International Programs
OVERVIEW
The Drew Center for AIDS Research, Education and Services (Drew CARES), directed by Eric G. Bing, M.D., Ph.D., is an HIV research and clinical center. We develop international and domestic programs devoted to combating and treating HIV. The Drew CARES team of international researchers includes Daniel Ortiz, Ph.D., Karen Cheng, Ph.D., Frank Galvan, Ph.D. and Ricardo Ovalle-Bahamón, C. Phil.
As part of our commitment to underserved people around the world, we do our work in such a way that it empowers communities. We work closely with governmental and non-governmental organizations, such as the Portuguese Institute for Preventive Medicine (IPMP) and the armed forces of Angola, Namibia and Rwanda, to transfer knowledge and skills so that their HIV programs can save lives and become self-sustaining.
At Drew CARES, we take a multifaceted and systematic approach to fighting the HIV/AIDS epidemic. In sub-Saharan Africa, we have programs in HIV prevention, treatment, and monitoring and evaluation. We develop programs to train local health providers to effectively and compassionately care for people infected with HIV/AIDS, giving hope to those infected and working to eliminate the stigmatize of the disease. Over the past three years, Drew CARES has brought medical personnel from its programs in Africa to Los Angeles for specialized training in HIV treatment, testing, and epidemiology. Conversely, Drew CARES sends American health professionals to our programs in Africa to train local health providers in HIV/AIDS treatment and mental health care.
The strength of our work comes from the commitment and innovation of our team. We are proud to stand together with our partners to fight HIV/AIDS in underserved communities throughout sub-Saharan Africa and other parts of the world.
PROGRAMS
ANGOLA
Since 2001, Drew CARES has been working throughout Angola with civilians and the Angolan military in the fight against AIDS.
Drew CARES has been creating cutting edge HIV prevention interventions, providing technical assistance and program support to the Angolan Armed Forces (FAA). Through funding from the National Institutes of Mental Health (NIMH), we have provided and evaluated an extensive HIV prevention intervention to military personnel throughout Angola.
With funding from USAID we have partnered with the Portuguese Institute of Preventive Medicine to oversee six voluntary counseling and testing (VCT) clinics throughout Angola. As many as 3,000 clients in total were visiting the clinics each month. Clients received information about preventing HIV and other STIs, HIV and STI testing, and treatment when available from clinic staff. Moreover in 2006, we started a prevention and community mobilization campaign to fight HIV based on findings from this project.
Through our partnership with the Angolan Armed Forces, we have created innovative HIV prevention tools for military personnel that include HIV prevention radio programs, HIV prevention comic books, and HIV prevention card games. Our radio drama, "Lunguka," has already aired nationwide with much praise. In addition, we have trained Angolan medical doctors in HIV treatment, created voluntary counseling and testing programs for military personnel, trained military health officials on statistical and research methods, and built laboratory infrastructure for HIV related testing and monitoring through funding from the US Department of Defense.
PROJECTS IN ANGOLA
HIV/AIDS Prevention among Angolan Military Recruits
PI: Eric Bing
Soldiers, many of whom are young, mobile, and sexually-active men, can unintentionally spread the human immunodeficiency virus (HIV) from high-risk populations (e.g., commercial sex workers) to lower-risk populations (e.g., their wives or girlfriends). In addition, high HIV rates in the military threaten the stability and security of countries, such as Angola in sub-Saharan Africa. Thus, an evidence-based prevention intervention targeted at this bridge group is timely and an important component of national and international HIV/AIDS prevention programs.
The primary goals of this study were to assess the impact over time, both within and between groups, of an HIV/AIDS-focused prevention intervention (treatment) and a non-HIV/AIDS-focused health promotion intervention (control) on HIV/AIDS-related behaviors, knowledge, attitudes, and motivation. This five-day, military-focused prevention intervention was evaluated in a group randomized controlled intervention trial to 568 male soldiers at 12 bases. The intervention was developed collaboratively by researchers from the Angolan Armed Forces and the Charles R. Drew University of Medicine and Science and was designed specifically for Angolan military personnel.
