At CROI, New Research into Old Challenges
By Michelle Betton | April 2, 2013
The needs of HIV-positive women living in remote areas were front and center at the recent Conference on Retroviruses and Opportunistic Infections (CROI), held last month in Atlanta, GA. A few weeks later, EGPAF staff gathered to talk about the conference and what its findings mean for people living with HIV around the world. Conversations at the meeting focused on important discoveries made in programs and research throughout the field of public health, including discoveries that may affect HIV programs. The presentations showed both promising outcomes from research studies and programs, and potential barriers to achieving optimal results.
One research study analyzed methods for getting pregnant women to take continued HIV medication to maintain their health. The results showed that 86 percent of women began treatment when HIV medication was integrated as a regular part of antenatal care (rather than being offered in another clinic or as part of a different health program). This result was much higher than when women were referred for the same services in other clinics or hospital divisions, where only 49 percent of pregnant women began HIV treatment.
In another study, women in Swaziland were asked if they would like to begin taking lifelong HIV medication before their health and medical guidelines required it. The World Health Organization states that people with a CD4 (T-cell) count below 350 should begin taking HIV medication. Seventeen percent of the women in the study declined to start taking HIV medication early, their reasons including feeling healthy, not wanting to commit to lifelong antiretroviral therapy (ART), concerns about possible side effects, and not feeling mentally prepared.
As researchers and health care workers around the world think about how to make HIV programs more effective, a third study found that the primary reason clients gave for not returning to clinics and hospitals for HIV medications and services was the distance between the nearest hospital and their home. Many families live in remote areas, and transportation can often be expensive and time-consuming. People living with HIV must sometimes travel for several days just to get the medication they need to stay healthy. One possible solution is to integrate community health workers into HIV programs, allowing them to visit clients’ homes to provide lifesaving services. As we learn more about the extent of the problem, we can work to solve it.
The knowledge generated from the program and research results from CROI helps to inform health care workers about how to create HIV programs that are more effective and beneficial to women, children, and families. Understanding the reasons that keep clients from accessing HIV services and learning how to better help clients access lifesaving services is critical to ensuring that future programs keep their clients healthy.
Michelle Betton is Associate Communications and Development Officer for the Foundation, based in Washington, D.C.