Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

638 Abstracts ThPeF8223-ThPeF8227

XIV International AIDS Conference

about the health status characteristics of persons living with HIV disease in the
border region, their treatment needs, or the barriers they face. The present study
describes the health status of HIV/AIDS residing in the Arizona-Sonora border
region.
Methods: Data was collected from 51 HIV/AIDS patients (53% Mexican-origin
Hispanic) enrolled as part of a larger study (Border SPNS) via face-to-face interviews assessing their sociodemographic and health status characteristics.
Results: The HIV/AIDS patients enrolled in the study are generally lower income
and unemployed, with 31% having less than a high school education. Over 65%
reported unprotected sex with other males, 27% reported unprotected sex with
injection drug users, 20% had shared needles, and 31% had been diagnosed
with a new STD. Male-to-male sex was the primary exposure category (52%), but
heterosexual transmission was very high (30%). Many have functional limitations
due to their health, and 21% have CD4 counts less than 500. Overall, 82% were
on HAART therapy. Depressive symptoms are also prevalent in this sample.
Conclusions: HIV/AIDS is a growing problem in the U.S.-Mexico border region.
A lack of health care access and the lack of HIV/AIDS trained physicians in the
border region contribute to this problem. This study suggests that HIV/AIDS patients in the border area present at a later stage of disease, often with functional
limitations and depressive symptomatology. Increased capacity to treat HIV/AIDS
in the border region is clearly needed.
Presenting author: barbara estrada, impact consultants, 5632 n cherokee ridge
road, tucson, az 85750, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8223 The cost of a clinic for HIV-infected employees in a
workplace health service in Welkom, South Africa
L. Kumaranayake', A.D. Grant1, S. Roux2, S. Charalambous2, J.H. Day2,
E. Rothwell2, N. Mahlatsi2, G.J. Churchyard2. 1London School of Hygiene &
Tropical Medicine, London, United Kingdom; 2Aurum Health Research, Welkom,
South Africa
Background: More than 28 million Africans are living with HIV/AIDS, and will
have shortened life expectancy without adequate care. In countries most affected,
strategies will be required to reduce the significant burden that HIV/AIDS is already placing on existing infrastructure and capacity. There is substantial potential
for private sector involvement in increasing access to care. In 1999, a specialised
clinic for HIV-infected employees ("Prevention Clinic") was established within a
health service for mine workers in South Africa. The clinic provides treatment for
HIV-related illnesses, counselling, and provision of isoniazid preventive therapy
(IPT) and cotrimoxazole (CMX) for prevention of common opportunistic illnesses.
The purpose of this study was to undertake a cost analysis of the implementation
of the prevention clinic.
Methods: Using standard costing guidelines, a cost analysis from the health service provider perspective was performed. Costs were collected retrospectively
using an ingredients-based costing methodology to consider both the financial
and economic costs. Cost and outcome indicators were collected for a 27-month
period between 1999 and 2001. All costs were expressed in 2001 US$. Both
start-up and implementation period activities have been included.
Results: At a total workforce level, financial and economic costs of the clinic were
$11-$14 and $11.50-$15 respectively per company employee for the 27-month
period. This represented an annual economic cost per clinic attendee of $64-$70.
A course of INH and CMX cost less than $20 per person.
Conclusions: HIV/AIDS has been documented to have an adverse impact on
the labour force, characterised by a loss of skilled workers, lower productivity and
increased benefit payments. Adding a specialised HIV clinic to existing workplace
health services is inexpensive, and could avert HIV-related opportunistic illnesses
and improve productivity
Presenting author: Alison Grant, Clinical Research Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom,
Tel.: [phone], Fax: [phone], E-mail: [email protected].
uk
ThPeF8224 Norms for clinical care of adults living with
HIV/AIDS in Honduras
I. Espinoza1, D. Padgett2, J. Trejo3. 1Departamento ITS/SIDA/TB,
Departamento de ITS/SIDA/TB, Apartado Postal 3966, Tegucigalpa, MDC,
Honduras; 2Unidad de Investigaci6n Cientifica, UNAH, Tegucigalpa, MDC,
Honduras; 3Hospital Leonardo Martinez, San Pedro Sula, Honduras
Issues: as part of the efforts of the national STI/AIDS/TB programme, a transdisciplinary group was organized to review the international standards on clinical
care of adults living with HIV/AIDS (ALWA). The purpose of this project was to
create the national norms to regulate clinical care of ALWA. Once they were developed, the norms were validated in two sanitary regions with 33 physicians with
different specialities and different levels of care.

