Over 23,000 thousand clinicians, researchers, policymakers, and activists gathered in Washington, D.C., this week to attend the international conference AIDS 2012. As the conference highlights recent breakthroughs in treatment and prevention under the theme “Turning the Tide Together,” Partners In Health staff members from Rwanda, Malawi, Haiti, and Boston are presenting evidence of how we and our partners have turned the tide already, achieving universal access to treatment and retention rates of well above 90 percent with programs that support patients with daily visits from community health workers to provide medical, social, and economic support.
Dr. Peter Drobac, director of Inshuti Mu Buzima (IMB), PIH’s sister organization in Rwanda, is presenting the impressive results of a study of HIV-positive patients who received treatment at two clinics in Rwanda between 2005 and 2010. The proportion of patients enrolled on treatment who were still alive and receiving care after five years was 93.5 percent—a truly “exceptional” figure, according to Cheryl Amoroso, IMB’s director of health information systems, monitoring and evaluation, and research. Elsewhere in Africa, a review of 33 studies found median retention rates of 70 percent after three years.
The Rwanda study presented by Drobac is one of few that also examines viral loads—the amount of virus in a patient’s blood—over an extended period of time. Of the group of patients who were enrolled in 2005, 96.6 percent had their viral loads suppressed.
“These patients have very high rates of program retention and HIV virus suppression, a success we attribute to a strong treatment program in partnership with the Ministry of Health and the critical community-based component of our model of HIV care,” said Cheryl Amoroso.
Other PIH participants at the conference are presenting posters and speaking on panels highlighting key elements of programs that have contributed to outstanding retention rates and clinical outcomes for patients, including nutritional support for HIV patients and electronic medical record systems to monitor their treatment.
A satellite session co-hosted by PIH, Harvard Medical School, and the United Nations World Food Programme focused on the relationship between hunger, malnutrition and poor health, presenting evidence of the impact that nutritional assistance can have on HIV treatment and adherence.
In another poster presentation, Amoroso and her colleagues are presenting the role of electronic medical record (EMR) systems in improving the care patients receive at different stages in their HIV treatment. The system, implemented with Rwanda’s Ministry of Health, is designed to manage clinical profiles of patients, alerting doctors to missed appointments and identifying potentially at-risk patients. It was put in place in clinics in rural Rwanda, where the high numbers of patients and limited access to resources made it difficult to ensure patients receive continuous care.
“By providing automated alerts of patients who are at risk or need further medical attention, the electronic medical record system ensures that patients don’t fall through the cracks,” said Amoroso. “Implementation of the EMR by PIH in Rwanda has been successful, and the government of Rwanda is currently leading expansion of the program across the country.”
PIH’s monitoring and evaluation team in Malawi found similar results in an analysis of their EMR system. The system is being used in the rural district of Neno, where PIH sister organization Abwenzi Pa Za Umoyo (APZU) supports a hospital serving more than 125,000 patients. The team’s findings indicate that with proper accuracy and supervision, an EMR system can help improve the quality of data and clinical management at sites with a high number of patients.
“The quantity and the quality of work PIH is presenting demonstrate both our engagement in research and the success of our programs,” said Amoroso. “We are excited to see what happens next.”
Other PIH presentations at the conference include:
- IMB’s Peter Celestin Niyigena discussing methods to improve child survival among infants in Rwanda who are exposed to HIV;
- Alice Nyirimana, also of IMB, discussing the unique needs and care of adolescents with HIV; and
- Junior Bazile, of APZU, presenting an evaluation of the Program on Social and Economic Rights, which provides food, shelter, and access to education and income-generating opportunities to HIV-infected patients and affected household members in rural Malawi.
The research presented by PIH staff may be available for viewing after the conference—please check back for more information. You can also learn more about the conference here.