by Dr. Eric Lugada, MD, PhD Presented at 2012 AIDS Satellite Meeting

1. Integrated Prevention Campaign
Implementation
Dr. Eric Lugada
MD. PhD

2. Background
 HIV diagnosis is critical for prevention and treatment. Prevention of co-infections such as
malaria and diarrhea delays disease progression
 Preventive interventions such as long-lasting insecticidal bed nets, point-of-use water
filters, condoms and HIV counseling and testing (HCT), when implemented on a large
scale, reduce malaria, diarrhea and HIV.
 Multi disease prevention campaigns can achieve rapid and high coverage at low cost, but
have not been widely evaluated in combination with HIV testing and prevention
 The Integrated Prevention Campaign, a 7-day campaign held in Kenya in September
2008, combined voluntary HCT with distribution of a CarePack® containing a bed
net, water filters, condoms and educational materials.

3. Method
 The campaign
– Mobilized stake holders and implemented a 7 day campaign intended to cover 80% of the
population aged 15-49
 Post campaign survey
– Two-months post-campaign survey to measure uptake of products and utilization of services
 Qualitative analysis
– Qualitative program evaluating contextual circumstances facilitating or discouraging uptake of
interventions
 Costs and cost - effectiveness analysis
- Cost and cost-effectiveness

4. The Campaign
 Micro planning- obtain buy in from ministry of health, district health authorities, community
leaders, PLWHA networks
 Mapped and selected 30 uniformly distributed test sites in Lurambi division in Kakamega
district Western Kenya
 Recruited and trained 600 personnel; MOH trained counselors, laboratory technicians and
product demonstrators
 HCT following Kenya MOH guidelines, after obtaining consent and filling national VCT
forms. Parallel testing done. QC done by sending 10% of samples for dry blood testing
 Group counseling (~20 people) received health education and instructions on how to use the
CarePack® contents; bed nets, water filters, condoms.
 CD4 cell count was determined at the community level outside traditional health structures,
those testing HIV(+) given a 3 months doze of cotrim and referred for further care

5. Campaign Process
Pre-Campaign During the Campaign Post-Campaign
Social Product Client
Mobilisation demonstration follow-up
HIV pre-test Campaign
Public health
counselling analysis
education
messages on
newspapers,
radio, etc Testing
Registration
Care for the
HIV positives
Campaign Opt out of Post-test
announcement HIV testing counselling
through banners,
road shows, etc
Commodity Commodity
distribution distribution

6. Campaign Experience and
Delivery of Preventive Interventions
All participating in the campaign received the CarePack®.

7. Summary campaign results:
Target population 51,178 sexually-active 15-49 yrs age group
Total tested 47007
Tested in age group 15 to 49 41,040 (>80%)
Women 28906
Women diagnosed HIV+ 1448 (5.0%)
Men 18101
Men diagnosed HIV+ 508 (2.8%)
Lowest HIV prevalence by age 15-19 years (0.8%)
Highest HIV prevalence by age 30-39 years (6.7%)
HIV+ put on cotrimoxazole 96%
The Integrated Prevention Campaign reached universal testing goal in 7 days.

8. Conclusion
 Integrated Campaign has the potential to:
– Address multiple public health problems in a country simultaneously thus achieving various national
objectives and MDGs in an efficient way.
– Reach universal testing goal in a short time, thus ensuring access to treatment.
– Break the social barriers associated with HIV testing. (stigma and domestic violence)
– Achieve universal coverage with bed nets, water filters resulting in prevention of malaria and diarrhea
– To get people early in the HIV disease cycle.
– Reduce disease programme costs by up to one half in some countries
– Avert significant DALYs in the target population, with economic savings.
– Strengthen health systems

9. THANK YOU