Handbook on Access to HIV/AIDS-Related Treatment : a Collection of Information, Tools and Resources for NGOs, CBOs and PLWHA Groups: Chapter 1: First questions to ask: 1.2 Linking treatment and prevention

Handbook on Access to HIV/AIDS-Related Treatment : a Collection of Information, Tools and Resources for NGOs, CBOs and PLWHA Groups
(2003; 130 pages) [French]

Table des matières

Preface
Acknowledgements
Acronyms
Introduction: Read this first!
	1. What is this handbook?
	2. Why was this handbook developed?
	3. How was this handbook developed?
	4. Who is this handbook for?
	5. How can this handbook be used?
	6. What is in the chapters of this handbook?
	7. What materials are needed to use this handbook?
	8. Who developed this handbook?
	9. Further sources of information
	Example of workshop schedule
Chapter 1: First questions to ask
	1.1 Care, support and treatment
		1.1.A Care and support
		1.1.B Treatment
	1.2 Linking treatment and prevention
	1.3 Access to treatment
		1.3.A Availability of treatment
		1.3.B Accessibility of treatment
	Information Sheet 1: Barriers to access to treatment
	Information Sheet 2: Factors affecting access to treatment
	1.4 Further sources of information
Chapter 2: Foundations of treatment
	2.1 The basic elements of treatment work
		2.1.A Supportive relationships for treatment work
		2.1.B Knowledge, skills and attitudes for treatment work
		2.1.C An ethical approach to treatment work
		2.1.D Information for treatment work
	2.2 How different treatments vary
	2.3 Working with others to improve access to treatment
		2.3.A Partnerships to improve access to treatment
		2.3.B Advocacy to improve access to treatment
	Treatment Information Sheet
	Treatment Assessment Sheet
	2.4 Further sources of information
Chapter 3: Putting treatment into practice
	3.1 Resources for HIV/AIDS-related treatment work
	3.2 Drugs for HIV/AIDS-related treatment
		3.2.A Managing HIV/AIDS-related drugs
		3.2.B The essential medicines concept
		3.2.C Guidelines for treatment
		3.2.D Choosing the right drugs
		3.2.E Drug names
		3.2.F Using drugs effectively
		3.2.G Fact sheet - antiretrovirals
	3.3 Sourcing and looking after good-quality drugs
		3.3.A Drug quality
		3.3.B Sources of drugs
		3.3.C Storing drugs
		3.3.D Keeping records and ordering drugs
	3.4 Providing drugs to people living with HIV/AIDS
		3.4.A Paying for HIV/AIDS-related treatment
		3.4.B Drug information
		3.4.C Dispensing drugs
		3.4.D Managing transport for HIV/AIDS-related treatment
	3.5 Training and management for treatment work
	3.6 Further sources of information
Chapter 4: Assessing needs and resources, and deciding what to do
	4.1 The assessment process
	4.2 Assessment frameworks
		4.2.A Assessing needs and resources - people living with HIV/AIDS and the community
		4.2.B Assessing needs and resources - the local environment
		4.2.C Assessing needs and resources - your NGO/CBO/PLWHA group
	4.3 Deciding what to do
		4.3.A Analysing your findings
		4.3.B Reaching a decision
		4.3.C Communicating your decision
	Information Sheet 3: Thinking creatively about what your group can do - treatment in context
	4.4 Further sources of information
Chapter 5: Learning from and improving HIV/AIDS-related treatment work
	5.1 Monitoring and evaluating HIV/AIDS-related treatment work
		5.1.A Keeping records of your work
		5.1.B Monitoring your work
		5.1.C Evaluating your work
	5.2 Changing and improving HIV/AIDS-related treatment work
		5.2.A Making the most of new resources and linkages
		5.2.B Coping with changes
		5.2.C Sharing your experiences with others
		5.2.D Scaling up, scaling down or staying the same
	5.3 Further sources of information
	Organizations that contributed to the development of this handbook
Back cover

1.2 Linking treatment and prevention

HIV prevention aims to prevent the transmission of HIV and reinfection. HIV/AIDS-related treatment aims to improve the quality of life of people living with HIV/AIDS. HIV prevention and HIV/AIDS-related treatment support each other in many ways.

