The 20th International AIDS Conference
July 20-25, 2014 | Melbourne, Australia
As the global HIV/AIDS community gathers for the 20th International AIDS Conference, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) urges conference delegates, policy makers, non-governmental organizations, and ministries of health around the world to prioritize children who are infected with and affected by HIV/AIDS.
We are on the cusp of eliminating mother-to-child transmission of HIV globally. EGPAF is helping mothers, clinics, and nations end the threat of AIDS to children worldwide. To date, we have reached 20 million women with services to prevent them from passing HIV on to their babies and we will continue our work until no child has AIDS.
However, many children and families around the world still lack access to the services needed to end this epidemic. Every day, almost 700 children become newly infected with HIV, more than 90% of whom contract the virus from their mothers. Only 24% of HIV positive children have access to treatment, and are one third less likely to receive antiretroviral therapy compared to adults. We need to identify and treat HIV-positive children as early as possible because without treatment -- nearly half of these children will die before their second birthday; 80% will die before their 5th birthday.
EGPAF is working hand-in-hand with governments, partners, mothers, families, and donors toward a health and social infrastructure that can end pediatric AIDS.
At AIDS 2014, EGPAF will participate in several pre-conference meetings, satellite sessions and exhibit several abstract-driven poster presentations. A full listing is below. The Poster Exhibition is open from Monday, July 21 to Thursday, July 24 at 10:00 a.m. – 6:30 p.m. and is located within the Exhibition Area. EGPAF presenters will be by posters to answer questions between 12:30 p.m. and 2:30 p.m. on Monday, Tuesday, and Wednesday.
Oral Abstract Sessions
6th International workshop on HIV pediatrics (pre-AIDS 2014 event)
Saturday 19 July, 2014 | 11:45 a.m. - 12:00 p.m. | Crown Melbourne Limited Convention Centre 8 Whiteman Street, Southbank
Speakers: Auxilia Muchedzi and Reuben Musarandega, EGPAF, Zimbabwe
Host: Virology Education
This abstract-driven workshop will discuss, review, and evaluate the latest developments in the field to cultivate better treatment methods and strategies for infants and children in developed and developing countries. EGPAF staff will present "Creating Demand for and Retention in Maternal and Child Health (MNCH) including PMTCT services: A randomized community based peer facilitator intervention in rural Zimbabwe."
Children and HIV: Start early, start now! (pre-AIDS 2014 event)
Friday and Saturday, July 19 and 20 | Grand Hyatt Melbourne 123 Collins Street
Speakers: Dr. Appolinaire Tiam, EGPAF, Lesotho Catherine Connor, EGPAF
Host: Teresa Group, Coalition for Children Affected by AIDS, Living Positive Victoria, and Straight Arrows
This symposium will examine proactive, integrated approaches that focus on early childhood and HIV. EGPAF staff will present oral abstracts in "PMTCT and ARV programs as entry points for early interventions" on Friday, July 18 | 1:15 - 3:00 p.m. and "Nutrition and infant feeding as an entry point for early interventions" on Saturday, July 19 | 1:00 - 2:30 p.m.; and will moderate "Early childhood development programmes and HIV – policy and practice" on Saturday, July 19 | 1:00 - 2:30 p.m.
A health systems strengthening approach towards elimination of new HIV infections among children and keeping mothers alive: A Zimbabwe experience
Sunday, 20 July 2014 | 9:00 a.m. - 11:00 a.m. | Session Room 109-110
Speakers: Minister Dr. David Parirenyatwa, Dr. Agnes Mahomva, Dr. Gerald Gwinji, Dr. Tapiwa Magure, Dr. Angela Mushavi, Dr. Esther Tumbare, Mr. Reuben Musarandega, Dr. Luiz Loures, Dr. Owen Mugurungi, Mr. David Mutambara,
Host: Zimbabwe Ministry of Health and Child Welfare and National AIDS Council in collaboration with EGPAF
Zimbabwe's Ministry of Health and Child Care and the National AIDS Council of Zimbabwe collaborated with EGPAF and other partners to scale-up elimination of mother-to-child HIV transmission through a health systems strengthening (HSS) approach. Panelists will discuss the vital role played by governments and partners in providing strategic direction and leadership to HSS activities.
