Archive for July, 2010
AIDS 2010 was a fantastic conference! High level speakers like Bill Clinton and Bill Gates, ground breaking science released like the microbicide vaginal gel, daily marches at the conference and around the city, and so much more.
Jhpiego was very busy with two oral presentations, 11 poster presentations, a great satellite event, and a busy exhibit booth. Despite all the activity, Jhpiego staff even found time to enjoy some quality time together at the end of long conference days too.
The messages heard over and over from participants and speakers were right in line with Jhpiego’s work-moving services to the community and integration of services. The common interests were evident in the packed rooms for Balwin Kileo’s presentation on opt-out HIV testing for male circumcision clients in Tanzania and Yassir Abduljewad’s presentation on addressing PMTCT gaps.
The satellite event built on the theme of moving services to the community- increasing access to care to save more lives. Stacie Stender advocate for moving tasks from doctors to nurses in order to be able to reach a larger population; Jason Wessonaar shared lessons implementing home based and work place counseling and testing in order to bring services to the people; and Tigistu Adamu described how male circumcision will have a tremendous impact on the global population.
Poster presentations on male circumcision and cervical cancer screening programs generated lots of interest in Jhpiego’s innovative solutions. Many attendees visited the exhibit booth after hearing about our posters to learn more about our programs and pick up valuable resources to use in their own work. Not only did booth visitors get great information, they also had lots of fun testing the knowledge on the Jhpiego Wheel of Knowledge and learning how to make hand sanitizer.
Teresia provided the grand finale for Jhpiego with her poster presentation on PMTCT and SBM-R. An appropriate conclusion for our work at the conference, the poster illustrated two key elements to Jhpiego’s work: technical leadership and improving the quality of health care.
We are already looking forward to the next International AIDS Conference in our own backyard, in Washington DC in 2012!
Yassir Abduljewad, Deputy Country Director–Ethiopia, addressed a packed room as he shared how the seven steps of the process improvement (PI) approach were used to improve PMTCT services in his area. His presentation, “Addressing PMTCT Gaps through a Systematic Process Improvement (PI) Approach,” gave data on seven health care facilities in five of the 18 zones in Oromia region where selected managers and providers were trained in the PI approach and provided with supportive follow-up post training. Within three months, six of the seven health care facilities reported improvements, including increasing: 1) hospital deliveries of HIV-positive women from 59% to 85%; 2) the percentage of HIV- positive women having their CD4 counts tested from 42% to 90%; and 3) the percentage of pregnant women’s partners tested for HIV from 13% to 51%.
Baldwin Kileo, Male Circumcision Program Manager–Tanzania, stated that HIV testing is part of a minimum package of MC for HIV prevention services. His presentation, “Opt-Out HIV Testing Leads to Nearly Universal Uptake among Male Circumcision Clients in Tanzania,” included results from observations and focus group discussions with MC clients in Iringa, Tanzania, regarding factors affecting individuals’ decisions to undergo HIV testing.
“Achieving and Sustaining High-Quality PMTCT Services in Kenya Using the SBM-R Approach”
Teresia Mutuku, Trainer–Kenya
Thursday, 22 July, 12:30–14:30
Poster Exhibition Area, Session THPE0615
Some final thoughts on Vienna 2010 from Alain Damiba, Jhpiego’s Senior Vice President.
As I pack to leave Vienna, I am reminded of the number of themes this week that resonate with Jhpiego’s focus on maternal, newborn and child health as an important platform for HIV/AIDS prevention and treatment.
These themes that many presenters reiterated also reinforce the strong value we put on capacity building and health system strengthening as part and parcel of our work with countries. It is rewarding to receive kudos from our colleagues who appreciate our long term perspective and our commitment to support their efforts and leadership!
Gearing up for universal access
Many advocates and activities in this conference reminded us all of the imperative to reach universal access for both HIV/AIDS prevention and treatment services. To achieve this goal and help move countries closer to the Millennium Development Goal No. 6, innovative approaches will have to be developed to dramatically increase access for the most vulnerable people so an impact at scale can be realized.
Jhpiego is proud to be contributing significantly to these efforts through its male circumcision technical assistance programs, community and facility-based counseling and testing, and its Prevention of Mother to Child Transmission (PMTCT) programs in many East and Southern African countries.
Male circumcision, the next frontier
As lights were dimming on one of Jhpiego’s successful presentations Tuesday evening on our male circumcision efforts in Tanzania, Tigi Adamu and Kelly Curran were busy planning their next move: Joining the government of Swaziland in circumcising 80% of eligible men in the country over the next 12 months to ensure a rapid decrease in HIV transmission in the country.
