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Study examines lessons learned at Africa's first public antiretroviral treatment clinic

A public clinic offering antiretroviral (ARV) treatment to people with HIV/AIDS, recently established in Botswana, has had its share of trials and errors. However, the obstacles it has encountered--and has largely overcome--can serve as valuable lessons for other developing countries trying to launch their own treatment programs, according to an article in the March 15 issue of Clinical Infectious Diseases, now available online.

According to World Health Organization estimates, only about 700,000 of the 6 million people with HIV/AIDS who need ARV treatment are getting it. Major efforts are underway to increase access to ARV treatment, but many countries are struggling with limited staff and infrastructure.

Botswana's high rates of HIV--more than a third of its adult population is infected--make it a prime candidate for publicly available ARV treatment. Africa's first public ARV clinic opened in Gaborone, Botswana's capital city, in January of 2002, and was immediately inundated with patients, some of whom had to wait four or five months to begin ARV treatment.

Physical space for consultation and counseling proved to be the first challenge. The facility's 4,000-patient capacity was quickly reached. To handle the influx, additional buildings were erected, and they now accommodate more than 11,000 patients being treated at the clinic.

Clinic staffing changes were also necessary. Initially, medical personnel were rotated in from inpatient hospital wards in order to gain outpatient care experience. However, to ensure consistent care for clinic patients, a core team of HIV specialists was eventually created to staff the clinic and train junior staff as HIV care providers. All ARV clinic staff members involved in patient care received ongoing training to get the most up-to-date information on HIV treatment.

The lack of medical personnel available to staff such a specialized clinic in an African nation has varying causes, depending
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Contact: Steve Baragona
sbaragona@idsociety.org
703-299-0412
Infectious Diseases Society of America
10-Mar-2005


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