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Improving access to HIV services among rural communities

Improving access to HIV services among rural communities Results from the TAZAMA study in Tanzania. Alison Wringe London School of Hygiene and Tropical Medecine 17 th July, 2011: IAS, Rome. Overview. TAZAMA & the Kisesa HIV cohort study

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Improving access to HIV services among rural communities

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  1. Improving access to HIV services among rural communities Results from the TAZAMA study in Tanzania Alison Wringe London School of Hygiene and Tropical Medecine 17th July, 2011: IAS, Rome

  2. Overview • TAZAMA & the Kisesa HIV cohort study • Key research results on access to HIV services • Unmet need for HIV services including PMTCT • The relationship between stigma and VCT use • Community responses: Village AIDS Committees and home-based care • Implications of findings for PMTCT

  3. City Kisesa cohort : 5 villages + trading centre in Magu

  4. Unmet need for HIV services VCT, no referral No clinic registration No VCT Registered, not screened Screened, not eligible Eligible, no ART On ART

  5. Key results (2) Urassa et al. IAS Vienna 2010

  6. Unmet need for HIV services

  7. Impact of stigma on VCT use Ref: Roura,2008

  8. Village AIDS Committees: HIV knowledge

  9. Challenges in delivering HBC

  10. Implications for PMTCT research • Poor access to HIV services including PMTCT explained by interplay between individual, social and programmatic factors: responses only targeting the individual unlikely to be succesful • Increasing the number of services alone doesn’t necessarily translate into improved access or reduced HIV-related stigma • Community-based initiatives have enormous potential to improve access - but need to be properly resourced in order to be effective • Many lessons regarding the scale-up of community-level initiatives can be learned from past programmes

  11. Acknowledgements • Study participants in Kisesa • Staff at the Kisesa health centre and Mwanza hospitals • National Institute of Medical Research • TAZAMA team in NIMR & LSHTM

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