THAE0101 - Oral Abstract Session
Success in reaching national pediatric uptake targets and similar adult retention rates in pediatric HIV clinics in the rural Southern Rift Valley (SRV) province of Kenya
Presented by Argwings Miruka (Kenya).
A. Miruka1, R. Achieng1, A. Aoko1, J. Tarus1, C. Sigei1, P. Yegon1, J. Maswai1, F. Sawe1, D. Shaffer2,3, K. Crawford3
1Kenya Medical Research Institute/Walter Reed Project, Kericho, Kenya, 2US Army Medical Research Unit, Kenya (USAMRU-K), Kericho, Kenya, 3US Military HIV Research Program (USMHRP), Bethesda, United States
Background: In Kenya, an estimated 7,000 - 10,000 children are HIV infected yearly. National targets for 10% of all HIV clinic patients registered being pediatric are often difficult to reach or fall behind adult uptake. In addition, concerns exist regarding retention of children in HIV/AIDS clinics. Such challenges are often magnified in rural settings due to frequent changes in caregivers,distances away from pediatric clinics, and extremes in poverty.
Methods: In 2004, HIV/AIDS
care and treatment programs began developing under the President´s Emergency
Plan for AIDS Relief (PEPFAR) program in the SRV Province of Kenya, a largely
rural population. Effort has been made
to decentralize care, making more clinics closer to rural populations
available. In addition, initiatives such
as the "Mwangalizi" ("care givers", often HIV positive adults
linked with children to assure they come to HIV clinics) project have been
implemented, and pediatric HIV support groups have been established. We describe aggregate program level data for
the development of/uptake in HIV pediatric clinics.
Results: Between 2004 and
2011, 17,572 children received HIV testing through both voluntary counseling
and testing (VCT) and diagnostic testing and counseling (DTC) initiatives. 5,310 children (mean
age 10.0 +/- 3.3 years, 50.6% female) were enrolled in 57 pediatric HIV
clinics. Of those enrolled, 44.3%
started first line ART, 2.5 % switched to 2nd line ART, and 1 has advanced to 3rd
line ART. In 2005, 7.0% of HIV clinic
attendees were children on ART, which increased
to 10.5% in 2011 (p < 0.001). In 2011,
the retention rate for adults who had started ART was 82.2%. In comparison, the retention rate for
pediatric patients who had started ART was nearly the same, 81.1% (p=0.2).
[Pediatric HIV clinic Uptake]
Conclusions: National pediatric
HIV clinic enrollment goals can be met in rural Kenya with ART retention nearly
the same as retention in adults.
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