• Well-designed HIV prevention activities can lead to increased voluntary counselling and testing (VCT), which in turn can lead to broader and quicker access to treatment for people living with HIV/AIDS.
• Well-designed HIV prevention activities can reduce fear and stigma around HIV/AIDS, which in turn improves the quality of life of people living with HIV/AIDS as they become more accepted and understood in their families and communities.

• Through VCT, people can learn about HIV prevention and, if they are HIV-positive, be given information about how to live safely with the virus and plan for the future. VCT also helps people to get assistance early on and to learn about possible treatments for health problems that may occur. For example, VCT can be helpful for preventing tuberculosis (TB) and sexually transmitted infections (STIs).

• If women learn that they have HIV/AIDS, because of prevention programmes and VCT services, they can access services which, if they become pregnant, will reduce the chance of passing on HIV to their unborn or newborn children. Women and men might also choose to increase contraceptive use.

• Access to care and support has been shown to increase condom use and other preventive behaviour among people living with HIV/AIDS. These positive changes can be reinforced when care and treatment programmes deliberately promote and distribute condoms.

• Increased availability of care and increased visibility and acceptance of people living with HIV/AIDS makes the broader population more aware of HIV/AIDS and increases safer behaviour.

Case study - Home care in Cambodia

In Cambodia, home-care teams from local organizations support a large number of families affected by HIV/AIDS. Most of the people living with HIV/AIDS found that their overall well-being improved due to the visits from the home-care teams; families spent less money on medicines and had to make fewer visits to hospital. In addition, neighbours, friends and family members came to understand more about HIV/AIDS and to be less afraid of the virus - there was less stigma around HIV/AIDS in the community, making it easier to provide education on HIV prevention.

Participatory group activity

Aim

To identify the links between HIV/AIDS-related treatment and HIV prevention.

Instructions

1. Explain the aim of the activity.
2. Present participants with a definition of HIV prevention.

3. Divide the participants into small groups of four to six people.

4. Ask each group to discuss whether they agree or disagree with the following statements:

• HIV/AIDS-related treatment can help to reduce the need for HIV prevention.
• HIV prevention can help to reduce the need for HIV/AIDS-related treatment.

5. Ask each group to make a diagram or drawing showing the links between HIV/AIDS-related treatment and HIV prevention.
6. Bring everybody back together and ask the groups to share their results. Encourage the participants to ask each other questions and to make comments.

7. Facilitate a group discussion about what has been learned from the activity, based upon questions such as:

• Does everybody have a similar view of the links between HIV/AIDS-related treatment and HIV prevention? Why?
• What is the single most important link between HIV/AIDS-related treatment and HIV prevention? Why?

Facilitators' notes

• Ensure that participants are clear about what is meant by HIV prevention before they assess its link to HIV/AIDS-related treatment. Ensure that their definition includes prevention of other illnesses as well as prevention of HIV transmission.
• Encourage participants to focus on the practical links between HIV prevention and HIV/AIDS-related treatment, rather than the theoretical ones.

• Ensure that participants keep focused on the links between HIV/AIDS-related treatment and HIV prevention, rather than getting distracted by debates about which is more important.

Example

At a skills-building workshop, NGO/CBO participants discussed the statements: "HIV-related treatment can help to reduce the need for HIV prevention"; "HIV prevention can help to reduce the need for HIV-related treatment." They found that, based upon their experiences, they strongly agreed with the statements.

Participants then drew a diagram of how they saw the links between HIV/AIDS-related treatment and HIV prevention in practice.

Reference: Adapted from a workshop on access to HIV-related treatment, India HIV/AIDS Alliance and the International HIV/AIDS Alliance, India, February 2001.