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URC Supports HIV Programs in 25 Countries
As a chronic, complex, communicable, and widely stigmatized disease, HIV poses challenges to health systems that require proven and innovative solutions that are keenly responsive to local conditions. University Research Co., LLC (URC) and its nonprofit affiliate Center for Human Services supports HIV programs that focus on creating better health outcomes for underserved and vulnerable populations. We currently support HIV programs in 25 countries in Africa, Asia, Eastern Europe, and Latin and North America. URC's projects in Nigeria, South Africa, Swaziland, Tanzania, and Uganda provide snapshots of our ongoing efforts to support healthy populations.
Nigeria: Reaching Women for HIV Counseling and Testing
Unequal gender norms often deter women from seeking HIV testing; many cannot leave work or home to access services and fear stigma if they test positive. Through the HIV and AIDS Comprehensive Care Initiative (HACCI), we partnered with a locally established organization, Women for Women International, to reach women in rural Nigeria. HACCI discussed issues surrounding HIV/AIDS with and offered voluntary counseling and testing services for groups of women who meet regularly through Women for Women. Three outreach campaigns have reached more than 400 women in one community in Enugu. Also, HACCI trained volunteers to disseminate information about HIV/AIDS and combat stigma in communities in four Enugu districts.
South Africa: Introducing Provider-Initiated Counseling and Testing
URC works closely with facilities to empower health care providers to provide high-quality, patient-specific, and comprehensive HIV counseling combined with accurate and reliable testing. We help health systems create and/or strengthen links between HIV and other health services for provider-initiated counseling and testing (PICT). With PICT, health care workers offer and recommend HIV testing to all patients, regardless of their reason for seeking services.
South Africa has more people living with HIV than any other country and the most new infections each year. Many South Africans do not know their status, despite widespread availability of counseling and testing. As described in The South African Journal of HIV Medicine, our Centers for Disease Control and Prevention-funded project, Increasing Access to HIV Testing and Counseling, helped introduce PICT in South Africa. We worked with health facilities in six provinces to integrate PICT with key, high-volume services, such as antenatal care, family planning, sexually transmitted infections, and TB. The project directly supported the testing of more than a million South Africans.
Swaziland: Strengthening Care and Treatment for HIV/TB Co-infection
HIV infection is a key driver of TB in many countries; the virus suppresses the immune system, allowing TB infections to spread. To effectively respond to the dual epidemics, URC works to integrate prevention, counseling and testing, and care and treatment services of HIV and TB. In Swaziland, only one TB clinic provided HIV counseling and testing services to TB patients before 2006, and less than 5% of TB patients accessed those services. Working in close collaboration with Swaziland's National TB Control Program, we helped integrate HIV PICT in all 51 TB clinics nationwide. From 2006 to 2011, testing among TB patients increased to 90%. We also work to quickly initiate TB/HIV co-infected patients into appropriate treatment; in Swaziland, our HIV project increased antiretroviral treatment for co-infected TB patients from near zero in 2008 to 60% in 2011.
Tanzania: Improving HIV Care for Mothers and Children
The prevention of mother-to-child transmission of HIV (PMTCT) is a vital component of our prevention programs; the virus can be transmitted from an HIV-positive mother to her infant during pregnancy, childbirth, or breastfeeding. Because PMTCT services require delivery to both mother and infant at multiple points in time and often in different facilities or areas of a facility, PMTCT can be particularly challenging to address. URC assists health systems in strengthening the PMTCT continuum of care, the comprehensive, interconnected array of services that includes prevention, treatment, and care for pregnant women and their infants during pregnancy, labor, delivery, and beyond.
In 2011, our US Agency for International Development (USAID) Health Care Improvement Project (HCI) launched a pilot initiative called AIMGAPS (Assuring Infants and Mothers Get All PMTCT Services) in 11 facilities in Tanzania's Iringa region to link all service areas that provide some component of PMTCT care. Representatives from these areas, which included antenatal care, reproductive and child health, labor and delivery, and HIV care and treatment, as well as ancillary services such as the pharmacy and laboratory, worked in teams to share data and information and coordinate and improve the care continuum. Uptake of PMTCT services improved: The proportion of HIV-positive pregnant women receiving HIV treatment or preventive treatment increased nearly 60% within a year. The percentage of HIV-exposed infants who received a definitive HIV test (when no longer at risk of contracting HIV) also increased, from 7% in January 2011 to about 75% in February 2012. We also work with facilities to ensure that all infants who test positive receive HIV treatment.
Uganda: Integrating Nutrition into HIV Care
The relationship between HIV and malnutrition is a vicious cycle: HIV infection can cause malnutrition and wasting, while poor nutrition can hasten the infection's progression. URC's NuLife – Food and Nutrition Interventions for Uganda project contributed significantly to comprehensive nutrition care and support for thousands of malnourished individuals infected with or affected by HIV/AIDS. The project engaged health workers in developing a seven-step process for providing good nutrition care, including assessing, at every visit, malnutrition with middle upper-arm circumference tape, a simple tool for determining nutrition status. From March 2009 to February 2011, facilities increased the percent of HIV patients assessed for malnutrition at each visit from zero to nearly 100%. NuLife provided treatment for malnutrition to more than 16,000 people. In addition, it developed nutrition protocols, training curricula, and monitoring and evaluation tools, while successfully advocating for the inclusion of ready-to-use therapeutic food in Uganda's essential medicines list, helping ensure that the Ugandan government would continue to make therapeutic food available even after the project's end.
For more information about our HIV/AIDS-related work, see our expertise page.