Article

Evaluation of a workplace HIV treatment programme in South Africa

University of KwaZulu-Natal, Port Natal, KwaZulu-Natal, South Africa
AIDS (Impact Factor: 6.56). 08/2007; 21 Suppl 3:S73-8. DOI: 10.1097/01.aids.0000279696.63438.aa
Source: PubMed

ABSTRACT To review the experience of implementing a workplace HIV care programme in South Africa and describe treatment outcomes in sequential cohorts of individuals starting antiretroviral therapy (ART).
A review of an industrial HIV care and treatment programme. Between October 2002 and December 2005, 2262 patients enrolled in the HIV care programme.
CD4 cell counts increased by a median of 90, 113 and 164 cells/microl by 6, 12 and 24 months on treatment, respectively. The viral load was suppressed below 400 copies/ml in 75, 72 and 72% of patients at 6, 12 and 24 months, respectively, at an average cost of US$1654, 3567 and 7883 per patient virally suppressed, respectively. Treatment outcomes in sequential cohorts of patients were consistent over time. A total of 93.6% of patients at 14,752 clinic visits reported missing no tablets over the previous 3 days. Almost half the patients (46.8%) experienced one or more adverse events, although most were mild (78.7%). By the end of December 2005, 30% of patients were no longer on ART, mostly because of defaulted or stopped treatment (12.8%), termination of employment (8.2%), or death (4.9%).
This large workplace programme achieved virological results among individuals retained in the programme comparable to those reported for developed countries; more work is needed to improve retention. Monitoring treatment outcomes in sequential cohorts is a useful way of monitoring programme performance. As the programme has matured, the costs of programme implementation have reduced. Counselling is a central component of an ART programme. Challenges in implementing a workplace ART programme are similar to the challenges of public-sector programmes.

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    • "Properly administered ART can extend the healthy life span of workers by ten years or more (Walensky et al., 2009). Research from South Africa has shown that workplace ART provision can achieve HIV viral suppression comparable to levels reported in developed countries (Charalambous et al., 2007). Rosen et al. (2008) found that pre-ART workers were almost twice as likely to report being unable to work in the previous fiveday work week than those who had recently begun ART. "
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