Sixth Annual Emergency Plan for AIDS Relief Track 1.0 ART Program Meeting “Integrating HIV Services at ART Sites” Pediatric HIV Care and Treatment Session August 11, 2008

Pediatric HIV Care and Treatment Session 1:40 – 1:50 pm – Provider initiated testing and counseling and decentralization of Pediatric HIV care and treatment in Africa – Gordon E. Schutze (Baylor) 1:50 – 2:00 pm – HIV testing of infants and children – Elaine Abrams (ICAP) 2:00 – 2:10 pm – Infant survival: challenges in implementation of early services – Doug Watson -Robb Schenenberger – ( AIDSRelief)- 2:10 – 2:25 pm – Pediatric barriers study results – Tanzania – Denis Tindyebma (EGPAF) 2:25 – 2:35 pm – FHI: Lessons learned and challenges on scaling up Pediatric HIV clinical care and treatment – Philippe Chiliade (FHI) 2:35 – 2:45 pm – Scaling up pediatric HIV programs: Data from three countries – Guerino Chalamilla (HSPH) 2:45 – 2:55 pm – Follow-up of HIV exposed infants: best practices and models of service delivery – Prepared by Anthony Endozien – Anthony Amoroso (AIDSRelief) 2:55 – 3:15 pm – Discussion: Implementation of new treatment recommendations, program indicators and basic care of HIV infected, affected and exposed children

Track 1.0 ART Program Data: Pediatrics Pediatric Service Care17,48044,52071,16090,438 ART5,42516,38325,32033,130

Age distribution of children on ART % % % Track 1.0 ART Program Data: Pediatrics

Number of facilities providing pediatric ART by year in Track 1.0 ART Funded Programs Facilities Total # Pediatrics 37 (18%) 66 (17%)101(17%)113 (17%)

Important changes/advances in Pediatric HIV WHO PITC guidelines WHO recommendations for pediatric HIV treatment: –Early treatment initiation in infancy regardless of clinical/immunological parameters –First line regimen based on exposure history to NVP for young infants –Change in CD4 cut-off for children mos/age PEPFAR II –New targets –New indicators with age group disaggregation –Emphasis on PMTCT and integration with MCH –Sustainability

Areas of Focus for Pediatric HIV Care and Treatment PMTCT program expansion and co-located with ART programs or prescribing privileges Enhance follow-up services for women identified in PMTCT and their children Implement systematic testing of family members of HIV positive children and adults Expand Pediatric Care and ART to sites with ART services for adults Implement pediatric HIV care/prevention packages Quality of Pediatric HIV care and treatment programs Targeted evaluations, PHE, other