NO TIME TO WAIT! Promoting Point-of-Care Early Infant Diagnosis - - PowerPoint PPT Presentation

NO TIME TO WAIT!

Promoting Point-of-Care Early Infant Diagnosis for HIV

GEORGINA CASWELL

30 JULY 2020

NO TIME TO WAIT!

Promoting Point-of-Care Early Infant Diagnosis for HIV

OVERVIEW

• Early infant diagnosis: the facts and barriers to uptake
• POC EID benefits and where it is in use
• The new GNP+ and UNICEF Strategic Framework

and Resource Pack

• Animation
• Q & A

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THE HIV RESPONSE IS FAILING CHILDREN

POINT-OF-CARE EARLY INFANT DIAGNOSIS IS NEEDED BECAUSE…

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EARLY INFANT DIAGNOSIS: THE FACTS

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In the Sub-Saharan region, in 2019:

• Only 61.2% of infants exposed to HIV were tested

within their first two months of life

• Only 51.1% of children living with HIV were receiving

antiretroviral treatment

• There were 130,000 new HIV infections in children

aged 0-4

• There were 58,000 AIDS-related deaths in children

aged 0-4

HIV estimates for children dashboard - UNICEF

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WHY IS EARLY INFANT DIAGNOSISSO IMPORTANT?

COUNTRY EXAMPLES OF INFANT TESTING & TREATMENT RATES, 2019 % OF HIV-EXPOSED INFANTS TESTED BEFORE TWO MONTHS OF AGE % OF CHILDREN LIVING WITH HIV ON TREATMENT CÔTE D’IVOIRE 53% 36% DEMOCRATIC REP OF CONGO 16% 28% UNITED REP OF TANZANIA 47% 66% ZIMBABWE 56% 71%

HIV estimates for children dashboard - UNICEF

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EID: WHAT ARE BARRIERS TO UPTAKE OF EID?

Mothers want to know the HIV status of their child. What’s

stopping them?

• Fear and stigma
• Lack of information
• Health system weaknesses

+ Only certain clinics offer the test + Can take as long as 3 months to get results (if at all)

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POC EID: BENEFITS

• Results are returned to caregivers much more quickly - 98% of POC testing results

were returned to caregivers within 30 days, compared with only 19% of lab-based EID results.

• The time between taking a blood sample and initiating an infant on ART is

significantly reduced - 92% of infants diagnosed using POC technology initiated ART within 60 days of sample collection, compared with 43% of those diagnosed using lab- based EID.

• Infants begin ART sooner and at a younger age - Infants diagnosed with POC

technology initiated ART much more rapidly (same day compared with 49 days) and at a younger age (1.6 months compared with 3.3 months) than those diagnosed through lab- based EID.

Bianchi F, Cohn J, Sacks E, Bailey R, Lemaire JF, Machekano R, et al. Evaluation of a routine point-of-care intervention for early infant diagnosis of HIV: an observational study in eight African countries. Lancet HIV. 2019;6(6):e373–81.

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POC EID: WHERE IS IT IN USE?

• Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, Eswatini,

Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Rwanda, Senegal, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe (funded and delivered by ASLM, CHAI, EGPAF, UNICEF and Unitaid).

• Burkina Faso, Cabo Verde, Central African Republic, Chad, Congo, Equatorial

Guinea, Gabon, Ghana, Mali, and Nigeria (led by UNICEF, in collaboration with the IRESSEF and RARS).

• Can we afford it? Study showed total cost of running a test and returning the

result to the caregiver within 30 days was much less with POC technology (US$27.24) than traditional lab-based methods (US$131.02).

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OUR NEW STRATEGIC FRAMEWORK

+ Aimed at community-based

• rganisations, applicable to other

partners too + To help CBOs engage with EID in different ways:

• To improve understanding of EID
• To share knowledge of EID (and POC EID)

with others in the community

• To advocate for improvements to services,

policies and funding relating to EID

• To actively play a part in the implementation

and monitoring of EID in communities

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OUR NEW STRATEGIC FRAMEWORK

+ Provides a step-by-step guide on how to develop an EID action plan + Additional materials include § Targeted FAQ leaflets for policy makers and caregivers § Job aid for peer supporters

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OUR NEW STRATEGIC FRAMEWORK

+ The step-by-step guide on how to develop an EID action plan:

Define your goal assess the situation consider your capacity choose your audience identify specific

• bjectives

create an action plan implement monitor and evaluate

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ASSESS THE SITUATION

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CONSIDER YOUR CAPACITY

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CHOOSE YOU AUDIENCE

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IDENTIFY SPECIFIC OBJECTIVES

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CREATE AN ACTION PLAN

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So for example…

Audiences Objectives Entry points /Opportunities Communications channels Activities

Mothers of HIV exposed infants To increase by 10% the number of infants being tested using POC EID technologies in your country within 2 years. Antenatal support groups Mentor mothers Conduct a training session for mentor mothers, to explain how POC EID technology works and the benefits it can bring.

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IMPLEMENT AND MONITOR

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RESOURCE PACK

+ To support the Strategic Framework a resource pack has been included:

• Advocates Fact Sheet
• Caregivers FAQ
• Job aid for peer supporters
• Guidance for policymakers

WHERE CAN YOU FIND THE RESOURCES?

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On the GNP+ website: WWW.GNPPLUS.NET/RESOURCES

NO TIME TO WAIT! ANIMATION

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https://www.facebook.com/GNPplus/videos/2774252666130285/

PILOTING THE TOOLS IN MALAWI & SENEGAL

N O T I M E T O W A I T !

Communities have a role to really mobilise, give information and create demand. Jackie Okinyi, Women Fighting AIDS in Kenya, 2019 The aim is to counsel, test and initiate, but this only works well if work has already been done to ensure there is a basic level of awareness about HIV. Pre-education needs to happen across the wider community. Edna Tembo, Community of Women Living with HIV/AIDS, Malawi, 2019

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THE CENTRAL ROLE OF COMMUNITIES

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QUESTION & ANSWER SESSION

We welcome questions on any

• f the topics covered in this

presentation. To get in touch, please contact us on info@gnpplus.net

CONTACT US: