A pilot project for the effective delivery of HAART in rural China.

The purpose of this pilot study, conducted in rural Jilin Province in northeastern China, was to develop and test an infrastructure for the delivery of highly active antiretroviral therapy (HAART) that might be applicable to other such areas across the country. Earlier attempts to provide antiretroviral therapy in rural areas met with mixed success in large measure because of social stigma, a lack of adequate physician training, and problems with patient retention. In response to these problems, a highly integrated and family-centered approach was developed that placed emphasis on the primary care level for regimen delivery. Using this structure, a treatment naïve cohort of 22 male and 20 female (n = 42) volunteers with HIV/acquired immune deficiency syndrome (AIDS) was given government-provided HAART. After 12 months, all volunteers remained in the cohort, and there were significant changes in both CD4 levels and ability to return to work. Per patient cost for the 12-month study was Dollars 1,259.00, with Dollars 1,149 being spent on treatment and Dollars 110.00 on educational and administrative costs. This project demonstrated that HAART can be delivered successfully in resource-poor rural areas in China.