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Situasi Terkini tentang Penelitian dan Pelaksanaan Test dan Treat di Indonesia

Situasi Terkini tentang Penelitian dan Pelaksanaan Test dan Treat di Indonesia. @America, 28 Oktober 2014 Lecture Series Pusat Penelitian HIV dan AIDS. Topik. Latar Belakang, tujuan Study design; KAPs of interest, sample, sites, intervention package Project governance structure Progress.

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Situasi Terkini tentang Penelitian dan Pelaksanaan Test dan Treat di Indonesia

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  1. Situasi Terkini tentang Penelitian dan Pelaksanaan Test danTreat di Indonesia @America, 28 Oktober 2014 Lecture Series Pusat Penelitian HIV dan AIDS

  2. Topik • Latar Belakang, tujuan • Study design; KAPs of interest, sample, sites, intervention package • Project governance structure • Progress

  3. Jumlah Infeksi Baruper tahun, per sub-populasi(2012 MATHEMATICAL MODELLING )

  4. Indonesia: Cumulative cross-sectional* HIV Care Cascade *Cumulative data up to Dec 2012 Source: Monthly ART report, MoH

  5. Tingkat Retensi ART selama 12, 24 & 60 bulan di beberapa negara, 2011 84% 78% 72% Source: WHO-HQ

  6. Test & Treat, Tujuan: ↓ HIV Immediate linkage to care and offer ART

  7. Implementasi Test & Treat: perlu telaah lanjutan • Intervensi2 meningkatkan kualitas cascade of care? • Perhatikan konteks lokal • Perhatikan KAP • Berkelanjutan • Partisipasi aktif masyarakat sipil terdampak? • Epidemi terkonsentrasi, KAP tidak mudah dijangkau? • Inisiasi awal ART, perhatian khusus: • Kepatuhan rendah • resistance

  8. The HATI ProjectHIV Awal (Early) Testing & Treatment Indonesia ProjectImplementation of ‘Test and Treat’ strategies for HIV treatment and prevention in key populations in Indonesia: a prospective implementation research study

  9. Study design: key objectivesKAPs of interest: MSM, FSW, Waria • Primary : To assess the impact of enhanced community based intervention compared with current practice, on: • The number of people from each key population started on ART and retained in treatment at 12 months. • The proportion of people from each key population who are virologically suppressed 12 months after HIV diagnosis. • Secondary: • To quantify and compare the HIV treatment cascade/continuum of care. • To assess safety of ART and acceptability of early ART initiation. • To assess behavioural aspects of a T&T strategy, including impact on risk behaviours. • Research capacity building objectives • To enhance the capacity of senior local researchers as research leaders. • To increase the research skills and experience of early career researchers.

  10. Study design: Schema YEAR-1: Pre-intervention phase (No intervention at all sites) -ART regardless of CD4 count -Set up data management and monitoring systems -Design and plan interventions YEAR-2: Implement selected interventions at selected sites Or, Selected interventions in a selected KAPat all sites YEAR-3: Full intervention package at all sites and allKAPs Year-4: Follow-up Assess outcomes at the end of 1 year of follow-up of patients recruited in each year

  11. Recruitment and Sample • Total sample size across 3 sites in 3 years: 600 HIV positive MSM and 600 HIV positive FSW • No specified target for waria • All sites may recruit all KAPs

  12. Sites: Bali, Yogya, BandungPrimary and Satellite Sites; the Roles (Bali)

  13. Development of Package Intervention

  14. Project Governance Structure

  15. Progress • MoU between WHO and Kirby will be signed by both parties soon • Draft MoU between Kirby and 3 universities (UGM, Padjajaran, Udayana) are being finalized • Draft detailed protocol is being finalized

  16. Terimakasih

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