ICAP News - July 2009

Peer Educator Training Held at Kigali Central Prison

In mid July, ICAP supported a peer educator training for 50 inmates living with HIV at Kigali Central Prison. The training, held in collaboration with Rwanda’s Ministry of Internal Affairs and the Ministry of Health, focused on a range of HIV-related topics, including treatment adherence, as well as women’s and children’s rights.

The training, the first of its kind at a Rwanda prison, was organized as part of the ICAP-supported Peer Educators Adherence Referral and Linkages (PEARL) program.

Since 2007, ICAP has supported HIV care and treatment at Kigali Central Prison, which houses more than 4,200 inmates. Currently, 670 prisoners are receiving HIV care, including provision of antiretroviral treatment for 250 individuals.
Another peer educator training will be held later this year at Gisenyi Central Prison in Rwanda.

“PEARL offers a strategic approach to dealing with HIV, which poses a major health challenge in our prisons,” said Steve Balinda, Rwanda’s commissioner of prisons.
In Rwanda, ICAP is funded by the U.S. Centers for Disease Control and Prevention under the President’s Emergency Plan for AIDS Relief.

Photo caption: As part of the peer educator training, inmates at Kigali Central Prison perform a skit about HIV.

For more about ICAP Rwanda, visit here.

ICAP Faculty Address Response to HIV at International AIDS Society Conference

In a plenary session at the International AIDS Society (IAS) Conference in July in Cape Town, South Africa, ICAP Global Director Wafaa El-Sadr, MD, delivered a talk titled “HIV and Inflammation: A Paradigm Shift,” in which she detailed mounting evidence about the role of inflammation and coagulation abnormalities in the pathogenesis of HIV disease and particularly in the occurrence of complications such as serious heart, liver and kidney diseases. “Clinical HIV latency is a misperception,” said El-Sadr. “HIV may be causing damage during early HIV disease and when the virus is controlled with antiretroviral therapy (ART).”

El-Sadr and Miriam Rabkin, MD, ICAP director for development, also assisted in the planning of a groundbreaking pre-conference meeting on “Accelerating the Impact of HIV Programming on Health Systems Strengthening.” In a presentation titled “HIV Program Design: Lessons Learned for a Broader Impact,” El-Sadr highlighted how HIV as a chronic communicable disease has inspired the establishment of health services uniquely able to respond to other health threats in resource-limited countries, particularly chronic non-communicable conditions.

Also at the conference, Elaine Abrams, MD, ICAP research director, gave a symposium presentation on “Improving the Quality of Mother-to-Child Transmission Prevention Programs (PMTCT).” Abrams described innovations developed by the ICAP teams in Ethiopia and Lesotho in collaboration with in-country teams that address key challenges, including engaging men in PMTCT and providing women with interventions for their own health during pregnancy and post-partum periods.

A total of 11 other presentations included ICAP-affiliated individuals addressing various aspects of HIV-related issues such as: initiating ART in eight sub-Saharan African countries; ART initiation among adults in HIV care and treatment programs in Mozambique; scale-up of ART in resource-limited countries; and issues regarding scale-up of medical male circumcision for HIV prevention, survival of infants initiating ART, and nutrition support services. All the presentations may be reviewed here.

Support for HIV Services Expanded to Remote Qacha’s Nek District in Lesotho

In Lesotho, ICAP has expanded its support for comprehensive HIV services to Quach’s Nek District, a mountainous area with some of the most difficult to reach health facilities in the country.

Among the first facilities to be assessed was Machabeng Hospital, where needs were identified for strengthened staff skills, improved records management systems, and better service linkages. In support of this facility and others in the district, ICAP, in collaboration with the Ministry of Health and Social Welfare and the Quach’s Nek District Health Management Team, recently coordinated a six-day training for multi-disciplinary team members on the comprehensive MTCT-Plus model of care.

“This training set a platform from which to build on the collaborative efforts of ICAP and health care workers in Qacha’s Nek to improve the provision of a comprehensive and integrated HIV care and treatment for HIV-infected women, their children and families,” said ICAP-Lesotho Country Director Raphael Ntumy, MD.

For more about ICAP Lesotho, visit here.

New Treatment Clinic Commissioned at Gombe Hospital in Nigeria

In late June, U.S. Ambassador to Nigeria Robin Renee Sanders commissioned a newly renovated antiretroviral treatment clinic, laboratory, adherence unit, and library, at ICAP-supported Gombe State Specialist Hospital. The site provides HIV care to more than 3,500 individuals, including antiretroviral therapy to 1,300 people.

During her visit, Sanders met with a support group of people living with HIV and learned about a food bank operated by the group to provide supplementary nutrition to clients. Joining Sanders in her visit were officials from the U.S. Centers for Disease Control and Prevention (CDC), Gombe State, the Nigerian Health Commission, as well as senior hospital staff.

ICAP, with funding from the CDC under the President’s Emergency Plan for AIDS Relief, supported renovations at Gombe Hospital. ICAP supports 123 HIV service sites in Nigeria.

For more about ICAP Nigeria, visit here.

Income-Generating Activities Empower Support Group Members in Rural South Africa Community

A support group of people living with HIV in a rural South Africa community has developed a number of income-generating activities, including producing clothing and growing vegetables, to provide home-based case visits and conduct HIV/AIDS education.

The Cebisanani Support Group emerged in 2003 from a PMTCT program at ICAP-supported Greenville Hospital in South Africa’s Eastern Cape. The group’s founding members initially began making beads and sewing aprons to generate income. Their activities eventually grew into growing vegetables and wood-working.

The support group has 35 active members, but as many as 500 people living with HIV are involved. In addition to supporting one another, the group is active in raising awareness of HIV/AIDS through educational songs and dramas. Group members also regularly speak about HIV prevention at churches and funerals, and engage traditional healers in advocacy efforts.

“When the support group began, members faced a great deal of stigma and discrimination from their communities,” said Nqandiwe Ntobela, a support group member. “But because they were well educated by the nurses at the clinic, they knew what they were doing was for their own benefit and that of others, and they never gave up.”

Photo caption: Cebisanani Support Group members tend to a garden, among several income-generating activities.

For more about ICAP South Africa, visit here.