Lessons learned: a total of 159 facilitator-physicians that provide care to ALWA
have been trained in all sanitary regions of the country. The result of the cascade
effect of training has produced a total of 216 new trained physicians in 4 sanitary regions. Clinical care and quality of life of ALWA has been improved in the
country.
Recommendations: Normatization of clinical care is a cost-effective and costbeneficial mean to improve care and quality of life of ALWA. An active participa
tion of experts and different sectors in the process guarantees acceptance and
use of the norms.
Presenting author: Ivan Espinoza, Departamento de ITS/SIDA/TB, Apartado
Postal 3966, Tegucigalpa, MDC, Honduras, Tel.: [phone], Fax: +504
2373174, E-mail: [email protected]
ThPeF8225 Developing guidelines for the clinical management
of HIV/AIDS in resource-poor settings
A. Bhattarai. Sukraraj Tropical & Infectious Disease Hospital, GPO Box # 3583,
GHA 1-647, Tangal, Kathmandu, Nepal
Issues: In developing countries demands for the clinical care of people living with
HIV/AIDS is evolving rather swiftly. Countries have either already developed or are
in the process of developing guidelines for the clinical management of HIV/AIDS.
Description: This paper examines the processes and prerequisites for developing such guidelines in resource-poor settings. First of all countries must have policies supportive of access to comprehensive HIV/AIDS care. The basic elements
of HIV/AIDS care activities by the level of service delivery must be identified and
each level of service delivery must then be consulted to develop the guidelines -
which would be both applicable and suitable to the local needs. Prior to this consultative process baseline information on the prevalence of Opportunistic infection
and other locally endemic infectious diseases must be available. HIV testing policies must be in place before the guidelines are developed and the basic testing
and counseling services must be available where the guidelines are to be implemented. It is also very important to have a national list of essential drugs that
meets the requirements of the clinical guidelines. Therefore, authorities responsible for reviewing the national list of essential drugs must also participate in the
whole process.
Lessons learned: Without addressing some prerequisites and following certain
consultative process guidelines for the clinical management of HIV/AIDS is unlikely to be effective.
Recommendation: This paper recommends that before developing the clinical
guidelines for the management of HIVAIDS, concerned authorities must
1) ensure policies supportive of access to comprehensive HIV/AIDS care
2) identify the basic elements of care by the level of service delivery
3) have baseline information on the prevalent opportunistic infection
4) develop and implement HIV testing policies
5) ensure a supportive national list of essential drugs
Presenting author: Achuyt Bhattarai, GPO Box # 3583, GHA 1-647, Tangal,
Kathmandu, Nepal, Tel.: [phone], Fax: +-, E-mail: [email protected]
ThPeF8226 What happens when there aren't any drugs? Living
longer and healthier with HIV
L.K. Francis. The Centre, Box A930, Avondale, Harare, Zimbabwe, Zimbabwe
Isues: The vast majority of HIV infected people live in circumstances where there
are no drugs available. It is essential that we develope self-help appropriate and
affordable alternatives to prolong length and quality of life for these people
Description: Since 1991 The Centre in Harare has been counselling and training
PLWH/A's in a holistic approach to disease management, based on nutrition and
education, along with long-term psycho-social support and prevention or prompt
treatment of opportunistic infections.In that time over 2500 clients have been
counselled, with fewer than 500 deaths, most of which occurred in clients who
presented in end-stage disease. PLWH/A's who were themselves counselled in
1991/2 are now working at The Centre as full-time counsellors, providing healthy
role models. The nutritional regime is based on local, traditional cuisine- it is therefore affordable and available
Lessons learned: It is possible to increase longevityand quality of life in HIV
infection through a holistic approach to lifestyle and disease prevention, even in
resource-poor settings
Recommendations: It is essential that these findings are urgently and widely
disseminated and the methods replicated throughout the developing world, especially in the ongoing absence of drug availability,
Presenting author: Lynde Francis, Box A930, Avondale, Harare, Zimbabwe, Zimbabwe, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8227 Antiretroviral regimen for prevention of
mother-to-child HIV transmission in Odessa region,
Ukraine
S. Posokhova1, O. Penin2, N. Nizova3, A. Sidyachenko4. 1Odessa Oblast
Clinical Hospital, Odessa, Ukraine; 2Odessa Oblast AIDS Center, Odessa,
Ukraine; 3Odessa State Medical University, Odessa, Ukraine; 4Odessa Oblast
Health Administration, Odessa, Ukraine

Issues: Antiretroviral therapy during pregnancy and delivery is one of the main
factors to reduce the risk of mother-to child HIV transmission. However, the health
care settings with limited resources cannot always afford costs of the treatment.
The data of short retrovire regimen was analyzed at Odessa Oblast Maternity
House and Odessa Oblast AIDS Center.
Description: This paper analyzes the effectiveness of antiretroviral therapy to
prevent MTCT at the health care setting with limited resources.