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HIV/TB CARE
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Highlights
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Results of the workplace programme match or exceed results obtained elsewhere in the developed and developing world.
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PEPFAR award for continued funding was increased to R5.3 million dollars a year in 2005.
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Successful accomplishment of PEPFAR targets for 2005.
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Establishment of a clinic at MES in Hillbrow and at Jade Square Centre in Klerksdorp for provision of voluntary counselling and testing, and HIV care and treatment.
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Publication in a high impact journal, namely JAMA, on work previously conducted by programme investigators.
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Participation at the 2nd IAS Conference in Rio de Janiero, Brazil, with four poster presentations with preliminary results of the workplace programme including data showing a reduction of deaths in patients on ART by 66% after 5 months of treatment and also the unique finding that INH treatment can reduce mortality patients on ART.
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Provision of scholarships for six doctors to attend the IAS Conference in Rio de Janiero, Brazil, and to visit an HIV centre at UCLA, Los Angeles, in the United States.
HIV Care and Treatment programme: 'Light for life'
The HIV Care and Treatment programme, ‘Light for Life’, is one of Aurum Institute’s largest and most established programmes. It has been in operation since October 2002, with the first antiretroviral treatments (ART) having been prescribed on 13 November 2002.
The HIV Care and Treatment programme comprises two large implementation projects, one in an industrial setting and another in a community setting. The workplace programme provides the systems, training, monitoring and evaluation for nine different companies based in over 70 health care sites in South Africa, Swaziland and Namibia. The sites range from large hospital clinics to smaller occupational health clinics. In addition, Aurum provides an HIV management service to medical schemes which is largely a general practitioner (GP) based programme.
For the community project, the Aurum Institute has received a grant from the United States’ President’s Emergency Plan for Aids Relief (PEPFAR) of approximately $5.3 million per year for five years. The aim of the project is to provide voluntary counselling and testing (VCT), and HIV care and treatment to individuals in communities. The services are mainly provided by a general practitioner network that is contracted to Aurum. Aurum also uses the PEPFAR funding to support a number of State facilities and nongovernmental organisations in order to provide the above services.
The programme also houses a large research component, which includes the continual evaluation of antiretroviral therapy implementation in the industrial and community projects. A number of masters and doctoral students are presently conducting studies ancillary to the antiretroviral therapy programme to further understand the adverse effects, adherence to and drug interactions involved in administering antiretroviral therapy.
The objectives of the HIV care programme are to:
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Enable greater access to HIV infected individuals requiring ART, firstly to employees of companies and then to surrounding communities around these companies. Access to care is now available to over 4000 employees and to individuals in communities,
with the target set at 5500 by June 2006.
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Ensure a high quality, integrated ART programme using a standardised model of delivery: The programme is based on a set of guidelines for VCT, Adult ART; Paediatric ART; Wellness, which includes counselling and monitoring of CD4 counts; and Prevention of Mother to Child transmission based on national and international standards. An HIV clinical consultancy provides expert advice on difficult cases, and sites are monitored with regards to adherence, in accordance with the model.
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Build local capacity: The HIV Care and Treatment team conducts training in clinical care by our professional nurses and doctors, and in counselling by our psychologists.
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Provide a framework for research to inform health care providers about antiretroviral therapy implementation in South Africa and in the developing world. Information regarding patients on the programme is collected in a standardised way and is captured on a central database, which facilitates investigation of patient records.
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Evaluate and report on the programme in terms of feasibility, business, public health, clinical and economic outcomes.
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