Diffusion of HIV/AIDS Prevention to Soldiers’ Social Networks
P.I.: Eric Bing
In parallel to the HIV/AIDS Prevention among Angolan Military Recruits study, we are also conducting a repeated cross-sectional study to determine the level to which HIV/AIDS prevention messages were diffused to social networks. We assessed the knowledge, attitudes, and behavior of nearly 2000 other soldiers who live and work on the same 12 bases. Data were collected at two time points, six months apart.
Acceptability of Handheld Computers to Collect Self-reported Sexual Behavior Data in Angola
P.I.: Karen Cheng
This study evaluates the cultural acceptability and cost-effectiveness of using handheld computers to collect sexual behavior data, in order to reduce disparities in access to HIV/AIDS prevention and care services in Angola, a country severely impacted by HIV/AIDS. Specifically, this study aims 1) to assess how comfortable Angolans feel in disclosing sexual behavior in handheld computer surveys compared to paper surveys, 2) to assess how comfortable Angolan interviewers feel in administering handheld computer surveys vs. paper surveys, 3) to assess the cost-effectiveness of handheld computer-based surveys compared to paper-based surveys.
Testing of an HIV Prevention Card Game for the Angolan Armed Forces.
PI: Daniel Ortiz
The goals of this pilot study are to evaluate the effectiveness and cultural applicability of a game that promotes greater awareness of HIV/AIDS prevention messages. By using a consumer driven approach and adapting innovations from computer and video gaming, a low-cost prevention tool can be produced and utilized throughout a resource-poor country that is threatened by rising HIV infections. Specifically, this proposal aims 1) To assess the added benefit of learning a novel, entertaining and culturally appropriate HIV prevention card game on HIV-related knowledge, attitudes and behaviors among Angolan soldiers receiving a standard HIV prevention intervention, and 2) To assess the diffusion of the game to others residing on the same base where the game is being taught and determine its impact on their HIV related knowledge, attitudes and behaviors.
Creating a culturally appropriate and enjoyable card game that promotes HIV/AIDS prevention has the potential to substantially increase awareness of risk behaviors and prevention methods in a high risk group. In the long-term, prevention materials that engage and entertain may have greater and longer lasting impact than other types of prevention strategies particularly in low resource settings where there are fewer opportunities for novel entertainment.
Assessment of HIV Prevention Needs Among Women in Angola
PI: Daniel Ortiz
In Angola, the war has displaced people from their home provinces forcing many people into slum housing in the capital city of Luanda. For many, living conditions do not include electricity, potable water, or adequate sewer systems. These extremely poor conditions facilitate the spread of disease which is further complicated by the lack of medical infrastructure. To examine the cultural issues important for addressing HIV/AIDS prevention among Angolan women we conducted a series of focus groups.
A total of 13 focus groups consisting of approximately 10 women per group were conducted in Luanda, Angola. A total of 135 women from three sub-populations were recruited: 49 women working in the marketplace, 20 internal refugees, 40 women near military bases and 26 women affiliated with faith-based organizations. The questions in the focus groups address general living conditions, family life, sexual behavior, sexually transmitted infections, relationships with men, and condom use.
CONTACT: Daniel Ortiz
CONTACT IN ANGOLA:
Andrea Curreri, Drew CARES, Angola Office Director
Ricardo Ovalle-Bahamon, Drew CARES, Angola Office Project Director
The Drew CARES office in Angola is located at:
Rua Comandante Gika, #10
Luanda, Angola
tel: 011.244.222.35.12.17
RWANDA
Since March 2006, Drew CARES International (DCI) has worked with the Rwandan Defense Forces (RDF) to expand their HIV/AIDS treatment and care program. The RDF health system provides services to soldiers, veterans, families of soldiers and veterans, as well as residents of the surrounding communities. Thus, this program has the potential to reach a significant portion of the population in need of health services.
In a short period of time, Drew CARES and RDF have achieved significant milestones. The laboratory at Kanombe Military Hospital (KMH), in the capital city of Kigali, has been upgraded with new CD4, biochemistry, and hematology machines. These new equipment have increased the capacity of KMH to support the laboratory needs of the RDF health system, as well as the civilian health system. In addition, 126 RDF health providers have been trained in laboratory, ARV treatment, or psychosocial care.
