How To Deal With Hiv Patient – Dr. David Maman, MSF epidemiologist. Zipporah Aluoch Odongo (pictured) is undergoing treatment for HIV and Kaposi’s Sarcoma in Homa Bay, Kenya.
Unless people living with HIV are tested regularly to monitor their health, with ongoing treatment using the right medications, the virus can continue to attack and severely suppress their immune systems. can be debilitating. And a person with a compromised immune system may be at risk for opportunistic infections such as tuberculosis, cryptococcal meningitis and Kaposi’s sarcoma.
How To Deal With Hiv Patient
Our challenge is that we don’t have the right metrics to identify all of these issues – and the metrics that we do have don’t work in all of the situations where we provide services.
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Zipporah was tested for HIV in 2016. But by the time she came to our clinic in Homa Bay, Kenya, the following year, she had developed Kaposi’s sarcoma.
This is a type of cancer that can appear in the late stages of HIV infection, especially if effective antiretroviral (ARV) treatment is used.
We treat many patients like Zipporah, who are living with HIV and facing many life-threatening diseases that are difficult to treat.
We continue to see very high death rates in people living with the virus in parts of sub-Saharan Africa – even where they have received ARV treatment.
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The world has come a long way in expanding treatment for those living with the virus in sub-Saharan Africa, the epicenter of the epidemic.
But without affordable medical equipment in the lives and conditions we work in, many people will continue to die from complications of HIV.
.@GileadSciences: Expand non-profit price of drug L-AMB to include cryptomeningitis indication for low + middle income countries. So #HIV patients can get better treatment with fewer side effects no matter where they live…
L-AMB is @GileadSciences’ drug for kala azar (#NTDs) and cryptomeningitis. It is too expensive for many countries. #AIDS2018
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.@MSF and more than 30 organizations signed a letter urging @ViivHC to make dolutegravir available to children who need it. #AIDS2018 π
. @ViiVHC ( @pfizer + @GSK ) = exclusive manufacturers of the pediatric version of the #HIV drug ‘dulotegravir’. Nearly two million children and infants with HIV are waiting for this effective and affordable πmedπ, but pharmacies are dragging their feet. #AIDS2018
Liposomal amphotericin B is a life-saving treatment for many diseases. Collaborative work among stakeholders is essential to address persistent barriers to access.
Tags: COVID-19, HIV/AIDS, tropical and neglected diseases, mucormycosis, cryptococcal meningitis, visceral leishmaniasis (kala azar), liposomal amphotericin B, UNAIDS
Hiv/aids Workplace Policy
MSF is responding to new simplified WHO guidelines for the treatment of cryptococcal meningitis, the number two killer of people living with HIV/AIDS.
Success in treating HIV-related spinal cord injury gives Gilead another opportunity to deliver on its promise to expand access to life-saving drugs.
“The biggest challenge we face at CHK Hospital is that these patients often come very late, we struggle to keep them alive but often we know them very well, their conditions. are kept hidden from the family who bring them.” Patients want community models. Care that facilitates access to prescription antiretroviral drugs (ARVs). Collecting essential medicines in resource-poor countries often takes time, effort and money.
Community care models are an effective way to manage the growing population of HIV patients in ways that fit the realities of their daily lives.
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These models are an important tool in scaling up HIV care. This relieves already overburdened health systems in high-burden countries, enabling not only more people to start treatment but more patients to continue their treatment.
Patient-centered care is an approach that puts patients first. This means that the actual conditions and limitations of patients are taken into account, and healthcare is adapted to those conditions.
Health system flexibility is a key factor in allowing for a patient-centered approach to care. This is particularly important in the fight against HIV, as most people living with the disease live in resource-poor countries (only 6.5% of people living with HIV live in high-income countries; 71 % live in sub-Saharan Africa). . Many of these countries have weak health systems that cannot manage millions of chronically ill patients.
Community models of care address barriers that ARV-stable patients face during treatment. They were first tested with ARV-stable patients who did not require intensive medical care.
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The types of community services have one basic principle: they set aside an appointment to see a doctor or nurse for a check-up (which is only necessary once a year for patients whose HIV treatment reduces their viral load). monitored by and fully functional) from taking the drug. Daily supply of ARV drugs (which may be once a month depending on the context). Drug delivery is organized at the community level in collaboration with peer groups.
There is a growing group of patients with resistance to ARVs, and the health system should be able to self-regulate in innovative ways by giving them responsibility for their treatment and making it easier for them to access their medicines. should be changed to accommodate them. In community-based care models, communities are involved in health system decisions and community members support each other in adherence to treatment. For the patient, it is a way to find strength in a group of people who share a common burden.
To end HIV we not only need to get more people on ARVs, but we also need to keep them on ARVs for life. It is only when people take their medication daily without interruption that they stop getting infections and are no longer able to transmit the virus.
People who are stable on ARVs do not need intensive medical care. Current HIV patients who are on ARVs and who adhere to their treatment are healthy and normal without frequent hospital overcrowding and hours-long queues for medication, just like people with diabetes. want to live a life of People living with HIV receive support in their community about coping with substance use problems and living with a chronic illness.
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The reality of the HIV epidemic is that the greatest public health efforts humans have ever made to control a chronic disease are fought primarily in poor countries. These countries cannot cope with the constant flow of patients who require lifelong monitoring and treatment. There are great needs, and limited resources. As African health systems are already overburdened, other ways need to be found to provide adapted services to the growing population of HIV patients. The solution lies in the hands of the patients themselves.
Community models of care address both sides of the growing treatment problem. From the patient’s perspective, it is a matter of adapting health services to the needs of long-term patients. And from a health system perspective, it frees up scarce human resources to get more people into treatment, ensuring that those who are already on treatment are already being treated. Don’t add to the burden on a weak health system.
When it comes to community care models, one size does not fit all. In order to make the best use of limited resources while dealing with large and growing demands, it is important that service models are adapted to the specific needs of patients and the capacity of the health system. have experimented with several models, from more facility-driven approaches to more patient-led approaches. Several can also coexist in one setting to meet the needs of different people.
A healthcare-driven strategy focused on appointment booking and faster medication refills in the village of Chiradzulu, Malawi. Individual patients visit the health center for refills once every three months. Medicines are administered directly by a member of staff, meaning seeing a nurse is no longer necessary. Medication refills can sometimes be as long as six months, thus saving the patient the burden and expense of frequent travel.
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Patients visit the clinic for consultation only once every six months, and their viral load is tested once a year.
The follower club model was tested in the South African township of Khayelitsha. Under this approach, patients, led by a lay worker, gather at a health center or community hall (such as a library) once every two months to distribute ARVs. The group allows for peer support and health education among its members. Patients visit the health center once a year for medical advice and virus level testing.
The model is being extended further into the community, and follow-up clubs are being organized in nursing homes rather than health centres.
This model is suitable for urban environments, especially where time spent in clinics is an issue for patients.
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There are discipleship clubs in Khayelitsha and community discipleship groups (see below) and discipleship clubs in KwaZulu Natal province.
Follower clubs have been established independently throughout the Western Cape province, and have begun to operate – also independently – in the Gauteng and Free State provinces.
. Every three months under this method
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