1 / 24

Project Imp.Ac.T “ Improving Access to HIV/TB testing for marginalized groups ” Nadia Gasbarrini

Project Imp.Ac.T “ Improving Access to HIV/TB testing for marginalized groups ” Nadia Gasbarrini Fondazione Villa Maraini

vivien-kidd
Download Presentation

Project Imp.Ac.T “ Improving Access to HIV/TB testing for marginalized groups ” Nadia Gasbarrini

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Project Imp.Ac.T “Improving Access to HIV/TB testing for marginalized groups” Nadia Gasbarrini Fondazione Villa Maraini The Project “Imp.Ac.T. – Improving Access to HIV/TB testing for marginalized groups” (Ref.: 2009 12 01) has received funding from the European Commission under the Health Programme 2008-2013. However, the sole responsibility for the study lies with the author and the European Commission is not responsible for any use that may be made of the information contained therein".

  2. Imp.Ac.T. – General information • Co-financed by the EC under the Programme of Community Action in the field of Health (2008-2013) • Project Coordinator: Villa Maraini Foundation (IT) • Partners: Foundation Regeboog Groep (NL), SANANIM (CZ), OZ Odyseus (SK) and Gruppo Abele (IT) • Collaborating partners: public clinical centres for infectious diseases in Rome, Turin, Prague and Bratislava (in Rome “INMI Spallanzani”, in Turin “Ospedale Amedeo di Savoia”) • Duration: 27 M, from 1 September 2010 to 30 November 2012

  3. Imp.Ac.T.- General Aims • To broaden the access to HIV and tuberculosis (TB) testing, prevention, treatment and care for vulnerable groups, such as drug users (DUs) and migrants DUs. • To reduce the gap between DUs/migrants DUs and health care services and reduce inequalities in their access to treatment. • To define a new kind of provider-initiated counseling and testing strategy, to be adapted even for other hard-to-reach groups.

  4. Imp.Ac.T.- Background and justifications • IN EU, an estimated 15% to over 50% HIV+ people are unaware of their infection. • The proportion of TB cases with positive HIV serostatus in EU range from 2% to 15%. • Late diagnosis increases risk of opportunistic infections, such as TB, and onward transmission. • DUs and migrants are ‘hard to reach' groups for health care providers. • Low-threshold facilities are important entry-points for contacting ‘hard-to-reach’ drug users. • Evidence suggests that individuals that are aware of their HIV infection engage less in risky behaviors related to sex and injecting drug use.

  5. Imp.Ac.T.-Specific objectives • To develop a model for improving the effectiveness of HIV and TB testing and counseling among DUs and migrants DUs; • To increase the percentage of DUs and migrants having access to HIV and TB testing; • To ensure that people living with HIV and TB receive treatment for both conditions; • To promote healthier ways of life and risk reduction among drug users and migrants DUs; • To assess the effectiveness of street HIV and TB testing in terms of proportion of new infection identified.

  6. Imp.Ac.T.- Expected outcomes • Increasing number of persons tested for HIV and TB and notified TB and HIV cases among those unaware. • Reduction of HIV and TB transmission not only among DUs and migrants, but in the whole community. • Easier access to treatment and care for marginalized groups, through better cooperation between low-threshold facilities and health care services. • Increasing awareness of local authorities about the need of developing targeted interventions for drug users and migrants.

  7. Imp.Ac.T.- Target Group • Clients of low-threshold services (street units; drop-in-centres; night shelters; out-patient-clinics…) in Rome, Turin, Bratislava and Prague; • All kind of DUs, with a particular focus on Problematic DUs (using EMCDDA definition: injecting or with long duration/regular use of opioids, cocaine and amphetamines); • Migrants DUs (first generation; documented and undocumented); • Being over 18 years of age; • Not being tested for HIV in the last three months.

  8. Imp.Ac.T-Methodology The project consisted of three phases: • Development of common tools and methodology for HIV and TB testing among DUs in low-threshold services; • Implementation of HIV and TB tests in low-threshold services for the target population; • Analysis and assessment of the effectiveness of such intervention and dissemination of results.