To better serve the soldiers and their families, DCI and RDF have forged a multidisciplinary team of doctors, nurses, social workers, HIV peer educators, and laboratory technicians. This team is mobile, traveling to distant brigades to stage and enroll newly diagnosed HIV-infected clients on ARVs and psychosocial care. The mobile team is currently seeing approximately 30 new clients per week. A second team is being developed in KMH to serve the 1300+ HIV-infected clients who are currently on treatment. This upgraded HIV/AIDS treatment and care program will be supported by a new strategic information system that will integrate HIV services through computerized databases and more efficient communication between service providers.
Preliminary reviews of the psychosocial charts suggest that many HIV-infected clients suffer from post-traumatic stress and engage in unhealthy coping behaviors, such as excessive alcohol intake. DCI and RDF are developing research projects to address these issues among HIV-infected individuals in Rwanda.
Funding for DCI’s work with RDF comes from the U.S. Department of Defense.
CONTACT: Ahmed Abajobir, Country Director, DCI Rwanda
CONTACT: Karen Cheng, Program Director, USA
Drew CARES office in Rwanda is located at:
Plot 873, South Kacyiru, Past Netherlands Embassy, Behind British Embassy.
P.O. Box 7303
Kigali-Rwanda
MEXICALI
Title: “Promoting Migrant Health through HIV Awareness”
Funding Agency: Health Initiatives of the Americas (University of California)
Location: Mexicali
Collaborating Institution: Facultad de Medicina, Universidad Autónoma de Baja California, Mexicali campus
Study Abstract
English:
For some Mexican migrants, the opportunities for receiving HIV-related interventions may be quite limited, especially for migrants who are in transition from one locale to another and who may not have the residential stability oftentimes required by HIV prevention programs. Such transient populations may benefit from HIV prevention programs provided by individuals with similar backgrounds as theirs who are able to provide HIV-related information in informal one-on-one settings in the migrants’ own environments. This project seeks to determine whether a peer education intervention with Mexican migrants is just as effective as a provider-based small group HIV prevention lecture as measured by the recipients’ HIV knowledge, HIV-related risk reduction skills, self-efficacy with respect to such skills, and intentions to engage in low-risk practices. A total of 612 Mexican migrants will be recruited. Mexican migrants from three migrant shelters in Mexicali will be trained as peer educators of a theory-driven HIV prevention intervention. Each peer educator will conduct individual educational interventions with other Mexican migrants. An outcome evaluation will be conducted to determine the extent to which those who received the peer education intervention differed from the recipients of the small group HIV prevention lecture with regards to the areas mentioned above and how both interventions differed from a no-treatment control group. If peer education is found to be as effective as a small group HIV prevention lecture, these findings can be used to develop more peer education programs to reduce HIV risk among Mexican migrants who lack residential stability.
Spanish:
Para algunos migrantes mexicanos, las oportunidades de recibir intervenciones relacionadas con el VIH son muy limitadas, especialmente para migrantes que están en transición de una localidad a otra y muchas veces quienes no pueden tener una estabilidad de residencia, como requisito para recibir los beneficios de estos programas de prevención de VIH. Tales poblaciones en transito pueden beneficiarse de los programas de prevención proporcionados por individuos de su misma población con similares problemáticas como los demás, y que puedan dar información relacionada con el VIH de uno a uno y en su propio ambiente de conocimientos. El objetivo de este proyecto es determinar si una intervención educativa de pares con los migrantes mexicanos es tan efectiva como la de una conferencia de prevención del VIH ofrecida por un proveedor a grupos pequeños de migrantes mexicanos en cuanto a sus conocimientos sobre el VIH, habilidades para la reducción de riesgo relacionado con el VIH, su auto eficacia con respecto a estas habilidades y la intención de lograr practicas de bajo riesgo. Un total de 612 migrantes mexicanos serán reclutados para este proyecto. Migrantes mexicanos de tres albergues en Mexicali serán entrenados como educadores de pares en una intervención para la prevención del VIH basada en una teoría de la literatura. Cada educador ofrecerá intervenciones educacionales individuales con otros migrantes mexicanos. Una evaluación de resultados determinará el grado al que los que recibieron.
CONTACT: Frank Galvan
