Abstract:
Chiang Saen Hospital has provided antiretroviral therapy (ART) to people infected
with HIV, especially the Burmese and Laotians residing in Thailand or in their own countries. The guidelines of the country program were applied. The cohort study design
measured ART adherence, survival rate, clinical outcomes, result of the prevention approach and psychological support as outcome indicators. Data were collected and analyzed using FUCHIA software. The Kaplan-Meier method was conducted for survival
analysis. The results revealed that 73 non-Thai PLHA (people living with HIV/AIDS)
who received ART from July 2004 to June 2007 (19 Laotians, 16 of whom resided in their
own country; 51 Burmese, 20 of whom resided in their own country, and three minority
people residing in Chiang Saen. Mean ART adherence was more than 98.2 per cent. Mean
survival time in months was 41 (95% CI 39.0-43.2). Survival at 36 weeks was 96 percent.
Three cases died after ART, two from AIDS and one from the adverse effects of ART. No
case had been lost to follow-up or stopped treatment. Thirty per cent of the patients
needed to change individual drugs due to adverse effects. The health of those on treatment improved. Access to ART increased the uptake of service in the prevention approach. Eleven cases received vocational loans and one case received an education fund.
It is one model of how the disadvantaged can access ART in cross-border areas and how
Thailand can support its neighbors. However, the effectiveness and the sustainability of
the program still need to be considered
