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HIV Treatment and Care Research priorities • Facilitator – Dr Saphonn Vonthanak • 12 participants • 29 agreed topics – not grouped on methodology or subject category • 3 scoring categories – Importance – Urgency – Feasibility • Short group discussion to clarify each topic • Each participant invited to give score out of 5 for each topic in each category • Mean score calculated for each topic in each category • Summary score for each topic Topics (1 – 15) 1 Sequencing 1st , 2nd, 3rd line ART 2 Viral load testing strategies 3 Drug resistance 4 Adherence over long term 5 Drug resistance 6 Appropriateness of current ART protocols to Cambodian population 7 Drug resistance 8 Management of HIV co infection (esp children) (TB, hepatitis, Cryptococcus Meningitis ..) 9 Co management of related diseases (hepatitis B, diabetes..) - health system 10 Neurological manifestations (adult and children) 11 Psychiatric / depression 12 Stigma and discrimination of health care professionals+ community: impact on testing / treatments/ adherence 13 Barriers to HIV testing and care of women not classified as high risk 14 Barriers to HIV testing and care of children < 2 years (laboratory) 15 Barriers to HIV testing and care of children (general) Topics (16 – 29) Barriers to HIV testing and care among particular populations (particular populations sex workers, IDU..) 16 17 Poverty / transportation effect on care and treatment / outcomes Health system strengthening + integration of HIV care and treatment into mainstream health services 18 19 Feasibility of integration of HIV care package into insurance package 20 HEF and health insurance and access to HIV care 21 Costing 2nd line regimens 22 Post exposure prophylaxis availability / behaviors 23 Impact of HIV infected status on household 24 Cost effectiveness including quality of life, with without treatment 25 Mother to child transmission rate (with and without ART intervention) 26 Ways to improve uptake of pregnant women to testing and care 27 HIV health care delivery options (Human Resources) Prevention among positive 28 Home based care role in the continuum of care Importance – top 11 1 Adherence over long term 5.0 2 Viral load testing strategies (best testing strategy- timing) 4.8 3 Sequencing 1st , 2nd,… line ART 4.5 Stigma and discrimination of health care professionals/ community 4 and impact on testing / treatments/ adherence 4.4 5 Management of HIV co infection (esp children) (TB, hepatitis, Crypto M…..) 4.3 6 Barriers of access to testing and care among particular pop (SW, IDU..) 4.2 7 Barriers to HIV testing and care of women (not classified as high risk group) 4.2 8 Poverty / transportation effect on care and treatment 4.2 9 Ways to improve uptake of pregnant women to testing and care 4.2 10 Cost effectiveness analysis including QOL of PLHA with, without treatment 4.1 11 HEF and health insurance and access to HIV/AIDS care 4.1 Urgency – top 10 1 Adherence over long term 4.9 2 Viral load testing strategies (best testing strategy- timing) 4.8 3 Psychiatric / depression 4.2 4 Barrier of access to testing and care among particular pop (SW, IDU..) 4.1 5 Sequencing 1st , 2nd, 3rd line ART 4.1 6 Management of HIV co infection (esp children) (TB, hepatitis, Crypto M…) 4.1 7 Prevention among positive “positive prevention” 3.8 8 short and long term toxicities associated with current protocols 3.7 9 Barriers to HIV testing and care of women (not classified as high risk group) 3.7 10 Mother to child transmission rate (with and without ART intervention) 3.6 Feasibility – top 10 1 Adherence over long term 4.3 Stigma and discrimination of health care professionals/ community 2 and impact on testing / treatments/ adherence 4.1 3 Barriers to HIV testing and care of children 3.7 4 Role of Home based care in CoC 3.4 5 Cost effectiveness analysis including QOL of PLHA + /- ART 3.3 6 Barriers to HIV testing + care of women (not classified as high risk ) 3.2 7 Barrier of access to testing + care among particular pop (SW, IDU..) 3.1 8 Short and long term toxicities associated with current protocols 3.1 9 Prevention among positive 3.1 10 viral load testing strategies (best testing strategy- timing) 3.0 Combined – top 10 1 Adherence over long term 170 2 Stigma and discrimination of health care professionals/ community and impact on testing / treatments/ adherence 152 3 viral load testing strategies (best testing strategy- timing) 150 4 Barriers to HIV testing and care of women (not classified as high risk group) 132 5 sequencing 1st , 2nd, 3rd line ART 131 6 short and long term toxicities associated with current protocols 129 7 Prevention among positive 129 8 Role of Home based care in CoC 129 9 Barriers to HIV testing and care of children 128 10 Poverty / transportation effect on care and treatment 128