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7/27/2019 Integrating Cervical Cancer Prevention Services into the Care and Treatment of Women Living with HIV/AIDS in Cote dIvoire Powerpoint

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Integrating Cervical Cancer Prevention Servicesinto the Care and Treatment of Women Living

with HIV/AIDS in Cote dIvoire

Date : 05/10/2013

Presenter Name : Oumar Toure

Country Office : Cote DIvoire

Presenter Title : Technical Advisor onCECAP


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Outline

Background

Cervical Cancer Prevention Project

Key Implementation Steps

Key Achievements

Challenges

Lessons Learned

Success Stories

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Background

Cte dIvoire: West Africa

Population: 20 millions inhabitants

Highest HIV prevalence in WestAfrica: 3.4

Cervical cancer is the leading causeof mortality due to cancer amongwomen

HPV prevalence in West Africa ishigher 21,5 versus worldwide 10

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1. Institut National de Statistique _ 2006

2. EDS_2012

3. Programme National de Lutte contre le Cancer _ 2012

4. (WHO-AFR/RC60/6-2010)


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Cervical Cancer Prevention Project

Five year CDC/PEPFAR funded project (2009-2014)Goal: To help reduce cervical cancer morbidity and mortality inWLHIV.

Specific objectives:

1. To orient stakeholders for the development andimplementation of national strategies and programs forcervical cancer prevention

2. To integrate cervical cancer screening as a systematic

service to offer as part of care and treatment of WomenLiving with HIV

3. To initiate mass awareness about cervical cancer burden

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Key Implementation steps

Advocacy meeting with stakeholders

Establishment of a high level technical advisory andtechnical working group

Rapid situation analysis

Procurement of equipment and supplies

Trainings

Supportive supervision visits to health facilities

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Key Achievements

20 pilot sites were upgraded in 19 health districts to provideVIA/cryo

8925 HIV+ representing 72% of female cohort aged 17 to 50receiving HIV care and treatment within 20 pilot sites

received at least once IVA 9% HIV+ women presented VIA positive among which 76%

received Cryo according to SVA

4522 HIV neg. also received the VIA at the same time among

which 3% were VIA+ 40% of women screening VIA+ presented large lesions not

eligible for cryotherapy


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Key Achievements cont.

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

HIV positive HIV ngative

9%

3%

Percent

HIV Status

Chart B : Percent of VIA positive by HIV

status

HIV

positive,

8925,(66%)

HIV

ngative

4522

( 34%)

Chart A : Number of new VIAscreenings conducted


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Key Achievements cont.

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

HIV positive HIV ngative

40%

25%

Percent

HIV status

Chart C: Percent referrals for large

lesions

76%

24%

Chart D : # SVA RATE HIV +

# of new cl ients with VIA+ receiv ing

imm ediate cryotherapy

# of new cl ients with VIA today AND

cryotherapy postponed


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Challenges

Constant transfer out of health care provider Existing clients circuit in the hospital

Lack of motivation of provider in general

Maintenance/repair of Cryotherapy machines

The lack of privacy about the HIV status in the facilities

Insufficient of referral sites for LEEP (2 for 20 sitesdispersed widely in the country)

Insufficient capacity of laboratories specimen analysis postsurgery after LEEP


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Lessons Learned

Importance of Workingclosely with PLHIV;

Match VIA screeningSchedule with any other;

Raise awareness of allhealthcare providers at anystation/ward of the facility;

Include a section onCECAP in the patient file

Match the screening daywith the market day

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Success Stories

Happy and delivered I feel said Mrs. K.A., an HIVpositive woman after she was told to be VIA negative inher one year follow up rendezvous.

MOH has decided to scale up cervical cancer screening

with VIA nationwide for the coming five years Other donors (UNFPA) awards CECAP through

VIA/Cryotherapy in CDI regardless to HIV status

Cervical cancer screening with VIA is mentioned as a

must in the national guideline for HIV/AIDS care andtreatment

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Successful integration of cervical cancer prevention inHIV/AIDS care and treatment leads to smile recovery

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MERCI BEAUCOUP

[email protected]

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