Where we were, where we want to be: Infant feeding in the context of HIV and AIDS
Tuesday, July 22, 2014 | 7:00 a.m. - 8:30 a.m. | Session Room 101-102
Speakers: Michelle Gill, Nigel Rollins, Chika Hayashi, Hloli Ngidi, Tamara Nsubuga-Nyombi
Host: UNICEF and the World Health Organization
This session will review the opportunities for improving HIV-free survival of children born to women living with HIV through breastfeeding and ARV.
By White S, Mwenechanya M, Yemane Berhan A, Simiyu R, Teri I, Walker D, Buono N
With funding from ViiV Healthcare, EGPAF provided technical assistance to six community-based organizations (CBOs) in Malawi to support efforts to achieve elimination of pediatric HIV. EGPAF's support was focused on improving monitoring and evaluation (M&E) systems. High quality data systems can provide accurate and timely data to inform CBO programming at the community level and can contribute to national health resource allocation decisions.
The role of CBOs in addressing human resource constraints in Malawi; lessons learned from establishing a community-to-facility referral
By White S, Mwenechanya M, Yemane Berhan A, Simiyu R, Teri, Walker D, Buono N
In 2011, Malawi introduced Option B+, resulting in a 748% increase in pregnant and breastfeeding women initiating ART between the second quarter of 2011 and the third quarter of 2012. With funding from ViiV Healthcare, EGPAF- Malawi provided technical assistance to six CBOs to support community-to-facility PMTCT referrals to support scale-up of Option B+.
Using internship opportunities to build and strengthen the technical skills of undergraduate students to manage HIV/AIDS programs
By Siziba S, Zinyemba C
Over half of all the people infected with HIV globally are between ages 15 and 24. In Zimbabwe, infection rates are high among youth, especially those in state universities and colleges. Incorporation of undergraduates into HIV/AIDS developmental organizations and policy formation systems directly involves them in the fight against AIDS while strengthening technical skills for postgraduate endeavors in HIV/AIDS programs.
By Tiam A, Bobrow E, Nyabela M, Ahimbisibwe A, Isavwa A, Diaho TM, Seheri L, Machekano R
With support from the WHO, EGPAF conducted a study in Lesotho to examine two indicators on infant feeding practices and postnatal ARV use among HIV-exposed infants. The objective was to determine whether the data for the indicators reflected actual feeding practices and ARV uptake among HIV-exposed infants.
By Muchedzi A, Chadambuka A, Musarandega R, Machekano R, Katirayi L, Woelk G
The adoption of the WHO 2010 Option A PMTCT guidelines in Zimbabwe necessitated research to identify new strategies to increase demand for early first ANC attendance and increase retention of mothers and babies in HIV care. This study tested whether peer-facilitated community support groups for pregnant and postpartum women increased the number of pregnant women booking earlier for ANC and strengthened retention in ANC/PMTCT services.
Supporting involvement of adolescents in prevention of mother-to-child transmission services: EGPAF's Zimbabwe programs mass media communications strategy
By Zinyemba C, Nyamundaya T, Makotore A
According to Zimbabwe Demographic Health Survey 2010/11, young and single pregnant adolescents are unlikely to utilize ANC services throughout their pregnancies, and are thus unlikely to have access to PMTCT services. Targeted education is needed to support young, at-risk women through their pregnancy and to enroll them in PMTCT services in Zimbabwe.
Beyond information dissemination: inspiring journalists to invigorate Zimbabwe's agenda to eliminate MTCT of HIV
By Zinyemba C, Nyamundaya T, Mushavi A
In 2011, Zimbabwe launched a strategic plan to eliminate new HIV infections among children by 2015. In this plan, Zimbabwe committed to national implementation of the WHOs 2013 PMTCT guidelines. With only two years remaining to achieve this goal, wide awareness of and engagement in PMTCT services among Zimbabweans is a priority for the Ministry of Health and Child Care (MOHCC). The country's established mass media is a vehicle to reach more people with important information regarding PMTCT.
Improvement in the quality of HIV prevention care and treatment among clients in 15 health facilities in Cote d'Ivoire
By N'Goran M, Essombo J, Diby J, Morris M, Ramachandran S, Angel A, Tuho M, Salam G
To support the national response to the HIV/AIDS epidemic in Cote d'Ivoire, EGPAF provides technical assistance to the MOH. EGPAF has enabled expansion of the HIV prevention, care, support and treatment programs through CDC/PEPFAR funding since 2004. While scaling-up services for HIV care and treatment, a baseline assessment of 15 facilities, conducted in 2008 revealed that lack of site-level adherence to national guidelines and poor organization of site-level service provision resulted in poor quality of care for HIV-positive patients.
