ABSTRACT
OBJECTIVES: Increasing the rate of people who know their HIV status is imperative, particularly in sub Saharan Africa, and this requires an assessment of strategies for increasing the utilization of testing services. This article discusses the relevance, feasibility, and effectiveness of national screening campaigns conducted between 2006 and 2010 in Burkina Faso. METHODOLOGY: An analysis of all data regarding testing uptake from 2006 to 2010 was conducted, along with interviews of key participants in the process. RESULTS: The results show that the 8 screening campaigns led to HIV testing of 487,727 people, that is, 50% of the total number of people tested and 24.6 % of HIV+ people diagnosed during this period. Campaigns succeeded in testing populations that are difficult to reach (especially young people), at a low cost. CONCLUSIONS: This strategy is relevant and useful for identifying HIV+ people. Its utility for HIV prevention campaigns requires further study. Campaigns are effective and cost-effective even in this country with a low disease prevalence. These results underline the importance of the synergy between community-based organizations and health services in the provision of counseling and testing.
Subject(s)
HIV Infections/diagnosis , HIV Infections/drug therapy , Health Promotion , Health Services Accessibility , Mass Screening , Adolescent , Adult , Burkina Faso , Feasibility Studies , Female , HIV Infections/prevention & control , Humans , Male , Young AdultABSTRACT
BACKGROUND: There is no data on long-term benefit of once-a-day antiretroviral therapy (ART) with combination of DDI, 3TC and EFV to allow its use in future therapeutic strategies. OBJECTIVES: To assess 24-month immuno-virological, adherence, tolerance, and effectiveness of a once-a-day ART with DDI, 3TC and EFV. METHODS: A phase 2 open trial including 51 children aged from 30 months to 15 years, monitored a once-a-day regimen for 24 months from 2006 to 2008 in the Departement de Pediatrie du CHUSS, at Bobo-Dioulasso in Burkina Faso. We tested immunological and virological response, adherence, tolerance and resistance of the treatment. RESULTS: Children with CD4 >25% at 24 months were 67.4% (33/49) CI 95% [54%, 80%]. The proportion of children with viral plasma RNA <300 cp / ml at 24 months of treatment was 81.6 % (40/49) CI [68.0% 91.2%]. Good adherence was obtained with more than 88% adherence > 95% over the 24 months. Drugs were well tolerated. CONCLUSIONS: Given the limited number of antiretroviral drugs available in Africa and the inadequacy of laboratory monitoring in support program, once-a-day treatment and especially the DDI-based combination strategies could be an attractive operational option.
Subject(s)
Anti-HIV Agents/administration & dosage , Benzoxazines/administration & dosage , Didanosine/administration & dosage , HIV Infections/drug therapy , Lamivudine/administration & dosage , Medication Adherence , Adolescent , Africa , Alkynes , Anti-HIV Agents/pharmacokinetics , Benzoxazines/pharmacokinetics , CD4 Lymphocyte Count , Child , Child, Preschool , Confidence Intervals , Cyclopropanes , Didanosine/pharmacokinetics , Female , Humans , Lamivudine/pharmacokinetics , Male , RNA, Viral/drug effects , Surveys and Questionnaires , Viral Load/drug effectsABSTRACT
Full Title:Le conseil post-test encourage-t-il les PVVIH a partager leur statut serologique? Pratiques et suggestions des conseillers au Burkina Faso (Does post-test counseling support PLHIV in disclosing their HIV status? Practices and propositions by counselors in Burkina Faso)Le partage du resultat du test VIH est; selon les normes; aborde lors du counseling post-test. Cependant; alors que les obstacles au partage d'un resultat VIH positif sont attestes; la litterature reste peu abondante sur la maniere dont les directives sont appliquees sur le terrain. L'objectif de cet article est d'examiner les pratiques de conseil concernant le partage du resultat avec l'entourage rapportees par les clients et les prestataires du conseil et test VIH (CTV) au Burkina Faso. Une enquete transversale a ete conduite en milieu urbain et en milieu rural en 2008. Un questionnaire integrant des questions semi-ouvertes a ete utilise. Un nombre total de 542 personnes qui ont realise le test depuis 2007 et 111 prestataires de services de conseil et test VIH ont ete interviewes. Les donnees ont ete analysees sur SPSS 12. Seulement 29des personnes testees declarent que le theme du partage du resultat avec l'entourage a ete discute avec elles lors du counseling post-test. Ce resultat s'explique par les incertitudes et les inquietudes des prestataires sur la maniere de partager et sur les risques de consequences defavorables du partage. Des strategies sont developpees par les prestataires pour soutenir les personnes dont la seropositivite a ete depistee a partager cette information avec l'entourage mais ils reconnaissent que ces actions sont insuffisantes. Les suggestions des prestataires pour ameliorer la situation incluent la lutte contre la stigmatisation vis-a-vis des personnes vivant avec le VIH; le renforcement des competences des prestataires et l'adoption de textes juridiques pour rendre obligatoire le partage du resultat avec le partenaire. En conclusion; l'etude a identifie plusieurs pistes pour ameliorer les pratiques de conseil concernant le partage des resultats au Burkina Faso. Ces observations pourraient avoir une portee globale pour la region Afrique