GHIC 2019: Global Health & Innovation Conference
April 13-14, 2019
Yale University, New Haven, CT

Unite For Sight's 2010 Global Health & Innovation Conference

Blog Report By Indu Voruganti, Unite For Sight Global Health Leadership Intern

Innovations in HIV/AIDS Strategies

"The Latin American and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis," Arachu Castro, PhD, MPH

The first talk in this session was on “The Latin American and Caribbean Initiative for the Integration of Prenatal Care with the Testing and Treatment of HIV and Syphilis," given by Arachu Castro, Assistant Professor of Social Medicine; Department of Global Health and Social Medicine, Harvard Medical School / Partners in Health. I was greatly anticipating this talk because, on my own travels to the Dominican Republic and Peru as a volunteer, I had witnessed the existing HIV/AIDS situation in several rural villages in both countries, and had encountered several of the barriers discussed in this talk. The talk focused on prenatal care as a great entry point for the early diagnosis and prevention of HIV and Syphilis. In recent years in Latin America and the Caribbean, the number of tested prenatal individuals has significantly increased; however, there is still a low coverage in the greater population. Dr. Castro began by discussing the state of prenatal testing in the Dominican Republic, and she said that congenital syphilis is highly prevalent. She then moved on to discuss the barriers to prenatal testing in Columbia. The barriers include transportation to clinics, which is essential when the timing of the testing is crucial. Also, Dr. Castro described that if tests are conducted, there is often no report of data, no planning, and no action taken by affected individuals or caregivers. Dr. Castro then discussed similar barriers that exist in screening and prophylaxis of HIV during pregnancy in Peru. In overcoming the existing barriers for timely and efficient prenatal testing and treatment of HIV and syphilis, Arachu Castro said, “research, methodology, attention to political processes, and the ‘human factor’ are essential to integrating prenatal care with HIV and Syphilis testing and treatment.” After listening to this talk and reflecting on my own frustrations as a medical volunteer in Latin America, The PATS program described in the following talk resonated with me as a potential solution to the barriers faced in testing and treatment in Latin America.

"Implementation of a Community Health Worker Model of Care to Improve Treatment Adherence Among HIV-Positive Children in Central China," Sarah Eliza Petrow

The second speaker in this session was Sarah Eliza Petrow, MSc, Co-Founder and Executive Director of Pediatric HIV/AIDS Treatment Support (PATS). PATS is an NGO that was established in 2007 in response to the urgent and ongoing situation regarding caring for HIV-positive children in rural China. The HIV epidemic in China began roughly in 1988 as a result of increased blood selling, sex trade, and IV sharing. PATS was established in response to this growing epidemic, partnering with the local organization AIDS Orphan Salvation Association, to promote the health of children affected by HIV/AIDS. The model of the organization is based on the implementation of community health workers trained by local doctors, who encourage treatment adherence and utilize existing resources and infrastructure to implement solutions to health barriers. PATS builds a local community of health workers and families that enables quality care of HIV+ children, including access to life saving anti-retroviral treatment. Sarah then moved on to describe the challenges of implementing their model, including geo-isolation and a fragmented healthcare system. Despite these challenges, PATS workers visit children regularly, using a picture based PATS guide for illiterate patients. PATS has been extremely successful to date, with a treatment adherence of 98% amongst those served, with children being more noticeably happy, social, and well adjusted. However, Sarah Petrow closed by saying that with the growing number of HIV-positive individuals, PATS is in need of greater financial assistance for further expansion and sustainability of the program.

"Russia's Progress in Caring for People Living with HIV/AIDS," Alexandra Vacroux, PhD

The final speaker in the session was the program officer of the Eurasia Program from the Social Science Research Council, Dr. Alexandra Vacroux on “Russia’s Progress in Caring for People Living with HIV/AIDS”. The talk began by painting the present scene of the HIV/AIDS epidemic in Russia. The transition of societies into a more modern setting in Russia has resulted in a loss of traditional institutions, resulting in a lack of proper sexual education, affecting the behavior of many young adults. The epidemic, which is concentrated in youth and was originally a gender equal disease in Russia, is now primarily shifting to heterosexual contact. Dr. Vacroux also described that there is a sense of an unrealistic optimism amongst individuals, which has led to risk taking, including individuals having a greater number of partners, and no use of protection. This risk taking is further inflated by the Russian Orthodox Church, which has a negative religious view of protection. According to Dr. Vacroux, four % of middle school students use drugs, and commercial sex work is considered acceptable amongst many young adults. The Russian AIDS Centers were established to provide effective care for HIV/AIDS patients. Increased funding has allowed for testing and surveillance, as opposed to prevention. NGO partners have been researching how to spread education through social networks. However, in doing this, they interestingly have chosen not to use a popular figure as a role model, due to a fear of the stigma that it would attach. Moreover, challenges in development of these programs include the fact that there are other serious problems, such as TB, which is prevalent in Russia. Other barriers to the progress of care have included an ineffective education campaign that targeted the wrong groups and combined HIV/AIDS education with somewhat unrelated campaigns such as anti-smoking. There is also a lack of materials about caring for HIV/AIDS individuals, and many medical professionals also don't have the proper knowledge about HIV/AIDS.

Key Takeaways