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[object Object],[object Object]
Objectives 1 ,[object Object],[object Object],[object Object],[object Object]
Objectives 2 ,[object Object],[object Object],[object Object]
Adherence vs. Compliance ,[object Object],[object Object],[object Object],[object Object]
Adherence to care  ,[object Object],[object Object],[object Object],[object Object]
How much adherence is required for HAART? Adherence, % % virologic failure Patterson, Annals of Internal Medicine, 2000 > 95 90-94.9 80-89.9 70-79.9 <70
How much adherence is required for HAART? ,[object Object],[object Object],[object Object]
Poor adherence and viral resistance  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How common is non-adherence to HAART? ,[object Object],[object Object],[object Object]
Forms of Non-Adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of non adherence ,[object Object]
Causes of non adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Consequences of poor adherence ,[object Object],[object Object],[object Object],[object Object],[object Object]
How to assess adherence?  ,[object Object],[object Object],[object Object],[object Object]
Self-reports ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pill counts ,[object Object],[object Object],[object Object],[object Object],[object Object]
Biological markers of effectiveness of treatment ,[object Object],[object Object],[object Object],[object Object]
Pharmacy records ,[object Object],[object Object],[object Object],[object Object],[object Object]
How do we promote adherence ,[object Object]
How to promote Adherence? 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How to promote Adherence? 2 ,[object Object],[object Object],[object Object]
Patient Readiness Assessment  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adherence Counseling check lists ,[object Object],[object Object],[object Object]
Factors affecting adherence ADHERENCE Disease  Characteristics Prior OI Patient/Provider  Relationship Trust and confidence Treatment  Regimen Number, food/ fluid  restrictions, side-effects Patient variables Sex, age, employment, education, alcohol,  social support depression, etc Clinical  setting  Friendly, supportive non-judgmental staff confidentiality, convenient  appointments
Barriers to adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Family & Community involvement ,[object Object],[object Object],[object Object],[object Object],[object Object]
Adherence monitoring ,[object Object],[object Object]
Adherence Counseling Skills 1 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Adherence Counseling Skills 2 ,[object Object],[object Object],[object Object]
Counseling Techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychosocial aspects in HIV/AIDS MANAGEMENT By Dr Makanyengo
Different perspectives of psychosocial intervention ,[object Object],[object Object],[object Object]
Part 1  Effect of psychosocial stressors on immune system in HIV/AIDS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Role of mental stressors ctd ,[object Object],[object Object]
Part 2 Psychosocial impact of HIV/AIDS in the lives of PLHWA  ,[object Object]
Psychosocial impact (Stress) ,[object Object],[object Object]
Psychiatric effect of HIV/AIDS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychiatric symptoms and dementia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stigma ,[object Object],[object Object],[object Object]
Definition ctd ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Manifestation of stigma ,[object Object],[object Object],[object Object],[object Object],[object Object]
Discrimination ,[object Object],[object Object],[object Object]
HIV/AIDS and stigma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Part 3. Psychosocial support in care of HIV/AIDS infected ,[object Object],[object Object],[object Object]
Types of counselling ,[object Object],[object Object],[object Object],[object Object]
Counselling requirements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adherence counselling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Check lists for adherence counselling ,[object Object],[object Object],[object Object],[object Object],[object Object]
Set up support groups ,[object Object],[object Object],[object Object],[object Object],[object Object]
Support groups ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Support group ,[object Object],[object Object],[object Object],[object Object],[object Object]
Support groups ,[object Object],[object Object],[object Object],[object Object]
Types of support groups ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Client tracing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case study discussion for 15 minutes ,[object Object],[object Object],[object Object],[object Object]
Case study ,[object Object],[object Object],[object Object],[object Object]
Case study continues ,[object Object],[object Object],[object Object]

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Module 9 adherence & psychosocial counselling

  • 1.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. How much adherence is required for HAART? Adherence, % % virologic failure Patterson, Annals of Internal Medicine, 2000 > 95 90-94.9 80-89.9 70-79.9 <70
  • 7.
  • 8.
  • 9.
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  • 15.
  • 16.
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  • 20.
  • 21.
  • 22.
  • 23.
  • 24. Factors affecting adherence ADHERENCE Disease Characteristics Prior OI Patient/Provider Relationship Trust and confidence Treatment Regimen Number, food/ fluid restrictions, side-effects Patient variables Sex, age, employment, education, alcohol, social support depression, etc Clinical setting Friendly, supportive non-judgmental staff confidentiality, convenient appointments
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Psychosocial aspects in HIV/AIDS MANAGEMENT By Dr Makanyengo
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
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