Accessibilité et impact des traitements antirétroviraux hautement actifs (HAART)

The Rural Development Agency created village AIDS committees to improve access to HIV/AIDS services for poorly serviced rural populations. The aim is to describe the committees’ activities and their immediate impact on the population. Methods: training and equipping of members, followed by supervision of their activities, namely raising HIV/AIDS awareness, preliminary tests, screening, post-tests, referral of HIV positives to healthcare centres, continuation of healthcare in the community (home visits, observance of antiretroviral therapy, psychosocial accompaniment and palliative care), creation and running of support groups, identification and support of OVCs, and creation and monitoring of IGAs for HIV positives. Results: in 5 years, 144 village AIDS committees in 6 areas; 288 members trained in ART observance, the fight against stigmatisation, palliative care in the community and monitoring of OVCs; 1512 campaigns conducted, reaching 1,754,676 persons; increase in the number of clients receiving advice and screening from 1526 to 42,117; 15,780 HIV positives receiving medical attention and 4,920 receiving ART; 22,381 OVCs identified and monitored. The role played by village AIDS committees in the provision of HIV services in Côte d’Ivoire is complementary to clinical health care. The experience should be reproduced in other low income countries.

The HIV/AIDS pandemic is a health problem in Côte d’Ivoire. With an HIV prevalence rate of 4.7% in the population aged 15-49 (EIS 2005), the epidemic is widespread. As part of Phase 2 of the Global Fund supported programme, the measurement of indicators is a priority for the country. Therefore, an evaluation survey that could be compared against a base study (February 2008) was conducted to evaluate the impact of the programme. The aims of the survey were: (i) to evaluate the survival rate after 12-18 months of anti-retroviral (ARV) treatment, (ii) to evaluate the main determinants of survival in patients on ARVs, and (iii) to determine the percentage of infants (18-24 months) born to HIV-positive mothers that test HIV negative. The results of the study show an estimated survival rate after 12 months of 75% for patients taking ARVs between July 2007 and April 2008, compared with 71.7% for patients on ARVs between January and December 2006, which is an improvement of 3.3 percentage points. The percentage of babies born to HIV-positive mothers that tested HIV-negative was 61.2%.