BACKGROUND: The President's Emergency Plan for AIDS Relief committed $15 billion to addressing HIV in resource-poor settings. OBJECTIVE: To assess the impact of The President's Emergency Plan for AIDS Relief on the treatment services of an HIV care program. DESIGN, SETTING, AND PATIENTS: Cohort study utilizing computerized medical records of nonpregnant adults enrolled into the Academic Model for the Prevention and Treatment of HIV/AIDS system, in western Kenya between 27 November 2001 and 24 July 2006. MAIN OUTCOMES MEASURES: Number of clinics and patients enrolled in Academic Model for the Prevention and Treatment of HIV/AIDS, as well as patient demographics, immunologic, and clinical characteristics during three periods defined by the availability of combination antiretroviral therapy (cART). RESULTS: Enrollment as of May 2006 was 23,539. Mean monthly enrollment increased from 64 to 815 between periods 1 and 3. The median CD4 cell count at enrollment during period 3 (172 cells/microl) was significantly higher than for period 2 (119 cells/microl; P < 0.001). World Health Organization stage at enrollment differed significantly between periods with 6.7% having stage 4 disease in period 3 compared with 13.8% during period 1 (P < 0.001). Significantly more patients had complete documentation of cART eligibility, during period 3 as compared with the previous periods. Time from enrollment to cART initiation decreased from a median of 64 weeks in period 1 to 12 weeks during period 3 (P < 0.001). CONCLUSION: The President's Emergency Plan for AIDS Relief funding has allowed Academic Model for the Prevention and Treatment of HIV/AIDS to significantly increase the number of individuals receiving HIV care and provided the ability to expand services allowing for identification of patients earlier in their disease process.
BACKGROUND: The President's Emergency Plan for AIDS Relief committed $15 billion to addressing HIV in resource-poor settings. OBJECTIVE: To assess the impact of The President's Emergency Plan for AIDS Relief on the treatment services of an HIV care program. DESIGN, SETTING, AND PATIENTS: Cohort study utilizing computerized medical records of nonpregnant adults enrolled into the Academic Model for the Prevention and Treatment of HIV/AIDS system, in western Kenya between 27 November 2001 and 24 July 2006. MAIN OUTCOMES MEASURES: Number of clinics and patients enrolled in Academic Model for the Prevention and Treatment of HIV/AIDS, as well as patient demographics, immunologic, and clinical characteristics during three periods defined by the availability of combination antiretroviral therapy (cART). RESULTS: Enrollment as of May 2006 was 23,539. Mean monthly enrollment increased from 64 to 815 between periods 1 and 3. The median CD4 cell count at enrollment during period 3 (172 cells/microl) was significantly higher than for period 2 (119 cells/microl; P < 0.001). World Health Organization stage at enrollment differed significantly between periods with 6.7% having stage 4 disease in period 3 compared with 13.8% during period 1 (P < 0.001). Significantly more patients had complete documentation of cART eligibility, during period 3 as compared with the previous periods. Time from enrollment to cART initiation decreased from a median of 64 weeks in period 1 to 12 weeks during period 3 (P < 0.001). CONCLUSION: The President's Emergency Plan for AIDS Relief funding has allowed Academic Model for the Prevention and Treatment of HIV/AIDS to significantly increase the number of individuals receiving HIV care and provided the ability to expand services allowing for identification of patients earlier in their disease process.
Authors: Vincent Ochieng-Ooko; Daniel Ochieng; John E Sidle; Margaret Holdsworth; Kara Wools-Kaloustian; Abraham M Siika; Constantin T Yiannoutsos; Michael Owiti; Sylvester Kimaiyo; Paula Braitstein Journal: Bull World Health Organ Date: 2010-04-16 Impact factor: 9.408
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Authors: Thomas A Odeny; Jeremy Penner; Jayne Lewis-Kulzer; Hannah H Leslie; Starley B Shade; Walter Adero; Jackson Kioko; Craig R Cohen; Elizabeth A Bukusi Journal: AIDS Res Treat Date: 2013-05-07