title: Recovery of HIV service provision post-earthquake.
abstract: OBJECTIVE
  To describe the level of functionality of President's Emergency Plan for AIDS Relief (PEPFAR)-supported HIV clinical services following the devastating earthquake that struck Haiti in January 2010.
  
  
  METHODS
  Available program-monitoring data from sites providing voluntary counseling and testing for HIV (VCT), antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT) services, and antiretroviral treatment (ART) were described, comparing pre-earthquake and post-earthquake periods during October 2008 to May 2010.
  
  
  METHODS
  Pre-earthquake HIV service baselines for VCT, PMTCT, and ART enrollment were defined as monthly mean total number of patients served over 15 months pre-earthquake. ART baseline was defined as total current patients by December 2009. Sites were categorized as high-earthquake or low-earthquake intensity based on location and instrumental shake intensity data.
  
  
  RESULTS
  Pre-earthquake mean monthly baselines were 41 087 (VCT), 11 909 (HIV testing at ANC sites), 648 (ART enrollment), and 296 (PMTCT enrollment); baseline total current patients on ART was 24 863. Service provision in January and May 2010, reported as percentage of baseline, was 43 and 78.7% (VCT), 50.8 and 88.7% (HIV testing at ANC), 46 and 81% (PMTCT), and 41 and 82.7% (ART enrollment), respectively. Current patients on ART decreased to 97% of baseline in April, rising to 103.9% by May; the initial decline was restricted to high-earthquake intensity areas.
  
  
  CONCLUSIONS
  Following the Haiti earthquake, there was a transient, marked decline in VCT and new ART patient enrollment, whereas follow-up of established ART patients remained impressively high. HIV treatment continuity should be reinforced in disaster preparedness and response strategies in HIV epidemic settings.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. igf4@cdc.gov
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Walldorf
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.forename: Jean S
authors.initials: JS
authors.lastname: Valles
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Sabatier
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Marston
authors.forename: Kurt
authors.initials: K
authors.lastname: Jean-Charles
authors.forename: Edieu
authors.initials: E
authors.lastname: Louissant
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
mesh_terms: D003376:Counseling; D003695:Delivery of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D055866:Earthquakes; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology*; D006205:Haiti / Q000453:epidemiology; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance