Effects of Lay Health Workers. Effects of decentralising testing.

Two presentations. The first looked at the impact Lay Health Workers can make on male and female HIV transmission, contraception and ART take up in South Africa. The second looked at the effected of decentralising testing in Myanmar.

Low HIV Incidence amongst Pregnant and Post partum Women Receiving a Lay Health Worker HIV Prevention Intervention in South Africa.

Background

Each year 1 million woman in South Africa become pregnant. Of those 30% is HIV positive.

Study

Health Workers provide information, education and counselling to male partners. They also education on multiple partners, mental health, alcohol use, provide condoms as well as linking care for those found to be HIV positive. They offered circumcision for men HIV negative and referred them accordingly, as well as symptom screening of STI’s.

Outcome

There was a huge decrease in people needing treatment within the group, verses the background South African population.  Maternal HIV incidences 73-86% lower than previous studies. Community based HIV prevention was effective, and Health Workers were found to be highly effective.

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High HIV Positivity amongst other Vulnerable Populations Reached Through Decentralized HIV Testing and Counselling in Myanmar.

I found this presentation interesting, as it demonstrated how taking the test to the people is more effective than having the people come to the test. This will change my practice, as instead of providing information on where people can have a HIV test, I will investigate the possibility of having the test ready to administer to my patients.

Introduction

224,794 PLWHA in Myanmar live with HIV, which equates to 0.6% of the population. The key populations are People Who Inject Drugs, female sex workers and men who have sex with men. However HIV appears in other population groups, which are not being well serviced by the centralised testing program.

In 2014 HIV testing was decentralised. Since then, there has been a steady increase in testing. The number of people diagnosed with HIV steady decreased.

Results

There are high rates of stigma and discrimination towards PLWHA. High rates of diagnosis have been detected in miners, boarder regions, migrant works and mobile populations i.e. truck drivers.

Tailored services need to be developed to cater for the mobile population and increase access to testing for gold/jade miners.