15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10118)

Ginwalla R, Ayles H, Sibande MN, Shanaube K, Siwale M, Kankasa C, Godfrey-Faussett P
ZAMBART, University Teaching Hospital, Lusaka, Zambia

ISSUES: Many resource poor countries with a high burden of HIV are scaling up access to antiretroviral drugs (ARVs). The government of the republic of Zambia has committed to a programme for the delivery of antiretroviral drugs to the whole population. However as ARV's become increasingly accessible, no clear system of delivery on a large scale is in place.

DESCRIPTION: In response to the dual epidemic of TB and HIV, a model for integrated TB/HIV management activities (ProTEST) was piloted in three peri-urban government clinics in Lusaka. Activities included; screening and treatment of HIV positive individuals (including antenatal clients and their partners) for TB and STI's, provision of TB preventive therapy, treatment for opportunistic infections in HIV clinics, and establishment of referral network to other service providers/support groups. The success of these test-sites has now been translated into policy change to roll out implementation of integrated TB/HIV/STI services countrywide.

LESSONS LEARNT: There has been a huge demand for VCT and the ProTEST HIV clinics as a result of improved access to care and support. To date this is one of the only sustainable, decentralised models for providing chronic HIV care in the context of resource-poor settings. With the introduction of ARV's the demand for both VCT and ARV's continues to rise. An avenue exists within the current ProTEST framework to effectively deliver antiretroviral drugs. In scaling up ProTEST and ARV distribution the programme implementers need to consider linking the two interventions. Recommendation: The ProTEST model provides a promising vehicle for delivery of ARV's in resource poor, high burden countries.

040711
B10118

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