  9. Phase 1:Development of common tools and methodology(7 months: September 2010 – March 2011) • Organization of workshops/seminars for exchange of experience among the partners and analysis of weaknesses and challenges of current HIV/TB testing strategies. • Development of tools for training courses for the multidisciplinary staff working in low-threshold services for DUs. • Identification of specific indicators/determinants for monitoring and reporting of new diagnosis among these target groups.

  10. Phase 1:Development of common tools and methodology (Implemented activities) 1° Workshop in Amsterdam 20-22 January 2011 Finalization of the Study Protocol: • Recruitment methods and tools • Pre- and post test counselling • Testing methods • Data collection: questionnaire and database • Follow up

  11. Phase 1:Development of common tools and methodology (Implemented activities) 2° Workshop in Turin 1-3 March 2011 Finalization of: • Training manual: structure • Training courses for the staff of low-threshold services • Focus groups with clients for data collection

  12. Methodology: Recruitment • Approaching by social/outreach workers; • Information about the project and the testing: informative leaflets on HIV and TB; • Response Monitoring Form: check eligibility and willingness to participate

  13. Methodology: Pre and post counselling • Informed consent (written or verbal according to country rules); • Information: HIV and TB infections, benefits and potential risks of testing; • Prevention counselling: risk assessment and reduction • Post-test counselling: both in case of reactive and negative results

  14. Methodology: HIV Testing • Rapid test DETERMINE HIV ½, third generation; • High sensitivity (100%) and specificity (99.75%); • By finger-stick sample; • Result in 15 minutes.

  15. Methodology: TB Testing • No latent TB infection, but ACTIVE TB detection • Clinical screening: Risk assessment + medical examination by doctor/ nurse • Sputum collection: 2 samples required in case of positive screening • In Prague, no sputum test but referral to X-ray

  16. Methodology: Questionnaire for data collection • Developed by the researcher • Collection of demographical, social and epidemiological data • Assessment of risky behaviours (drug use and sexual intercourse) • Administrated while waiting for HIV test results

  17. Methodology: Database • 1 developed by Villa Maraini on website • 1 online survey tool developed by Sananim for direct administration • Entry of all questionnaires and test results

  18. Methodology: Follow up • Agreement with clinical centres/collaborating partners • Referral of HIV reactive cases and TB suspected cases (positive to first sputum examination; positive to screening in Prague) • Tools: schedule of appointment; referral paper; accompaniment of clients by social workers • Exchange of data with clinical centres on testing results

  19. Phase 2:Implementation of HIV and TB tests in low-threshold facilities(April 2011- June 2012) • Training courses in each project site for the staff providing HIV/TB testing (social workers, psychologists, health professionals) • Pre-intervention focus groups with the target groupon risk behaviors, knowledge of HIV and TB transmission, history of testing • HIV and TB counselling and testing in low-threshold services managed by project partners and other NGOs • Follow-up of preliminary positive cases • 1° Experience-Sharing Meeting in Bratislava to discuss problems and find solutions

  20. Phase 3: Analysis and assessment of the intervention (May – November 2012) 2° Experience-Sharing Meeting in Prague, May 2012: • Presentation of data collected and testing results; • Discussion of main problems encountered; • Definition of the content of the Guide Manual on best practices; • Organization of National Conferences and Final Conference for dissemination of project results.

  21. Phase 3: Analysis and assessment of the intervention (May – November 2012) • Analysis of data of all the tested individuals by the researcher; • Evaluation of the project: self-evaluation form and evalution interviews; • Development of Guide Manual on HIV/TB testing for DUs and migrants in low-threshold services; • National Conferences in Prague and Bratislava, for dissemination of results at national level; • Final Conference in Rome, for presentation of project results at international level.

  22. Imp.Ac.T. - Key deliverables • Project website: www.projectimpact.eu • Training Manual on HIV/TB counselling and testing of DUs/ migrants in low-threshold services • Training Courses on HIV/TB testing for service providers • Guide Manual on HIV/TB testing for DUs and migrants in low-threshold services • National Conferences in Slovakia, Czech Republic, Italy • Final Conference • HIV and TB tests for marginalized groups: DUs/PDUs, migrants DUs, sex workers, alcoholics, homeless

  23. Imp.Ac.T. – Photo gallery

  24. Thank you for your attention

More Related