Innovation at work in the Jhpiego booth
In resource limited settings, where water and soap are rare and expensive commodities, the need to maintain proper infection prevention practices can be daunting. No longer. Jhpiego staff (Angella Ogutu and Mary Kay Carver) have demonstrated throughout the day to numerous fascinated visitors how they can mix alcohol and glycerine to produce a solution that they can use to wash their hands. Congratulations to our team for offering affordable and innovative solutions once again!
More from Alain Damiba, Jhpiego’s Senior Vice President, in Vienna:
According to a recent study by KK Case presented this morning, more than
half of new HIV infections could be averted if programs in Africa focus on
combination of ART, VCT, and MC.
For Asia, outreach and harm reduction for MSN, IDU needle exchange and drug substitution, plus ART is the winning combination of program approaches.
Another expert documented how prevention makes treatment more affordable and sustainable.
I learned that the scale up of HIV/AIDS treatment will have the
following benefits on a program:
Improve maternal and child health
Reduce transmission of HIV
Reduce incidence of tuberculosis
Reduce overall mortality
Reduce vertical transmission
Reduce the incidence of opportunistic infections
At the conference, some define Game Changer or Innovation as “changing the way something is done, made, or thought of,” resulting in better impact on the target issue! They have taken a page from Jhpiego’s book.
In conversations at the conference, there was a lot of interest in Kenya having decentralized ART (with help from Jhpiego and
other INGOs) to include AIDS treatment services
in TB clinics. Kenya has 600 ART sites and 1,800 TB sites so the
potential is high for expansion of ARV services in the TB sites which will promote further integration between TB and HIV.
Talking about TB/HIV integration, Kevin de Cock, Director of the Global AIDS Program at CDC/Atlanta, reports that there is “no one size integration fits all” solution! What is needed from his perspective are key ingredients such as:
Risk assessment and trade-offs
Leadership, and Policy change
An overflow crowd glued to a TV screen in a conference room listened as Yassir Abduljewad Ahmed, deputy director of our Ethiopia office, discussed innovative approaches to addressing PMTCT gaps through integration and a systematic process improvement approach.
Integration is the way to move forward.
In her poster presentation, “Cervical Cancer Screening for HIV-Positive Women in Guyana,” Megan Harris, Monitoring and Evaluation Officer, shared key lessons learned from a cervical cancer prevention program currently being implemented in Guyana. The program targets HIV-positive women.
Sharon Kibwana, Program Officer, summarized key programmatic lessons learned from implementing cervical cancer prevention programs targeted for HIV-positive women in low-resource settings in her poster presentation, “Cervical Cancer Screening for HIV-Positive Women: Programmatic Lessons Learned.”
By Alain Damiba, Senior VP
I was able to elbow my way through the crowded exhibition area into the poster section of the AIDS conference center this afternoon. Armed with the two-page “cheat sheet” that our communications office has prepared, I was able to locate all four Jhpiego posters. I patiently got in line in front of each one to wait for my turn to be explained Jhpiego’s work in Zambia, Nigeria, Kenya, and Tanzania.
I found out that in Zambia, Jhpiego-supported continuing medical education in ART has improved provider knowledge by 15% at pre/post tests!
In Nigeria, integrated PMTCT yielded more clients than vertical stand alone PMTCT. Our team found out that women actually prefer to go far away to get services from integrated clinics than to seek services in stand-alone PMTCT clinics near their homes! If you want to find out why, please go talk to Oniyere at Poster number MOPE 08666.
I also learned from Beth, our colleague from Kenya, that home-based HIV counseling and testing accelerates uptake in testing in the Western region of Kenya where 93% of eligible people were tested compared to 34% nationally! If you want to find out more, Beth at poster MOPE0420 is ready to chat.
Also I was surprised to discover from Tigistu that forceps-guide (FG) technique for male circumcision (MC) is the fastest technique for newly trained providers as compared to dorsal slit (DS) and sleeve resection (SR)! This finding is relevant for Ministries of Health who are designing rapid scale up adult MC.
Finally, I learned from USAID (who asked our own Tigi to present their poster) that 29 million men need to be circumcised over the next 5 years (equivalent to an 80% coverage) in 14 countries in East and Southern Africa to avert 4 million HIV infections!
Tigistu Adamu, HIV/AIDS Technical Advisor discussed a sometimes controversial topic—male circumcision. His poster, “Surgical Time and Number of Procedures Conducted during Training Varies by Type of Adult Male Circumcision Procedure. What Is the Implication for Programs?,” stated that male circumcision (MC) impact models suggest that rapid scale-up of adult MC to 80% coverage in the eastern and southern Africa region would avert four million new HIV infections by 2025. This requires efficient service provision. One of the key considerations is the selection of a method that lends itself to task shifting, rapid learning and speedy service provision. Hence, the procedure time among the common circumcision methods was compared.
