ObjectiveAs elsewhere, due to scarcity of data and limited awareness of HIV infection, especially in older children, the HIV epidemic among Ethiopian children appears neglected in national programs (children ART coverage is of only 12% in 2013). This paper estimates the country burden of HIV in older children and investigates the prevalence of HIV in orphans and vulnerable children (OVC) households.Design/MethodsWe analyzed national HIV data for Ethiopia, using Spectrum/ Estimation and Projection Package (EPP) and primary data on children living in households with at least one HIV-positive adult in the Amhara and Tigrai regions. Descriptive analysis of the age and sex distribution of HIV-positive OVC in Ethiopia was performed.ResultsOur Spectrum/EPP analysis estimated the population of HIV-positive children under 15 years old to be 160,000 in 2013. The majority of children (81•6%) were aged five to 14 years. The estimated number of orphans due to AIDS was 800,000. The empirical data from almost 10,000 OVC under 18 years showed 11•9% were HIV-positive, the majority of whom were between five and 10 years old with no significant difference between males and females.ConclusionsThere is a large population of children living with HIV in Ethiopia, the magnitude of which not previously recognized. The majority were vertically infected and never identified nor linked into treatment. OVC represent a reachable group which could account for a substantial proportion of the HIV infected older children. We recommend that HIV programs urgently synergize with social protection sectors and address these children with HIV testing and related services.

Objectives Congenital diaphragmatic hernia (CDH) is a congenital malformation in which the diaphragm and lungs are underdeveloped, leading to cardiorespiratory and other problems. This study aimed to explore professionals’ views regarding prenatal counselling in CDH. Methods A qualitative study was performed among healthcare professionals involved in the care of CDH patients in Radboud university medical center Amalia Children’s Hospital. Semi-structured interviews were conducted until saturation was achieved. Transcripts were qualitatively analysed to gain insight into professionals’ views regarding counselling. Results Eighteen professionals with various backgrounds were included. The professionals agreed that the first counselling session should be soon after diagnosis and additional sessions should be offered. Concerning counselling content, participants considered explanation of the diagnosis, prognosis, short- and long-term consequences, treatment options and practical aspects important. As for decision-making about possible termination of pregnancy, all professionals emphasised the importance of the parental role, but the preferred parental involvement varied. Regarding practical aspects, preferred counsellors were a neonatologist, obstetrician, paediatric surgeon and/or medical social worker. Participants emphasised that the counselling should be adjusted to parents’ needs. Conclusions This study gained insight into professionals’ views regarding the timeline, content, decision-making process, and practical aspects of prenatal counselling in CDH.

research included geographic mapping of RG's locations, qualitative and quantitative surveys and mapping of existing services. Geographic mapping was based on interviews of primary (N = 225) and secondary (N = 1240) key informants and showed more than thousand RGs locations. 125 representatives of each RG were interviewed during quantitative survey and 45 MARAs had in-depth interviews. Results Data shows that spots are very mobile which requires recurrent mapping. Street-based spots are popular locations for SBCs and FSWs. As a local peculiarity, mobile spots for IDUs were revealed, which means that drugs can be delivered by order. The preliminary data of size estimation in Zaporizhzhia shows that average number of FSW, IDUs and SBC is 2023, 2892 and 1388 relatively, what could be useful for planning and developing services. Obtained data shows high level of risk practises among MARAs (the percentage of condom use among FSWs with regular client is 65%, with occasional clients -76%; the percentage of IDUs who have used only sterile syringes is 78%). Range of HIV and Reproductive Health programmes revealed different types of services for MARAs with a poor access due to subjective reasons and geographical location of establishments. Conclusions Research revealed the lack of HIV-prevention services for MARAs. For higher efficiency the developed HIV-prevention model should be very flexible. Service delivering process should be strongly supported by local government; the activity coordination and referral system should be thoroughly organised.Knowledge and attitudes about HiV/aids and sexual HealtH Practises in First-Year uniVersitY students

Background We implemented a facility-based intervention aimed at reducing the proportion of patients lost to follow-up at an outpatient HIV clinic in Jinja district, Eastern Uganda, over a period of 6 months (February-July 2012). Methods The intervention was implemented with the aim of decreasing the proportion of patients lost to follow-up from 1% (23/2328) at baseline to 0.25% by July 2012. Simple and innovative strategies were introduced into the HIV clinic. These included retraining of clinic staffs on the importance of patients keeping their appointments; development of new messages on keeping appointments; retrieving patient files a day before the day of appointment; sending two text message reminders a day to the clinic; and actively following up patients who had not kept their appointments through home-visiting. At each follow-up visit, reasons for the patients' failure to keep appointment were noted and information on age, gender, CD4 count (captured from patient records) and duration in HIV care was obtained. Data were fed into an IQ Care programme and analysed using Microsoft Excel. Results The proportion of patients lost to follow-up decreased from 1% (23/2328) at baseline to 0.4% (9/2528) in 6 months. Men, those with a CD4 > 350, those aged < 30 years and those in care for < 1 year had the biggest decline in proportion of patients lost to follow-up compared to other patients. Conclusion The proportion of patients lost to follow-up declined by 60% through use of simple and innovative strategies introduced in the HIV clinic. Universal Hiv screening of inMates in israeli Prisons: sHoUld tHe Policy Be UPdated?

3. Accelerated Partner Therapy (APT Pharmacy): nurse initiated PN at the general practise followed by assessment of sex partner by trained community pharmacist; 4. Patient referral, where patients are advised by phone by qualified health adviser on the need for partner to be tested and treated. 5. Provider referral, where patients accept the offer of a specialist health adviser contacting one or more partner(s) by phone.For all pathways primary costs were collected prospectively in a specific exploratory study. Results The least costly strategy is nurse led PN (strategy 2) costing approximately £53 per index case (2011 costs). The most costly strategy is provider referral (strategy 6) which cost £96 per index case. Conclusion Where health service providers assume responsibility for contacting partners there will be substantial additional cost. Before any such policy is implemented, a demonstrable improvement in PN outcomes should be established. Aim to design a specific HIV patient satisfaction questionnaire Methods Four work streams were employed to develop and test a new questionnaire. Firstly, key themes identified in the systematic review were used as a topic guide for focus group discussion to assess their relevance and importance. Four focus groups comprising 32 participants were conducted and revealed the importance of physician knowledge and expertise; dignity, autonomy and respect; and good communication. The second stream involved interviews with ten patients, exploring their motivation to complete a questionnaire. Thirdly, data from the focus groups and interviews were used to develop an initial questionnaire which was cognitively tested on a further ten patients, this provided face validity for the questionnaire design, layout and wording. The final stream employed a pilot study of the questionnaire with 80 clinic attendees. Results The pilot survey demonstrated that there was a high completion rate. Two questions were modified and additional routing instructions were added. Pairwise correlations reflected the thematic structure of the questionnaire and supported good criterion validity. Conclusions The combination of a systematic analysis of previous patient survey tools, focus group discussions and cognitive testing of the questionnaire was used to ensure high content validity. The questionnaire was found to be acceptable to patients and a high completion rate was attained without the use of a financial incentive. DeveloPment of a valiDateD QualiaiDs: Quality of ambulatory HealtH services P6.062Background Between 2007 and 2012, there was an increase of 14% of Specialized Care Services for people living with HIV/AIDS (PLHIV), totaling 724. A decade ago the Qualiaids evaluates the quality of outpatient care in public services in Brazil. The aim of this study is to describe the dimensions of this evaluation method, the highlights of care services and its importance in monitoring the quality of care for PLHIV. Methods Were made three national applications: one manual and two online through a questionn...