Situasi Terkini tentang Penelitian dan Pelaksanaan Test danTreat di 28 Oktober 2014 Lecture Series Pusat Penelitian HIV dan AIDS

Topik Latar Belakang, tujuan Study design; KAPs of interest, sample, sites, intervention package Project governance structure Progress

Jumlah Infeksi Baru per tahun, per sub-populasi (2012 MATHEMATICAL MODELLING ) 3

Indonesia: Cumulative cross-sectional* HIV Care Cascade *Cumulative data up to Dec 2012 Source: Monthly ART report, MoH

Tingkat Retensi ART selama 12, 24 & 60 bulan di beberapa negara, % 78% 72% Source: WHO-HQ

Test & Treat, Tujuan: ↓ HIV Immediate linkage to care and offer ART

Implementasi Test & Treat: perlu telaah lanjutan Intervensi2 meningkatkan kualitas cascade of care? – Perhatikan konteks lokal – Perhatikan KAP – Berkelanjutan Partisipasi aktif masyarakat sipil terdampak? – Epidemi terkonsentrasi, KAP tidak mudah dijangkau? Inisiasi awal ART, perhatian khusus: – Kepatuhan rendah – resistance

The HATI Project HIV Awal (Early) Testing & Treatment Indonesia Project Implementation of ‘Test and Treat’ strategies for HIV treatment and prevention in key populations in Indonesia: a prospective implementation research study

Study design: key objectives KAPs of interest: MSM, FSW, Waria Primary : To assess the impact of enhanced community based intervention compared with current practice, on: – The number of people from each key population started on ART and retained in treatment at 12 months. – The proportion of people from each key population who are virologically suppressed 12 months after HIV diagnosis. Secondary: – To quantify and compare the HIV treatment cascade/continuum of care. – To assess safety of ART and acceptability of early ART initiation. – To assess behavioural aspects of a T&T strategy, including impact on risk behaviours. Research capacity building objectives – To enhance the capacity of senior local researchers as research leaders. – To increase the research skills and experience of early career researchers.

Study design: Schema YEAR-1: Pre-intervention phase (No intervention at all sites) -ART regardless of CD4 count -Set up data management and monitoring systems -Design and plan interventions YEAR-2: Implement selected interventions at selected sites Or, Selected interventions in a selected KAP at all sites YEAR-3: Full intervention package at all sites and all KAPs Year-4: Follow-up Assess outcomes at the end of 1 year of follow-up of patients recruited in each year

Recruitment and Sample Total sample size across 3 sites in 3 years: 600 HIV positive MSM and 600 HIV positive FSW No specified target for waria All sites may recruit all KAPs

Sites: Bali, Yogya, Bandung Primary and Satellite Sites; the Roles (Bali)

Development of Package Intervention

Project Governance Structure

Progress MoU between WHO and Kirby will be signed by both parties soon Draft MoU between Kirby and 3 universities (UGM, Padjajaran, Udayana) are being finalized Draft detailed protocol is being finalized

TERIMAKASIH