VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
What Do We Know About Adherence in ICAP Programs?: A Review of the Data
1. ICAP Adherence Data Molly McNairy, MD, MSc Supporting Sustainable Adherence to HIV Prevention, Care & Treatment ICAP Technical Workshop October 19-22, 2009Kigali, Rwanda
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3. Meta-Analysis: Adherence at 2 years Rosen et al. PLoS 2007 32 studies in SSA 1996-2007 ~75,000 patients in non-research ART 6 mo = 80% pts retained 12 mo = 60% pts retained At 2 Years*: BEST CASE = 84% WORST CASE = 46% AVERAGE = 61% ~40% LTFU at 2 years Of which, LTFU 56%, Death 40% 61% at 24 months
4. A closer look at ICAP Adherence Data June 2009 URS, PFaCTS, Patient-level “Those are other programs”
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8. Two-year cumulative risk of death, loss to follow-up9, and loss to program8among ART patients since ART initiation (Total 91,612 patients)
9. Pediatric ART patients since ART Initiation Patient level data through June 2009 (n= 28 sites)
10. Applying the Meta-Analysis ResultsTo ICAP Adherence Data “Good Adherence>95%” Our GAP *Rosen et al PLoS Med 4 (10) 2007
11. Cumulative and current enrollment in ART care at ICAP-supported HIV care and treatment programsas of June 2009 (n= 327,092) Cumulative initiating ART Lost to follow up Reported dead Number of patients ART patients retained in care
12. Status of ART patients at ICAP sites June 2009 (n= 327,092) 10.3% per year on ART Lost to Follow-up 5.3% per year on ART Reported Dead .59% per year on ART Stopped ART *Includes patients who transferred out while on ART.
13. PFaCTS Data on Adherence services Type of patient support service Type of adherence service # outreach workers Methods for tracking missed appointments Time to follow-up/tracking
14. Sites offering on-site patient support services (n=323) Take Home: All sites have services, but what are those services doing? % sites with service
17. Mean number of outreach workers at ICAP-supported HIV care and treatment sites (n=183) Mean number of outreach workers
18. Number of outreach workers per 1,000 active ART patients at ICAP sites with at least 1 dedicated outreach worker,PFaCTS Round 4 (Jan-Jun 2009) n=8 n=48 n=18 n=11 n=17 n=39 n=8 n=33 n=207 n=24 n=1 Note: The bubbles represent the median across sites and the bars represent the IQR.
30. Proportion of adult ART patients on second line regimens in ICAP supported care and treatment sites, June 2009 Note: Restricted to sites that report >=90% of regimen data
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32. ICAP has LTFU rates similar to other large ARV programs