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Home-based HIV/AIDS counseling and testing initiative in western Kenya reaches 1 million people

May 22, 2014

AMPATH announced at the 2014 Consortium of Universities for Global Health Annual Conference that their groundbreaking initiative to provide perpetual home-based counseling and testing had reached the one millionth person in western Kenya.

Getting tested for AIDS

William and Jane Tenai of the village of Soy in Kenya become the 1-millionth person and 1-millionth-and-one person to be tested for HIV/AIDS in their home communities through AMPATH.

The Eldoret, Kenya-based Academic Model Providing Access to Healthcare, or AMPATH, a consortium of 11 North American academic health centers led by the IU School of Medicine, working in collaboration with Moi University School of Medicine and Moi Teaching and Referral Hospital in western Kenya, has been implementing the program in cooperation with the Kenyan Ministry of Health, United States Agency for International Development and the AbbVie Foundation.

"This initiative has now resulted in more than 1 million people being reached for testing and counseling, and if found to be HIV positive, immediately referred into care and treatment," said Sylvester N. Kimaiyo, M.D., CEO of AMPATH. "We will not win the AIDS battle by waiting for sick people to come to our clinics, but only by bringing HIV testing to people's homes in Africa. We are grateful to all our partners -- especially the Kenyan Government, USAID and our lead private sector partner, the AbbVie Foundation -- who have made this possible through their support.”

In the village of Soy, Uasin Gishu County, Mr. William Tenai, 43, and his wife Jane Tenai, became the 1-millionth person and 1-millionth-and-one person respectively to be reached in their homes since the inception of the Primary Health Care Team program.

AMPATH team

The AMPATH field team stands outside the site of the 1-millionth test.

“I was nervous at first to learn my HIV status,” said Mrs. Tenai. “Now I know my HIV status is negative and also how to stay safe thanks to the health talk by the AMPATH counselor.”

A celebration event was also held in the Soy village by Dr. Kimaiyo, who met the local administration led by the local area chief, Mr. Ben Chulele and elder, Joram Mwangi. Robert Clay, deputy assistant administrator of Global Health at USAID.

"We are proud of our partnership with Moi Teaching and Referral Hospital and AMPATH and the program’s role in addressing the Kenyan government’s priority for HIV testing and advancement of medical care for HIV positive individuals," Clay said. "This program has been a successful example of an effective partnership in fighting HIV/AIDS, in a resource poor setting, which could be replicated in other AIDS endemic regions of the world."

With AbbVie Foundation support, AMPATH is building an operational model of care, called FLTR, that is structured to stop the HIV pandemic. This involves finding every HIV-infected person; linking that person to care; treating the individual; and retaining that person in care.

AMPATH team

AMPATH CEO Sylvester N. Kimaiyo, M.D., center, with William and Jane Tenai.

"We are honored to support the work of AMPATH as they scale-up up their HIV testing and treatment model, which has had an outstanding initial success rate," said Tracie Haas, president of the AbbVie Foundation. "By building on AMPATH's remarkable FLTR model, we may finally have the ability to slow down and eventually defeat the AIDS pandemic."

In addition to reaching HIV-positive people and connecting them with necessary services, the AMPATH program is also helping those who test negative by making them aware of their status and providing information and support so they remain HIV-free. This initiative has also benefited from electronic clinical information management systems including AMPATH’s Medical Record System, based on an OpenMRS platform, and use of smart phones to collect and convey information and facilitate modern record keeping that have enabled task shifting and high quality, cost-effective delivery of care.

The campaign was officially launched in 2009 by the Right Honorable Raila Odinga, then Prime Minister of the Republic of Kenya, GBCHealth and the U.S. President's Emergency Plan for AIDS Relief. Early participants in the Health at Home/Kenya Impact Initiative included the Abbott Fund, Accenture, Bristol-Myers Squibb Foundation, CfC Stanbic Bank Kenya (a member of Standard Bank Group), The Coca-Cola Company, Deutsche Post DHL, Pfizer Inc., Premier Medical Corporation, SAB Miller and Standard Chartered Bank.

While historic numbers of patients are receiving modern antiretroviral treatment, the incidence of new infections and prevalence rates remain stubbornly high in Kenya.

AMPATH team

Residents of the village of Soy celebrate the milestone.

The primary health care team campaign has brought not only HIV testing to hundreds of thousands of people’s homes -- mostly in remote areas -- but also TB screening, malaria bed nets, deworming medication, orphan and vulnerable children identification, nutrition assessments and the promise of care and treatment if a person is found to be positive.

In a pilot area of 500,000 people, counselors are also screening for hypertension and diabetes through blood pressure and blood sugar testing. The approach of bundling services has reduced the stigma of these home visits as well as providing access to care to people in need.

Significantly, AMPATH’s primary health care teams were welcomed into the majority of homes and more than 95 percent of those eligible agreed to be tested.

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