Office of Overseas Programming & Training Support (OPATS)

Overview of Care, Support, and TreatmentHIV 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 life of PLHIV over all stages of the disease and their caregivers

Helps PLHIV to stay healthy and productive for 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 AdaptationInsert 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?

The Continuum of Care

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 cliphttp://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.