Plans for Analysis of USG Emergency Plan Multi-Country

ART Program

John Aberle-Grasse CDC, Global AIDS Program

U.S. Department of Health and Human Services

Analysis Proposal

Analyze the “quantity” and “quality” of HIV care and treatment programs supported by the USG multi-country partners across the 15 Emergency Plan focus countries

Publish “simple” description of results in a prominent medical or public health journal, submitted in approximately 9-12 months

Analysis Rationale

The Emergency Plan ART program is very large and complex and should be monitored and evaluated to assess progress both in scale-up and service quality

Program success (and challenges) should be published to inform the medical and scientific community and the US public that supports the program

Analysis Rationale

Track 1.0 grantees (4) and the Department of Defense and Family Health International provide direct ART services across multiple countries to over 1/3 of patients in the Emergency Plan

This large (relatively) standardized ART program data and reporting represents a unique and significant opportunity to describe the extent and quality of HIV care and treatment being supported by the USG

Proposed Title and Authorship

Working title- Scale up of Antiretroviral therapy by Emergency Plan Multi-country

partners: 2004-2007

Authorship-Emergency Plan Multi-country ART

Partner and Agency Group

Analysis

Based on recommendations by the US Office of the Global AIDS Coordinator Adult Treatment Technical Workgroup for description of USG-funded HIV care and treatment programs

Describe services provided between Track 1.0 program start up in 2004 through Sept 30, 2007

Quantity of Program (scale up) Calculate quarterly- FY04Q4 to FY07Q4

Patients ever enrolled in HIV care Patients currently in HIV care Patients ever started on ARTPatients started on ART during quarterPatients currently on ARTFacilities providing ART

Analysis

Quality of Program- (cohort) Proportion alive and on ART (6, 12, 24 mos)

Including transfer in, excluding transfer outMedian difference in CD4 from startProportion with undetectable viral load (<400 cells/µl)Proportion started on 2nd line ART

Proportion not on ART (6, 12, 24 mos)DiedStoppedLost to follow up

Of those enrolled in HIV care, proportion on care at 12 months

Analysis

Administration of analysis

Task Force to guide and move analysisInclude participants from USG agencies and grantee partner groupsContact John Aberle-Grasse at this meeting, or phone, or email

The USG work group includes: CDC GAP: Tedd Ellerbrock, Laura Porter, Seymour Williams, Hong-Ha Truong, John Aberle-GrasseUSAID: Robert FerrisHRSA: Jin ParkDoD: To be determined

Activity Date Comments

Convene Task Force Sept 26

Data request sent to partners Oct 5 Quantity & Quality data

Quantity data due Nov 15 Partners submit (routine)

Data & analysis meeting Nov 16-21 Data problems & analysis

Report for Track 1.0 complete

Dec 15 Routine tables, etc

Quantity data analysis due Jan 12 Partners review

Quality data due Jan 12 Partners submit

Quality data analysis due Feb 15 Partners review

Full paper for review Mar 28 Partners review

Analysis- Proposed time table

Thoughts for Discussion

Do partners support this proposal?

Have quarterly data from Track 1.0 partners, is data for DoD and FHI readily available?

What disaggregation? (sex, age, country, partner, facility type)

How best do we “simplify” and present multi-country, multi-partner “quality” analysis?

Additional analysis of more detailed issues and data subsets

Other thoughts?

For more information contact:

John Aberle-Grasse CDC GAP 1600 Clifton Rd, MSE 30

Atlanta, GA 30333 404.639.6201 Email: JAberleGrasse@cdc.gov