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Comprehensive Care for People Living with HIV/AIDS (PLHA). Part A: Module A1 Session 4 . Objectives. Describe the purpose and components of a comprehensive care and treatment program in primary, secondary and tertiary health care settings Discuss the HIV/AIDS continuum of care

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part a module a1 session 4
Comprehensive Care

for

People Living with HIV/AIDS

(PLHA)

Part A: Module A1

Session 4

objectives
Objectives
  • Describe the purpose and components of a comprehensive care and treatment program in primary, secondary and tertiary health care settings
  • Discuss the HIV/AIDS continuum of care
  • Discuss the management of HIV/AIDS as a chronic disease
objectives continued
Objectives, continued
  • Describe the importance of and elements of standards of care
  • Discuss the opportunities within care and treatment programs to promote prevention
  • Discuss HIV/AIDS programmatic issues in their local situation
background
Background

The purpose of HIV/AIDS care, treatment and support programs is:

  • To assure equitable access to diagnosis, medical care, pharmaceuticals and supportive services
  • To reduce morbidity and mortality from HIV/AIDS complications
  • To promote prevention opportunities within care and support service delivery
  • To improve the quality of life of both adults and children living with HIV/AIDS and their families
components of comprehensive care treatment and support
Components of Comprehensive Care, Treatment and Support
  • Medical and nursing care
  • Psychological support
  • Socioeconomic support
  • Involvement of HIV positive individuals and their families
  • Respecting human rights and meeting legal needs
medical and nursing care
Counseling and testing

Prophylaxis of opportunistic infections (OIs)

Management of HIV-related illnesses, including OIs

TB control

STI management

Management of HIV disease

Palliative care

Access to HIV-related drugs

Interventions to reduce parent-to-child transmission

Clinical HIV/AIDS care for mothers and infants

Support systems such as functional laboratories and drug management systems

Nutritional support

Health education

Adequate universal precautions

Medical and Nursing Care
psychological support
Psychological Support
  • Community services to meet the emotional and spiritual needs of HIV-positive individuals and their families, including support through post-test clubs and peers
socioeconomic support
Socioeconomic Support
  • Material and social support within communities to ensure nutritional and daily living needs are met
  • Support for orphans and vulnerable children (OVC)
involvement of individuals and families
Involvement of Individuals and Families
  • Involvement of HIV-positive individuals and their families in service planning and delivery to ensure that HIV care and support programs intended for them address their needs and include human rights
respecting human rights and meeting legal needs
Respecting Human Rights and Meeting Legal Needs
  • Services that address stigma and discrimination issues in health facilities, in communities and in the workplace and that promote equal access to care
slide11
Clinical Care

(medical & nursing)

VCT , PMTCT

preventive therapy (OIs, TB)

management of STIs and OIs

palliative care, nutritional support

antiretroviral therapy

Socioeconomic Support

Psychosocial Support

counseling

material support

orphan care

economic security

n

community support services

food security

p

spiritual support

o

Human Rights & Legal Support

r

stigma & discrimination reduction

e

i

succession planning

PLHA participation

v

e

n

Comprehensive HIV/AIDS Care and Support

Adults and Children

Affected by

HIV/AIDS

t

chronic disease management approach
Chronic Disease Management Approach
  • HIV/AIDS care requires a chronic disease management approach
  • Priority has been on acute illnesses (respiratory illnesses, malaria,etc.)
  • Available HIV/AIDS treatments, by prolonging the lives of those who are HIV infected, create a demand for long-term care
principles of chronic disease management
Principles of Chronic Disease Management
  • Requires patient and health providers to work as a team
  • Demands consistent relationship between patient and health-care team members
  • Requires regular interdisciplinary care team meetings to discuss care issues, review treatment protocols, express concerns and support colleagues
principles of chronic disease management continued
Principles of Chronic Disease Management, continued

Ongoing care involves regular visits with clinic and support staff to:

  • Monitor disease status and treatment effect
  • Provide ready response to emerging health and socioeconomic issues
  • Maintain easily retrievable documentation
principles of chronic disease management continued1
Principles of Chronic Disease Management, continued
  • Support for care team members is essential for providing quality care and preventing frustration and burn-out
  • Currently available treatment is lifelong. It is to be expected that motivation to maintain wellness and adherence to treatment will vary during the course of the disease
standards of care
Standards of Care

The purpose of setting standards of care is:

  • To promote delivery of the highest possible quality of care
  • To establish measures for evaluating and improving client services

This requires:

  • Deciding how to achieve standards
  • Applying them in clinical practice
  • Evaluating to see if they have been achieved
standards of care continued
Standards of Care, continued
  • At each level of the health care system, different standards will apply for an essential comprehensive care package
  • Both the development of practice standards and quality assurance to monitor the implementation of these standards are important to delivering appropriate HIV care
standards of care continued1
Standards of Care, continued

Clinical services include affordable and standardized practices based on international and national guidelines:

  • Preventive therapies
  • Management of HIV- related conditions and opportunistic infections
  • Laboratory services
  • Secure supply of prescribed medications
  • Antiretroviral therapy (ART)
  • Post-exposure prophylaxis (PEP) for occupational injuries and rape
  • STI management
  • Palliative care
prevention as part of care and treatment
Prevention as Part of Care and Treatment

Targets of opportunity for integrating prevention into care and treatment:

  • Clinic waiting room: posters, videos, brochures and condoms
  • Provider-patient interaction: provider should remind clients about prevention of HIV transmission—ABCs
  • Home care: visitors to the homes of PLHAs can carry condoms and talk about proper precautions
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