Published on January 12, 2009
Progress of HIV/AIDS Treatment and Care Program in China : Progress of HIV/AIDS Treatment and Care Program in China Division of Treatment and Care, NCAIDS, China CDC Slide 2: The adult HIV/AIDS Treatment Program Pediatric HIV/AIDS Treatment Program M&E Training Program for HIV/AIDS Physicians Family Care Pilot Project TB/HIV Co-infection Pilot Project IDU ART Adherence Pilot Opportunistic Infections (OIs) prophylaxis treatment program Future work Adult HIV/AIDS Treatment Program : Adult HIV/AIDS Treatment Program Accumulated No. of People Received ARV Treatment : Accumulated No. of People Received ARV Treatment National ARV Treatment : National ARV Treatment ARV Regimen AZT+ddI+NVP(33.16%) AZT + ddI + NVP (80%) d4T+3TC+NVP(32.50%) d4T + ddI + NVP (20%) d4T+ddI+NVP(10.47%) AZT+3TC+NVP(8.49%) Patients’ General Information : Patients’ General Information Age Distribution Patients’ General Information : Patients’ General Information Male: Female=1.2:1? Transmission: Former Plasma Donors (FPD) takes the majority 60.85%. Figure 1 : Figure 1 Figure 2 : Figure 2 ARV Treatment has been implemented for 3 yrs, Patients’ median life span extended for 2 yrs : ARV Treatment has been implemented for 3 yrs, Patients’ median life span extended for 2 yrs Pediatric HIV/AIDS Treatment Program : Pediatric HIV/AIDS Treatment Program History of Pediatric ARV Treatment : History of Pediatric ARV Treatment Before July, 2005, there’s no pediatric ARV medicine, and pediatric treatment were not well organized. In July 2005, with “The Notification about Starting Pediatric ARV Treatment Pilot” from MOH, pediatric ARV treatment started in 6 provinces (cities) using pediatric ARV medicine donated by Clinton Foundation. In the later half of 2006, pediatric treatment was extended to all over China. Over 400 children have started ARV treatment using pediatric medicine by now. Virological changes of children who had received treatment for a year(32 cases who used adult ARV treatment, and 52 naïve patients) : Virological changes of children who had received treatment for a year(32 cases who used adult ARV treatment, and 52 naïve patients) ARV Treatment Information System : ARV Treatment Information System By December 2006, information of 30197 patients has been reported by 31 provinces (autonomous regions and municipalities). Information of 21777 patients has been connected with Epidemic Database. ARV treatment management criteria automatic creation has been achieved in web-based reporting platform. Data quality control AIDS Training and Community Care Project in Guangxi, China : AIDS Training and Community Care Project in Guangxi, China Project Objectives : Project Objectives Capacity Building Medical staffs (clinical doctors, CDC, lab and other staffs ) Community care (community worker, peer educators, PLHAs, residence) Training center construction Training models for different target population Training course for different groups Care community construction Training Subproject-Clinical Physician Training : Training Subproject-Clinical Physician Training Training centers are named as “National HIV/AIDS Clinical Center” By the end of November, 2006, 37 physicians and 10 nurses from 25 HIV/AIDS clinics have been trained, covered 22 cities and counties with the worst HIV/AIDS epidemic in Guangxi. Training Subproject-Clinical Physician Training : Training Subproject-Clinical Physician Training Training curriculum: HIV/AIDS Epidemiology, Etiology, Immunology, Clinical Diagnosis, ARV Treatment, OI Diagnosis and Treatment, Management of ARV Side Effects, Occupational Exposure Prophylaxis and Management, Adherence and Lab Tests etc. 8 Weeks = 1 Week presentation + 7 weeks clinical training Trainees become trainers after the training. Training Subproject-Public Health Doctors Training : Training Subproject-Public Health Doctors Training 13 public health doctors, covered 4 high-prevalence counties and cities. 