Table 1.
Country and Program Characteristics of the TCHARI sites
| Country | Barbados | DR | Haiti | Jamaica | Martinique | Trinidad | PR |
|---|---|---|---|---|---|---|---|
| GDP per Capita ($US)* | 13,849 | 5078 | 785 | 4705 | 39,922 | 19,076 | 17,100 |
| Funding sources for ART | Ministry of Health with World Bank loan | Ministry of Public Health and Welfare with World Bank loan | GFATM and PEPFAR** | GFATM** | Ministry of Health | Governme nt of Trinidad | Ryan White |
| HIV prevalence (%) *** | 1.4 | 0.9 | 2.2 | 1.7 | 0.3 | 2.0 | 0.2 |
| % HIV-infected patients HBsAg-positive** | Not known in HIV+; felt to be low | Not known in HIV+; felt to be low | 4% of HIV+ | Not known in HIV+; felt to be low | 2.5% of HIV+ | 4.5% of HIV+ | 6% of HIV+ without IVDU; 7% of HIV+ with IVDU |
| % HIV-infected patients HCV Ab positive** | Not known in HIV+; felt to be low | Not known in HIV+; felt to be low | <1% of HIV+ | Not known in HIV+; felt to be low | 5.5% of HIV+ without IVDU; 96% of HIV+ with IVDU | Not known in HIV+; felt to be low | 54% of HIV+ without IVDU; 96% HIV+ with IVDU |
| Year of expanded ART access | 2002 | 2003 | 2003 | 2004 | 1996 | 2003 | 1998 |
| Total number of patients in the study | 560 | 1207 | 4717 | 476 | 325 | 725 | 193 |
| Total number of adults on ART at the of end 2009 | 793 | 14,000 | 25,673 | 6549 | 750 | 2335 | Not calculated |
| Percentage of patients receiving free ART | 100% | 100% | 100% | 100% | 100% | 100% | 85% |
| ART initiation criteria during the study period | WHO criteria**** | WHO criteria**** | WHO criteria**** | WHO criteria**** | CD4<350 cells/mm3 or symptomatic HIV disease | CD4<250 cells/mm3 or AIDS-defining condition | WHO criteria or clinical judgment of physician |
| Virologic monitoring during study period | Conducted routinely | Suspected treatment failure | Suspected treatment failure | Suspected treatment failure | Conducted routinely | Conducted routinely | Conducted routinely |
| Method of tracking patients that miss visits (contact is done with phone calls and/or home visits) | Community nurse contacts patient if they miss 2 visits or are 6 months late | Peer counselors contact patient after one missed visit | Field workers contact patients within one week of each missed visit | Adherence counselors contact patients after 2 missed visits (visits usually every 3 months) | Phone and mail after one late visit. | Adherence nurse calls or visits patient at home after one late visit. | Phone call after 2 missed visits (visits usually every 6 months) |
*
GDP (Gross Domestic Product). International Monetary Fund. Economic Outlook Database available at: http://imf.org/external/pubs/ft/weo/2009/01/weodata/index.aspx [60]
**
GFATM (Global Fund to Fight AIDS, Tuberculosis and Malaria); PEPFAR (U.S. President’s Emergency Plan for AIDS Relief); HBsAg (hepatitis B surface antigen); HCV Ab (hepatitis C antibody)
***
UNAIDS database, 2010 [61]; for Haiti, Republique d’Haiti Programme National de Lutte contre le Sida, 2010 [62]
****
At the time of the study, the World Health Organization (WHO) recommended ART for all patients with a CD4 cell count <200 cells/ml or an AIDS-defining illness