to address HIV prevention needs of female sex workers in remote rural areas.Photo credit: MSH staff

Non-brothel based female sex workers operating in difficult to reach areas in rural North Eastern Nigeria are most vulnerable to exposure to sexually transmitted infections and unplanned pregnancies. Due to their remote locations, most implementing partners and agencies often neglect them in their interventions. Combination prevention interventions, when strategically tailored to address the HIV prevention needs of female sex workers operating in hard to reach rural areas, lead to multi-dimensional positive results.

The poster (Combination Prevention Interventions: A Tool for Increasing Access to Safer Sex Products and Services, and Improving Safer Sex Negotiation among Non-Brothel Based Female Sex Workers in Rural North Eastern Nigeria) was authored by Amaechi Okafor and Nwokedi Ndulue.

Transitioning planning: Kware State experience

PEPFAR indicated that it will transition clinical, chemistry, and hematology laboratory tests in Nigeria; and maintain a cap on ART enrollments in states with lower than national prevalence rates. One of these states is Kwara, with an HIV prevalence rate of 1.4 percent (national prevalence is 3.4 percent, according to NARH 2012). The Pro-ACT project supported Kwara State to implement a model for incremental transitioning of PEPFAR investments to governments at sub-national level. Now, HIV and AIDS services in the state can continue without disruption even after the transition of donor funding.

Emmanuel Atuma, Abdulrauf Ayinla, Sylvester Akande, Sam Faramoju, James Ezekiel, and Musa Salami authored the poster (Planning for the transitioning of PEPFAR investments to Government in Nigeria: Kwara State experience).

Child Status Index and OVC Well-being

Navindra Persaud, Oby Onoh, Esther Lee, and Zipporah Kpamor’s poster (Using the Child Status Index to Measure Changes in Well-being in Orphans and Vulnerable Children) presents findings from the CUBS project on an assessment of children orphaned and made vulnerable by the HIV/AIDS epidemic, who are vulnerable to sexual abuse, exploitation, illness, and homelessness.

The assessment sought to identify factors that determined changes in well-being of a cohort of orphans and vulnerable children (OVCs) who received support in six core areas (food and nutrition, shelter, legal and social protection, health, psychological care, and education) in Nigeria. Interventions for OVCs seem to show results if measured over a longer period. Despite receiving services, a small group of OVCs showed no improvement in their well-being.

Programs targeting OVCs should seek to identify and provide services based on their unique needs.

Numerous MSH staff contributed to this blog post. For more about the conference, follow hashtag .

Updated, July 30, 2015

Comments

Adaeze Umolu
Well done to all of MSH for these contributions to the work in HIV. Would like to recognize the Nigerian team for sharing with the world what has worked in our country. Hopefully some of these interventions will be replicated where are are critically needed.

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