2 weeks Training curriculum: HIV/AIDS epidemiology, high risk population intervention methods and epidemic situation management etc. Participate behavior intervention activities: needle exchange, Methadone maintenance, commercial sex workers intervention and voluntary consultation and testing (VCT) etc. Training Subproject-Lab Staff Training : Training Subproject-Lab Staff Training 4 sessions of HIV test lab training 15 cities/counties, 50 staff from local CDC, hospitals and Maternal-Child clinics. Training curriculum: HIV screening test, lab standardized management, quality management, bio-safety, HIV test techniques, CD4/CBC test, VCT related tests, and occupational exposure etc. Training Subproject-Lab Staff Training : Training Subproject-Lab Staff Training 2 sessions of HIV screening test training All 87 HIV screening labs in Guangxi, 96 staff were trained Training curriculum: MOH “National HIV/AIDS Test Guideline” , lab bio-safety management, HIV/AIDS screening test procedure, HIV/AIDS lab equipments and maintenance, waste disposure, HIV/AIDS occupational exposure and management, and HIV/AIDS tests practice. Training Subproject-HIV/AIDS Staff Training : Training Subproject-HIV/AIDS Staff Training One HIV/AIDS Prevention and Control Training 70 trainees were from 14 high-prevalence cities and counties. National experts were invited to give presentations about national HIV/AIDS treatment and care policies, the newest research and achievement in HIV/AIDS treatment and care and HIV resistance test, etc. Community Care Subproject-Nanning : Community Care Subproject-Nanning Baseline survey to investigate the population’s understanding about HIV/AIDS. covered 300 Injection Drug Users (IDUs), 200 Commercial Sex Workers, and 400 Community residents. Community education has covered 40 communities, activities include lectures in communities, and send out booklets and posters. Community Care Subproject-Nanning : Community Care Subproject-Nanning Established “Green City Home of Love” Recruited 3 peer-educators To provide a activity venue for people living with HIV/AIDS (PLHAs) To let the PLHAs know each other, provide each other with psychological support, and also can discuss with each other Community Care Subproject-Liuzhou : Community Care Subproject-Liuzhou Baseline survey covered 1200 people, including medical staffs, community residences, commercial sex workers, IDUs, students, and company employees. Posters about HIV/AIDS prevention and control have been posted in communities and buses. Booklets have been sent to communities. Family Care Pilot : Family Care Pilot Finalized project protocol and related technical documents Training. Multi-department cooperation 4 counties in Guangxi were selected as pilot sites. By December 2006, 10 HIV(+) pregnant women were found and started ARV treatment. At the same time, their infants will be given Early Infant Diagnose, and all HIV(+) babies will be involved in pediatric treatment. TB/HIV Co-infection Pilot : TB/HIV Co-infection Pilot Strengthen the screening in pilot through enhancing TB diagnose in AIDS patients, and HIV surveillance in TB patients.By December 2006, 119 TB patients were screened with 34 HIV(+), and 360 HIV(+) patients were screened with 27 TB. Both TB and HIV ARV treatment were offered. Patients who are not eligible for ARV treatment, SMZ prophylaxis was offered. IDUs ARV Treatment Adherence Study : IDUs ARV Treatment Adherence Study ART counselor manual and adherence education cartoon were made, to enhance patients education in order to improve adherence. Guangxi and Yunnan were chose as pilot sites and implemented investigation of possible factors that may affect IDU population adherence, in order to implement different intervention methods, and observe adherence and treatment effectiveness. OI Prophylaxis : OI Prophylaxis “Technical Guideline of Using SMZ for the Purpose of HIV Related OI Prophylaxis”. Pilot was implemented in two counties of Hubei and Anhui provinces and also in Global Fund and GAP counties. Prophylaxis services were started in Guangxi aiming to infants exposed to HIV(+) mothers. Future Works : Future Works HIV/Hepatitis Co-infection Scale-up of Family Care and TB programs Pediatric Resistance Research Adult and Pediatric Second-line treatment Adult ART Monitoring and Evaluation Slide 33: Thank you for your attention!