By N'Goran M, Diby J, Essombo J, Fassinou P, Leunkeu E, Bohoussou F, N'da JP, Ramachandran S, Woelk G, Aka D
Early infant diagnosis (EID) provides opportunities for life-saving interventions. In Cote d'Ivoire, 87.3% of children born to HIV-infected mothers are not tested for HIV within 2 months post-natal. Recognizing these challenges, EGPAF, an implementing partner of Cote d'Ivoire’s Ministry of Health, adopted a series of interventions to improve EID performance.
Effect of task sharing for HIV counseling and testing using lay counselors in outpatient departments at public health facilities in Nyanza Province, Kenya
By Muthama DP, Matu L, Oluoch F, Mboya F, Ochuka B, Weimi B, Kimanga D, Ong'ech J, Syengo T
HIV prevalence in Nyanza, Kenya is almost triple the national rate (15.1% verses 6.2%). HIV counseling and testing has been below 9% at MOH outpatient departments partly due to few staff and high workload. The PAMOJA Project, funded by CDC/PEPFAR, implemented by several agencies including the EGPAF, supports HIV care and treatment at 85 sites in Nyanza. The project introduced task sharing, by recruiting lay counselors to increase access to care and treatment.
By Tiam A, Thompson A, Isavwe A, Ahimbisibwe A, Kabelo M, Oluwasanmi A, Mokone M, Putsoane M
Lesotho's national ART guidelines recommend use of post-exposure prophylaxis (PEP) among HIV-negative clients who are exposed to the virus through needle prick, and genital fluids, especially in cases of sexual assault. An analysis of PEP (how many clients utilize these services, why and how they are referred) had not been conducted.
By Wusumani S, Nhlabatsi B, Kudiabor K, Chouraya C
In 2009, the EGPAF-Swaziland's clinical services team performed a needs assessment in 30 facilities to assess gaps in PMTCT service delivery to HIV-positive pregnant women and HIV-exposed infants. Results indicated low numbers of clients returning to clinics to receive CD4 and DNA PCR test results, and low levels of adherence and retention among clients in HIV care and treatment. To improve HIV test result acquisition, adherence and retention, EGPAF adopted the use of mobile phones to actively follow-up clients.
By Tumbare E, Nyamundaya T, Mushavi A, Mahomva A, Musarandega R
The Zimbabwe national PMTCT program was established in 1999 through a pilot involving single-dose Nevirapine (sdNVP). In 2010, Zimbabwe adopted the WHO guidelines recommending a more efficacious multi-drug regimen for PMTCT. However, three years after adoption of these guidelines, almost half of the national PMTCT sites are still only offering sdNVP as the only form of prophylaxis. In 2011, EGPAF developed and implemented a strategy to rapidly scale-up implementation of 2010 guidelines.
Strengthening community-health facility linkages to generate demand and retention in PMTCT programs in Tsholotsho District, Zimbabwe
By Muchedzi A, Chadambuka A, Musarandega R, Machekano r, Woelk G
Access to HIV prophylaxis early in pregnancy is associated with better health outcomes among HIV-exposed infants. According to the Zimbabwe Ministry of Health and Child Care, in 2011, only 19% of pregnant women nationally accessed ANC services in their first trimester. In Zimbabwe, traditional beliefs and lack of universal health education are barriers to early ANC attendance. To heighten national awareness and education on PMTCT and importance of early ANC visits, EGPAF and the Ministry co-hosted a 13-week radio program between July and September 2012.
Increasing access to PMTCT services among pregnant women in Zimbabwe by using radio to bridge the information gap
By Makotore A, Mahomva A, Nyamundaya T, Zinyemba C, Chadambuka A
Access to HIV prophylaxis early in pregnancy is associated with better health outcomes among HIV-exposed infants. According to the Zimbabwe Ministry of Health and Child Care (MOHCC), in 2011, only 19% of pregnant women nationally accessed ANC services in their first trimester. In Zimbabwe, traditional beliefs and lack of universal health education are barriers to early ANC attendance. To heighten national awareness and education on PMTCT and importance of early ANC visits, EGPAF and the MOHCC co-hosted a 13-week radio program between July and September 2012.