Oniyire Adetiloye, Project Director–Nigeria, shared important lessons on truly effective integration. His poster, “PMTCT Integrated Model of Services vs. the Stand-Alone PMTCT Model: What Are the Different Program Results/Outcomes?” outlined the benefit of the PMTCT integrated model versus the stand-alone PMTCT model. What different program results/outcomes were identified? The abstract was a 13-month comparative study among three stand-alone PMTCT sites in Jhpiego’s Centers for Disease Control and Prevention (CDC)–PMTCT project and three integrated PMTCT sites in Jhpiego’s (CDC)/United States Agency for International Development (USAID) integrated PMTCT/Maternal and Child Health Integrated Program (MCHIP) projects. The study clearly demonstrated better project results and outcomes in the integrated model sites when compared with the results from the stand-alone sites.
Beth Marigu Barasa, Program Officer–Kenya, described an innovative strategy for increasing access to HIV testing and counseling. Her poster, <em>“Home-based HIV Testing and Counseling: An Innovative Strategy for Reducing the HIV Testing Gap,” showed how employing home-based HIV testing and counseling (HTC) at a large scale can help reduce the existing gap in HTC uptake and improve the community response to HIV testing outcomes (i.e., care and treatment).
Visit the Jhpiego booth (E–441) to sign up to receive an email with all Jhpiego IAS presentations after the conference.
“Convenience Is King!”
A Jhpiego Satellite Session at 18:30 in Mini Room 1.
When it comes to prevention, care and treatment for HIV/AIDS, convenience is king. That’s Jhpiego’s mandate: The easier it is to access services, the more people will receive treatment. Increasing access to services means saving more lives, and Jhpiego is committed to both.
Join us for conversation and refreshments with Jhpiego’s HIV/AIDS experts from around the world as they share best practices and their experiences in:
• Mobilizing health outreach workers to educate communities on prevention of HIV/AIDS
• Taking HIV and TB care to people, with antiretroviral therapy (ART) initiated and managed by nurses
• Reaching the masses through community-based voluntary counseling and testing
• Sharing evidence-based prevention services, such as male circumcision
“Cervical Cancer Screening for HIV-Positive Women in Guyana”
Megan Harris, Monitoring and Evaluation Officer
Tuesday, 20 July, 12:30–14:30.
Poster Exhibition Area
“Cervical Cancer Screening for HIV-Positive Women: Programmatic Lessons Learned”
Sharon Kibwana, Program Officer
Tuesday, 20 July, 12:30–14:30
Poster Exhibition Area, Session TUPE0143
“Results of a Cervical Cancer Screening Intervention among HIV-Positive Women in Semi-Urban South Africa”
Duvai Mukuvisi, PMTCT–Cervical Cancer Prevention Program (CECAP) Technical Officer–South Africa
Tuesday, 20 July, 12:30–14:30
Poster Exhibition Area
Tomorrow’s “Ask the Expert” Session at the Jhpiego booth (E–441):
“HIV Counseling and Testing”
Jason Wessenaar, Project Director, Siyazi Counseling and Testing Project–South Africa
It’s a busy day for Jhpiego tomorrow in the poster exhibition session at 12:30.
Come hear Jhpiego’s HIV expert Tigistu Adamu kick off Jhpiego’s presentation line-up for the conference. His topic: “Surgical Time and Number of Procedures Conducted during Training Varies by Type of Adult Male Circumcision Procedure. What Is the Implication for Programs?”
Also, join our Nigeria Project Director, Oniyire Adetiloye as he presents his poster on models for prevention of mother-to-child transmission (PMTCT) of HIV, “PMTCT Integrated Model of Services vs. the Stand-Alone PMTCT Model: What Are the Different Program Results/Outcomes?”
Last, but most certainly not least, be sure to hear from Beth Marigu Barasa, a Program Officer from our dynamic Kenya team. Her topic: “Home-based HIV Testing and Counseling: An Innovative Strategy for Reducing the HIV Testing Gap.”
Tomorrow’s “Ask the Expert” Sessions at the Jhpiego booth (E–441):
“HIV Counseling and Testing”
Yassir Abduljewad, Deputy Country Director–Ethiopia
Be sure to visit the Jhpiego booth (E–441)! The hall opens tomorrow. Come spin the wheel of knowledge, test your HIV/AIDS knowledge, and win great prizes! You can also sign up to receive an e-mail with all Jhpiego International AIDS Society (IAS) presentations after the conference.
Plan ahead to attend the Jhpiego satellite session, “Convenience Is King,” on Tuesday, at 18:30 in Mini Room 1. Enjoy music, food and great information from our leading experts.