Cascade of HIV Care in Uganda

  • Moses Kamya, MBChB, MMed, MPH, PhD
    Professor of Medicine, Chair of the Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda

Summary

Presentation from UCSF-GIVI CFAR's 14th Annual Research Symposium, Implementation Sciences and the Global response to HIV AIDS: Bringing Research to Reality - Locally, Nationally, Internationally, held Friday, October 25, 2013.

Moses Kamya: Cascade of HIV Care in Uganda

Presentation Slides

  • Cascade of HIV Care in Uganda
  • Outline
  • Background
  • The Cascade of HIV/AIDS Care
  • Pre-ART Cascade of HIV care-National picture
  • 6 month cohort in 2008 at 7 hospitals: 54% of pre-ART patients were lost before they were initiated on ART
  • Nearly 60% of loss occurs in the first 3 Pre-ART visits
  • The full EID cascade from 2013 shows that 44% of the loss is accounted for by mothers not receiving results
  • Mulago Hospital ID ward - 4A
  • Late stage diagnosis common in Mulago National Referral Hospital
  • Initiation of ART during 2 weeks of eligibility
  • Reasons for delayed initiation of ART in hospitalized HIV-infected, ART-naïve patients
  • Cascade of HIV care-Makerere University Joint AIDS Program (MJAP) experience
  • Outcomes of newly diagnosed HIV-infected patients referred to care after Provider Initiated HIV testing and Counseling at MJAP
  • Outcomes of phone contacts made n=86
  • Outcomes of referrals N= 500
  • Conclusion
  • Loss to follow-up among HIV-infected Patients Entering Care with CD4 Levels > 350/μ at MJAP clinics: Loss to follow-up=absent from clinic for 9 months
  • Retention in clinic vs. retention in care at any clinic site, N=6, 711
  • Conclusion
  • The "START" (a Streamlined ART Initiation Strategy) Study
  • Background and Rationale
  • Standard of Care
  • Starts
  • Outcomes
  • Conclusions
  • Acknowledgements
  • Thank you for listening