Overview of Care, Support, and Treatment HIV Care, Support, and Treatment
Definition of Care and Support A comprehensive, wide range of services for PLHIV and caregivers (other than anti-retroviral therapy) that meet holistic needs PEPFAR. December 2009. The U.S. President’s Emergency Plan for AIDS Relief: Five-Year Strategy. Annex: PEPFAR and Prevention, Care and Treatment. Washington, DC: PEPFAR and UNAIDS. 2010. UNAIDS 2011-2015 Strategy: Getting to Zero. Geneva: UNAIDS
Definition of Treatment • Anti-retroviral therapy (ART) is the treatment of people infected with HIV using a combination of at least three anti-retroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease http://www.who.int/hiv/topics/treatment/art/en/index.html
Purpose of Care, Support, and Treatment • Improves the survival, well-being, and quality of lifeof PLHIV over all stages of the disease and their caregivers • Helps PLHIV to stay healthy and productivefor as long as possible PEPFAR. Dec 2009. The U.S. President's Emergency Plan for AIDSRelief: Five-Year Strategy. Annex: PEPFAR and Prevention, Care and Treatment. Washington, DC: PEPFAR
Care, Support, Treatment, and Prevention: 3 Pillars Figure from UK Consortium on AIDS and International Development/HIV Care & Support Working Group. 2008. What do we really mean by "HIV Care and Support"? Progress towards a comprehensive definition. London: UK Consortium on AIDS and International Development
Care, Support, and Treatment: The ART Era • Rapid, dramatic expansion of HIV care and treatment in the developing world is one of the largest public health successes in history • ART transformed HIV from survival (measured in weeks or months) to a chronic, lifelong disease
Care, Support, and Treatment: The ART Era • Keep in mind, care and support is vital with or without ART • Psychosocial support to PLHIV taking ART is directly associated with improved ART adherence and better health outcomes • Clinical care prolongs and improves the quality of life • Cotrimoxazole (to prevent opportunistic infections) has great impact on health and survival of PLHIV
Know Your Epidemic, Know Your Response • Some CST services are needed across all epidemics: generalized, concentrated, low-level • Peer support • Management of TB • Some CST services are specific to a type of epidemic, key population, and local context. For example, • People Who Inject Drugs (PWID) – drug dependence treatment, promotion of viral hepatitis vaccination • In sub-Saharan Africa – food security, malaria prevention
Know Your Epidemic, Know Your Response in (Country) Post Adaptation • Insert post-specific information on type of epidemic and a few examples of major care and support services. Give only a few, key examples. Do not include too many details. As appropriate, link to the Global Health Sector Training Package session Introduction to Epidemiology.
Challenges in CST • Knowing your status and accessing care • Retention in care and support • Access and adherence to ART • Stigma and discrimination • TB • Gender • Integration, coordination, and linkages • Quality of services
CST Basics: Group Task • All groups: Read the Handout “Care, Support, and Treatment Basics” • Groups 1-3: Discuss, then select two points (based on your observations in country so far) that you consider most important about Care and Support in (insert post name) and explain why. • Groups 4-6: Discuss, then select two points (based on your observations in country so far) that you consider most important about Treatment in (insert post name)and explain why.
Wrap Up • Compare this discussion to our experiences “What Helped Us Get Better” • What strikes you as similar? Why? • What strikes you as different? Why?
Continuum of Care: Definition • A network that links, coordinates, and consolidates care, support, and treatment services (provided in homes, communities, and health facilities) and is also the group of services themselves
Continuum of Care: Explanation • Counseling and Testing: Knowing one’s status is a gateway for care, support and treatment (as well as prevention) • Services/levels in the Continuum of Care are represented by the “circles” • Linkages in the Continuum of Care are represented by the “arrows”
Continuum of Care: Practice • Watch this short film clip http://www.viewchange.org/videos/kiberatv-life-beyond-hiv • As you watch • Listen for the services that Agneta and Benta describe. Write these on (color) sticky notes, one idea per note. • Listen for the linkages that Agneta and Benta describe. Write these on (color) sticky notes, one idea per note.