OPC: Van Don PAC/P87 Coordinator: 0% 0an 8ien Leadership 1acilit) Director: $g%)en D%c 8%ng C9ief of OPC:

PC: $g%)en 4%an 7i% Site onitor!s" Dinh #hi $ich %anh Located at: D8C P38/D38 PAC Services delivery 82C A52 MM2 Services !s" Care ; 7%pport (8BC< O0C:) =D> 17? Ot9er *er-ice* (Plea*e *pecif))

City/Provincial: Quang Ninh

7ocial *%pport facilit) Ot9er: ::::::::

&ntegrated Co'located 4 4 4 4

Donor 7MA52 2A 7MA52 2A 7MA52 2A 7MA52 2A

(o)ile

%istory

29e OPC 'a* opened in Mar 2006@ =t 'a* an OPC in A%ang $in9 Pro-ince and de*ired to *er-e t9e need* of 600 P68=0@ 29e late*t *%r-e) &) PAC in A%ang $in9 pro-ince *9o'* t9at t9ere are a&o%t #00 infected client* '9o 9a-e 9ig9 need for A52@ A52 *er-ice 'a* integrated 'it9 82C in 200 and MM2 *er-ice* in B%l) 20"2@ 29e OPC al*o pro-ide* ot9er *er-ice* *%c9 a* 9ome &a*ed care and *%pport and PM2C2 =n Ma) 20"2< -iral load *er-ice 9a* &ecome a-aila&le in t9e pro-ince

1. A B C D / 1 3

Operation Date clinic opened for care and treatment (MM/YY) __Mar__/_2006___ OPC operating time: :00am!"#:00pm $%m&er of 'or(ing da)*/'ee(: +/# CD, te*ting a-aila&le . Ye* $o 0iral load te*ting a-aila&le . Ye* $o 2B 3ene4pert a-aila&le . Ye* $o Admini*trati-e f%nding pro-ided &): P/P1A5: 6ifegap/CDC . 7MA52 2A 31 MO8 Clinton 1o%nd ot9er:

Clinical 2ec9nical A**i*tance pro-ided &): $one 6ifegap/CDC 8A=0$ . 7MA52 2A 31 MO8 Clinton 1o%nd Sta++ing Doctor*/P9)*ician A**i*tant* Co%n*elor* C8BC team 6a& tec9nician P9armaci*t Ot9er (plea*e *pecif)) onths"

82D C $82DC ot9er: -Contracted 1%ll!time Part!time 4 4 4 4 4 - #otal

D*.

E ,VN 1%ll!time Part!time

A B C D / 1

.. /or0load !average in the last 1* A E 82C -i*it*/mont9 B E A50 -i*it*/mont9 C E MM2 -i*it*/mont9 1. Patients 5eporting period: A=0 20"F 2ro : Main indicator*: A B C D /

+ -i*it*/da) F0 -i*it*/da) "20 -i*it*/da)

#o: (ale 2e ale G"+ H"+ G"+ H"+ , "2 "6 2, 2#F 2I# (ale " I "0 2e "+0 0 22 "0 "F0 ",0 ale #otal

$%m&er of c%m%lati-e regi*tered patient* $%m&er of c%rrent Pre!A52 patient* $%m&er of c%rrent (acti-e) A52 patient* 2otal n%m&er of c%rrent patient* $%m&er of patient* c%rrent recei-ing A52: ! 1ir*t line A52 ! 7econd line A52 $%m&er of patient* ne'l) *tarted on A52 'it9in pa*t "2 mont9* A-erage CD, co%nt &a*e!line at A52 enrollment 'it9in pa*t "2 mont9* $%m&er of lo*t!to!follo'!%p 'it9in pa*t "2 mont9* ! A52 patient* ! Pre!A52 patient* $%m&er of deat9* (A52 patient* onl)) 'it9in pa*t "2 mont9* 5ate of retaining in care after "2 mont9* of A52 (K)

#otal ,6F 0 #0 $A "#

F"F 0 F

1 3 8

= J

+ I+K