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ACCESS TO TREATMENT BY PEOPLE LIVING WITH HIV IN ZAMBIA

ACCESS TO TREATMENT BY PEOPLE LIVING WITH HIV IN ZAMBIA. Presented by: Kunyima Lifumbela Banda Network of Zambian people living with HIV/AIDS (NZP+). Introduction. Government with support from Co-operating partners has been providing free ART in public health institutions in 2006.

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ACCESS TO TREATMENT BY PEOPLE LIVING WITH HIV IN ZAMBIA

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  1. ACCESS TO TREATMENT BY PEOPLE LIVING WITH HIV IN ZAMBIA Presented by: KunyimaLifumbela Banda Network of Zambian people living with HIV/AIDS (NZP+)

  2. Introduction • Government with support from Co-operating partners has been providing free ART in public health institutions in 2006. • The number of public and private facilities providing related services such as CD4 counts has also grown • There has also been an increase in the supply of HIV-related services in both rural and urban areas

  3. Cont… • Increase in access to medication for prevention and treatment of opportunistic infections such as TB

  4. Overview of ART Situation • 1 million people living with HIV in Zambia • 368,821 PLHIV accessing treatment • 57% are women • 31% are Men • 27,419 children 0 – 14 years

  5. Cont… • 96% on 1st Line treatment • 4% on 2nd line treatment • Under 1% on 3rd Line treatment • 69% urban • 31% rural • 54% receive care at health centre level

  6. Facilities Providing HIV related services • About 1,800 health facilities in Zambia (Government, private, NGOs) • 1,468 provide VCT • 1,253 provide PMTCT • 484 provide ART • 297 provide pediatric ART

  7. Conti… • 150 facilities provide CD4 • 3 sites provide PCR testing – UTH, Kalingalinga and Arthur Davies Hospital • 2 sites provide viral Load – UTH and Kalingalinga

  8. Facilities soon to provide Viral Load and PCR • Chipata General Hospital • Ndola Central Hospital • Mansa General Hospital

  9. NZP+ Survey on Access to Medical services • NZP+ conducted a survey access to medical services by people living with HIV in 12 districts. • Survey was conducted among people living with HIV • Objective was to get experiences from PLHIV on access to treatment

  10. General Information • 59% of people interviewed were women • 98% were above the age of 30 • 60% single (unmarried or widowed)

  11. Information on ART • 98% where on ART • 40% did not know the name of drugs they were taking • Less than 1% were on second line treatment • 66% did not frequently get a CD4 test done • 60% did not know their CD4 count • 19% get information from the support groups • 24% from medical staff

  12. Cont.. Reason for testing • 62% tested after a long illness • 11% referred after TB treatment Distance to ART centres • 12% within 10km • 75% above 20km

  13. Access at health facilities • 70% indicated 3 hours as minimum time before seeing medical personnel • 48% saw a clinical officer on appointment days and 25% say a nurse • 60% felt that time spent with the medical personnel was not enough but generally expressed satisfaction with the ability to express themselves.

  14. Cont… In the PLHIV Stigma Index study: • 8.4% of respondents reported being denied health services (including dental services) • 9.7% of the respondents reported having been denied family planning services as a result of their HIV status • 11.8% indicated that they had been denied sexual and reproductive health services.

  15. Challenges

  16. Challenges

  17. Our Role in increasing uptake of services • Advocacy for increased ART • Community Mobilisation • Community preparedness • Information provision • Treatment literacy • Community Referral • Contribution at health facilities • Pre and post test counselling • Adherence support • Referral • Record keeping • Linking PLHIV to business development services

  18. Our Recommendation • Scale up access to treatment as close to people as possible • Need for integration of services - HIV, TB, MCH, SRH services • Scale up testing and treatment for children and adolescents • Scale up availability of pediatric formulae • Scale up support to community initiatives • Promote treatment as prevention

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