20th International AIDS Conference - Melbourne, Australia


WEAD04 Surviving and Thriving: Children, Adolescents and HIV
  Oral Abstract Session : Track D
Venue: Plenary 2
Time: 23.07.2014, 14:30 - 16:00
Co-Chairs: Ayu Oktariani, Indonesia
Craig McClure, UNICEF

14:30
WEAD0401
Abstract
Powerpoint
Webcast
Balancing ART access for pregnant women living with HIV and follow-up care for HIV exposed infants: a four country assessment of key PMTCT interventions
P.A. Idele1, J. Rodrigues2, C. Luo3, A. Fakoya4, R. Ekpini5, C. Omeogu6
1UNICEF, Data and Analytics, New York, United States, 2IATT Secretariat, HIV and AIDS, New York, United States, 3UNICEF, HIV and AIDS, New York, United States, 4Global Fund, Geneva, Switzerland, 5UNICEF, Health Section, New York, United States, 6IATT Secretariat, New York, United States

14:45
WEAD0402
Abstract
Powerpoint
Webcast
Transition program of HIV-infected adolescents to adult HIV care in Buenos Aires, Argentina, 4-years experience
S.E. Arazi Caillaud1, D. Mecikovsky1, A. Bordato2, J. Lattner3, L. Spadaccini3, R. Posada4, C. Rodriguez5, P. Cahn3, R. Bologna1
1Hospital de Pediatría Dr J.P. Garrahan, Pediatrics Infectious Diseases Unit, Buenos Aires, Argentina, 2Hospital de Pediatría Dr J.P. Garrahan, Mental Health Unit, Buenos Aires, Argentina, 3Fernandez, Infectious Diseases Unit, Buenos Aires, Argentina, 4Mount Sinai School of Medicine, Pediatrics Infectious Diseases Unit, New York, United States, 5Argerich, Infectious Diseases Division, Buenos Aires, Argentina

15:00
WEAD0403
Abstract
Promoting adolescent antiretroviral adherence and sexual and reproductive health uptake: interim findings from the Mzantsi Wakho study in Eastern Cape of South Africa
R. Hodes1, B. Vale2, E. Toska2, L. Cluver2, Mzantsi Wakho, Collaborative Initiative for Pediatric HIV Education and Research)
1University of Cape Town, AIDS and Society Research Unit, Cape Town, South Africa, 2University of Oxford, Social Policy and Intervention, Oxford, United Kingdom

15:15
WEAD0404
Abstract
Powerpoint
Webcast
Do orphans report worse caregiver interactions and psychological and health-related outcomes than non-orphans in mixed households?
C. Reardon, G. George, C. Mucheuki, K. Govender, T. Quinlan
Health Economics and HIV/AIDS Research Division, Durban, South Africa

15:30
WEAD0405LB
Abstract
Powerpoint
Webcast
Rights driven institutionalization of sexual and reproductive health in Pakistan: a conservative Muslim society
Q. Baig
Rutgers WPF, Islamabad, Pakistan

15:45
WEAD0406
Webcast
Moderated discussion

Powerpoints presentations
Balancing ART access for pregnant women living with HIV and follow-up care for HIV exposed infants: a four country assessment of key PMTCT interventions - Priscilla Idele

Transition program of HIV-infected adolescents to adult HIV care in Buenos Aires, Argentina, 4-years experience - Rosa Bologna

Do orphans report worse caregiver interactions and psychological and health-related outcomes than non-orphans in mixed households? - Gavin Lloyd George

Rights driven institutionalization of sexual and reproductive health in Pakistan: a conservative Muslim society - Qadeer Baig



Rapporteur report

Track D report by Purnima Mane


P. Idele presented a paper on a four country study (Malawi, Tanzania, Zambia and Lesotho) focused on balancing ART access for pregnant women and follow up care for infants. While some countries seemed to have problems in providing certain services for maternal care, in general countries fared well in most areas of maternal care. The same could not be said consistently  about services for children other than availability of ART. Involvement of communities took various forms including lay counselors, community health workers, patient advocates etc. and definitely helped the success of the programs. However the absence of getting information to a central level and siloed approaches for mothers and their infants acted as barriers to successful programming.

Rosa Maria Bologna presented on behalf of the primary author on a transition program from HIV positive adolescents to adults in Argentina. Caring for one’s own health was associated with successful transition. A range of behaviors including non-compliance with medical regimen, lack of adherence to clinic appointments, not attending sessions on transitions was associated with unsuccessful transition. The study concluded that a support strategy was needed for adolescents to transition to living as HIV positive adults. 72.3% did make a successful transition and had suppressed CD4 counts, demonstrating the value of such transition programs.

Rebecca Hodes presented data from one of the largest qualitative studies being conducted in South Africa. The study focuses on ART adherence and SRH uptake in Eastern Cape amongst teenagers. The study aimed at understanding adherence and the conditions under which it occurred, and understanding their SRH behaviors and uptake. Since self-reporting on tablets was the major means of data gathering, there was a much higher rate of reporting of behaviors usually not reported on such as anal sex. It was noted that the teens saw the health system as distant to their lives and a larger degree of interest in other related services like transportation, skills development, etc. The dream consultation indicated some useful suggestions like access to the facility, playgrounds at the health centre for making it youth friendly. Young people also wanted ARTs not to make them unattractive and this belief helped adherence. Fertility was also a great desire and any fear that ARTs would interfere with this desire was a problem for adherence. Among many other interesting findings was the fact that there were high rates of illegal termination of pregnancy and nurses often deceived patients to get them to use barrier methods as opposed to long term contraceptive methods in the interest of dual protection.  

Gavin Lloyd George presented findings from a study on orphans and whether they reported worse caregiver interactions and out comes than non-orphans in mixed households. While orphans did face more psycho social problems than others, orphanhood was far from being a determining factor. For example, neither psychosocial outcomes including anxiety/depression, affability, and resilience, nor the quality of caregiver-child interactions differed significantly between orphans and non-orphans in mixed households. The likelihood of substance use or having had sex did not vary between orphans and non-orphans either.

Qadir Baig talked about the work on rights-driven institutionalization of SRH in Pakistan being conducted by his organization. With low HIV prevalence rates but increasing rates of STIs, it was felt that a multi pronged approach with young people, and those who influence their environment like parents, teachers, health workers, would be more useful. An educational policy on SRH was also developed and approval from the religious groups was achieved.

Questions from the audience suggested some concern about orphans still living under poor circumstances in many countries and elimination of MTCT still being an issue. An interesting point made was that other studies pointed to difference between non-AIDS and AIDS orphans and the reality that children who have very ill parents with HIV are often worse off compared to orphans .




   

    The organizers reserve the right to amend the programme.