Promising adherence results in the context of lifelong ART implementation in the Kabeho study in Kigali, Rwanda
By Bobrow E, Mugwaneza P, Ndayisaba G, Ndatimana D, Gill M, Hoffman H, Uwimbabazi J, Baribwira C, Remera E, Guay L, Asiimwe A and the Kabeho Study Team
In April 2012, Rwanda began implementing Option B+. In April 2013, EGPAF and the Ministry of Health initiated the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV. The study, supported by PEPFAR/USAID, will determine the 18-month HIV-free survival of a cohort of HIV-exposed children in the PMTCT program.
By Scaduto C, Nawar E, Uehling A, Bruno S, Hailemariam S, Woldemariam E, Ismail S
In 2007, EGPAF developed the Global AIDS System for Evaluation and Reporting (GLASER), an internet-based application designed to store routinely-reported program data from all sites supported by EGPAF. GLASER currently stores aggregated program data from over 10,000 health facilities in 20 countries.
By Ramachandran S, Morris M, Bianchi F, Cathcart R, Kebede G, Nawar E, Scaduto C, Secien J, Teri I, Uehling A, Ismail S
M&E systems play a vital role in generating data needed for evidence-based management of HIV/AIDS prevention, care, and treatment programs. Considering this critical function of M&E, it became increasingly evident that M&E systems contain certain structural pillars to be robust and sustainable. To this end, there is a need to design and implement a packaged M&E approach that includes these pillars.
Piloting an electronic patient tracking system for PMTCT at facilities in Zimbabwe: Reducing health care staff workload
By Muchuchuti C, Zondo M, Mabuku J, Chimhanda L
Health care workers in Zimbabwe are responsible for recording client data into paper-based registers. They compile monthly summaries from these registers to send to the Ministry of Health and Child Care. The paper-based registers are used to measure progress in PMTCT programming. The paper-based recording system has proven to be time-consuming and subject to human error.
By Musaradega R, Tachiwenyika E, Nyamundaya T, Ncomanzi T, Moga T, Muchedzi A, Mutede B, Chimhanda L
The adoption of WHO's 2010 Option A PMTCT guidelines in Zimbabwe necessitated research to identify new strategies to increase demand for early first ANC attendance and increase retention of mothers and babies in HIV care. This study tested whether peer-facilitated community support groups for pregnant and postpartum women increased the number of pregnant women booking earlier for ANC and strengthened retention in ANC/PMTCT services.
Retention and adherence among mothers and infants in the PMTCT program in Zimbabwe: A retrospective cohort study
By Tachiwenyika E, Musarandega R, Murandu M, Chideme M, Mhangara M, Chingombe I
WHO's 2010 PMTCT guidelines called for longer and more complex regimens of ARV to more effectively prevent mother-to-child HIV transmission; implementation of these guidelines necessitated longer follow-up of patients. In 2013, EGPAF supported Zimbabwe's Ministry of Health and Child Care to assess site-level retention and treatment adherence among HIV-positive pregnant women, HIV-exposed, and HIV-infected infants.
By Isavwa A, Tiam A, Ahimbisibwe A, Thompson A, Morris M, Kebede G, Machekano R
Annually, nearly 15,000 HIV-positive women deliver children and, without PMTCT interventions, over 3,750 children could become perinatally infected in Lesotho each year. The rate of eligible health facilities offering PMTCT has increased from 17% in 2006, to 63% in 2007, to 100% by the end of 2011. Little documentation on the extent of population-based coverage of PMTCT services exists, however. EGPAF conducted an assessment in September 2013 on population coverage of PMTCT services.
Acceptability of Option B+ among HIV-positive pregnant and lactating women in selected sites in Malawi
By Katirayi L, Namadingo H, Bobrow EA, Yemane berhan A, Phiri M, White S, Chimbwandira F, Buono N, Molland KM, Tylleskar T
In 2011, Malawi implemented Option B+, a policy recommending lifelong maternal ARV treatment for PMTCT, irrespective of clinical staging or CD4 count. This study seeks to explore the acceptability of Option B+ and the barriers and facilitators that affect a woman's decision to initiate lifelong ART.
Haba Na Haba: Technical Assistance Provision at the Elizabeth Glaser Pediatric AIDS Foundation (June 2014): Download PDF
Zambia Annual Report: Saving Mothers, Giving Life (June 2012-September 2013): Download PDF