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The distribution of Cell Phones to Mothers of EID HIV positive Infants in Haiti :

The distribution of Cell Phones to Mothers of EID HIV positive Infants in Haiti : A model for Increasing Adherence ?. Background : EID. Test every infant born to an HIV + ive mother . The DNA PCR = HIV D x from 4 wks of age. Rapid ELISA = 18 months of age – Maternal antibodies

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The distribution of Cell Phones to Mothers of EID HIV positive Infants in Haiti :

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  1. The distribution of Cell Phones to Mothers of EID HIV positive Infants in Haiti: A model for Increasing Adherence?

  2. Background : EID • Test every infant born to an HIV +ive mother. • The DNA PCR = HIV Dxfrom 4 wksof age. • Rapid ELISA = 18 months of age – Maternal antibodies • Early diagnosis Early treatment • Untreated, mortality is over 50% < 2 years. HIV positive child < 2 years old age to start ARV treatment upon diagnosis.

  3. The numberof children infected is the ultimate measure of the success of the PMTCT program • Without the EID its impossible to know when the “Elimination of Transmission From Mother to Child” has been met.

  4. 2009 2008 2010 2011 - 2012

  5. Birth & Feeding Plan • FP Discussion • OPTION • B + • ARVs • Infant Prophylaxis • (AZT/NVP • 6 WKS) • Positive Infants Start ARVs • Negative Infants re-test after weaning • Pregnant women HIV +ive • Infant PCR 4-6 Wks

  6. Methods May 2010 • Given to mothers of newly diagnosed HIV + infants through the PCR program • Regularly communicate with the mothers about the child • Mothers who gave consent and signed “Contract” • Consent of Mothers with pre-existing cell phones • Contacted weekly - health status, appointments, drug adherence.

  7. Results

  8. Questionnaire

  9. Why were you given a phone? • 50

  10. Limitations • Small Sample Size :The EID program diagnoses 150 children per year in Haiti • No biologic markers of adherence • No Pre and Post follow : Given phones close to the time of diagnosis. • Not a randomized controlled trial. We did not want to risk losing children to follow up.

  11. Anecdotes LOOK away if Offensive! • Phones given close to the time of diagnosis, Phones helped start treatment earlier. • When children become acutely ill, mothers can ask for advice esp : cholera epidemic. • Links to health agents : drugs shortages/ transport issues • One Mother planned to commit suicide, but because of regular contact she felt more positive about the future. • One of our mothers was beaten by her partner • Phone as a security deposit for food.

  12. Other uses of Mobile technology in Haiti EID program • Live, online spreadsheet that is linked to the reference labs. • In 2010 median of 1 day for result transmission to the providers. 2000 children. Smart Phone Access the spreadsheet • Communicate with Pregnant Women • Adolescent Outreach

  13. Conclusions • Using cell phones with families of HIV-positive children has helped monitor these children. • Approx. 20% of PCR positive children identified are lost to follow up within 12 Months • Phones 20 USD in Haiti; not prohibitively expensive. The use of cell phones, as part of an active community tracking program has benefitted the Haiti EID program.

  14. Thanks and Acknowledgments MSPP USAID/ PEPFAR Voila Foundation Caris Foundation Directors

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