Transcript of "Improved access to hivaids services through comprehensive care and treatment centres b etemesi"
IMPROVED ACCESS TO
CARE AND TREATMENT
Dermato-Venerologist, Nakuru Provincial Hospital
• Nakuru Provincial Hospital comprehensive
care and treatment centre opened in January
• Services offered are intended to provide
holistic family focused care to those infected
and affected by HIV. Efforts are made to
reach out to the family when an „index client‟
presents to the Comprehensive Care Centre
• Currently over 9000 adults and children are
under care and treatment with an average of
100 patients per day seen at the CCC
• Services are provided to different groups
catering for their specific needs: pregnant
women, children, youth and adults.
• Apart from Voluntary Testing and Counselling
(VCT), Early Infant Diagnosis (EID),
Diagnostic Testing and Counselling (DTC) are
carried out for one to know whether they
require CCC services
• Among the services provided at the CCC is a
pharmacy specifically for the provision of
ARV and opportunistic infection drugs.
Adherence counselling is also provided to
clients and/or care-givers
• In general stigma is severe social
disapproval of personal behaviour,
characteristics or beliefs that are against
what is considered “normal”. It results in
social rejection arising from fear, and/or lack
of understanding or knowledge.
• AIDS related stigma refers to the negative
social response against people perceived to
have HIV or AIDS and those who are closely
associated with them.
• Stigma can fuel responses of discrimination,
prejudice, fear, denial and anxiety.
Commonly encountered actions
that can stigmatize
• Judgemental attitude why people of certain age
brackets (especially the youth and elderly) or
profession can acquire HIV
• The avoidance or extra care taken by health
care workers when handling people infected
• Guardians reluctance to bring HIV infected
children to the CCC for care and treatment
• Labelling of certain conditions especially skin
disease and tuberculosis
• Whether by coincidence or choice HIV patients
being found in one section of the ward.
Reactions to stigma
• Guardians neglect of children (AIDS orphans)
under their care for fear of community
• Removal of labels on ARV bottles, or simply
switching the incriminating bottles for fear
of being identified to be taking ARV leading
• Self-blame and denial of having the disease,
often leading to refusal to disclose HIV
status to partner/spouse, children or
• Reluctance to collect drugs from the CCC
pharmacy since it will be know that they are
Reactions to stigma
• Health workers on ART pretend to be picking
ARV for a patient or relative for fear of
being identified as the user.
• Where a drug for an OI is unavailable from
the CCC pharmacy the patient will demand a
different prescription that is not CCC
branded so that it can not be identified when
they purchase the drugs elsewhere.
• Youth who require comprehensive care avoid
coming to the CCC because they don‟t want to
mix with the adults and if they come they will
usually come with an adult so that it looks like
it is the adult requiring the services.
Reducing the stigma
• As the main causes are unfounded fears and
ignorance or lack of adequate knowledge
about the disease, the best interventions
involve tackling these causes
• Initial interventions need to target the
stigmatizers: health care provider both
medical and non-medical, the general
community, faith leaders with factual and up
to date information. This is done through
making available literature with the
information (e.g. leaflets and brochures),
morning health talks, videos and seminars,
targeting various groups, etc.
Reducing the stigma
• People affected as well as those living with
HIV or AIDS also need be to be targeted.
Counselling is the cornerstone to reduction of
stigma of PLWHA, their partners, family and
care givers. It is used to provide needed
information at every point where treatment
and care is provided and is critical in helping
those affected as well as those infected to
cope with fears and emotions related to HIV
& AIDS, thus improving understanding and
acceptance of HIV status
• Support groups provide psycho-social and
material support by sharing of experiences,
empowering themselves with skills,
information and opportunities. Support groups
provide a supportive environment with an
ambiance of care and understanding.
• Ensuring all health care workers are kept up
to date with information on HIV and AIDS
• Introduction of stigma as a topic in the ART
Take home message
• The person infected with HIV or living
with AIDS and those associated with
them should not treated differently
from any other person.
• We should remember that AIDS is a
disease like any other. We need to be
well informed about the disease so that
we can free ourselves from irrational
responses or reactions to HIV and
Stella Etemesi, Dr Marion Ong‟ayo,
Lydia Njuki, Matron Mary Mware,
Matron Sarah Mosop, Mary Mose,
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