1. Caribbean Health Leadership Institute Cohort 5 Group 5 – Action Learning Project 06 th November 2012

2. Acknowledgements Dr. Ellen Grizzle (Mentor) Dr. Carnille Farquharson Dr. Donna-Michelle Royer-Powe Ms. Ferdinia Carbon Ms. Joy Crawford Mr. Fazad Mohammed

3. Thoughts from Group Members Good group work makes hard work easier Good group dynamics, working with people strengthens any weaknesses Distance is not a limitation to communication Use your resources wisely and effectively

4. Problem Statements How can ‘treatment as prevention’ improve the outcome of our HIV programmes? Are government and private practitioners able to pursue this option given current resources?

5. Literature Review

6. Concept and Definition Treatment as prevention a relatively new concept Describes ARVs being used by all HIV diagnosed patients regardless of CD4 and viral load levels Decreases the viral load of blood and sexual secretions in treated persons to undetectable levels Essentially prevents transmission of the virus and infection to their sexual partner Theoretically should significantly impact the disease regionally [and worldwide] by initially zeroing the rate of new infections and possibly eradicate the disease

7. PROCESS

8. Action Learning Group was set up Group was named (CHLI5five) and logo developed Communication between group members was established using Skype, Blackberry messenger and Google group. Weekly group meetings were held at a designated time and duration with a new moderator at each meeting Members’ strengths were highlighted

9. Members were assigned roles for ALP Target population was determined Questionnaire was developed using PMTCT Policy Meetings were moved to monthly basis Questionnaires were administered and submitted for analysis Data analysis was prepared and report formulated. Information brochure developed for target

10. Research - Methodology Self administered questionnaire 40 questionnaires were distributed and a total of 28 questionnaires were returned (70% response rate)

11. Research - Instrument Self administered questionnaire – Comprised of combination of dichotomous and open ended questions. – No names or identifying marks were recorded – Questionnaires were delivered to eleven different institutions across four countries

12. Research - Challenges Time frame – Time constraints allowed for a small sample size – Due to competing commitments group members were strained to execute data collection Geographic Spread of team members – Team members were present in 4 countries leading to breakdown in communication Lack of willingness of respondents – Many respondents did not see the project as a priority and refused participation in the study

13. Research - Benefits Geographic Spread of team members – Team members were present in 4 countries allowing for semi-regional review Instrument used – A self administered questionnaire allowed for respondents to respond on their own time in confidentiality reducing bias – Cost effective

14. Findings

16. Recommendations Development of IEC materials for patients about their treatment options These materials can help facilitate further dialogue between doctor and patient regarding treatment options It can also be used as a conversation starter between couples regarding their unborn child

18. Lessons Learnt from action learning project Flexibility and Compromise Patience Difference between assertive and aggressive Effective use of limited resources Innovation (overcoming barriers to communication) Sensitivity to cultural differences Time management

19. Questions/Feedback Thank you