Treatment, Care and Support

Health systems in the worst-affected countries are often ill equipped to meet the basic health needs of communities, let alone to provide a comprehensive range of treatment, care and support services for PLHA, partners, family members and carers.  Nonetheless, the global commitment to expand access to ARVs provides new opportunities to advocate for an approach to scaling up that strengthens health systems and builds community capacity. In contexts where health infrastructure is weak and resources are limited, the good practice principles can guide NGOs in advocating for comprehensive and integrated treatment, care and support programmes.

The impact of HIV on PLHIV, their families, partners, dependants and carers are complex and far-reaching, and include:

  • despair about the consequences of progression of the disease, the effects of illness, the possibility of death and the effects of bereavement
  • fear of becoming infected or infecting others
  • social isolation, including deterioration of family relationships and reduction or loss of social status
  • economic implications, including reduction or loss of livelihood or employment, inability to support dependants, pressures on children and young people to provide for or contribute to meeting families' economic and care needs, and
  • the many manifestations of stigma and discrimination.

While this section provides good practice principles in HIV-related treatment, care and support, the complex consequences of HIV on individuals, families and communities underscore the need to foster strategic partnerships to facilitate effective referral to other programmes and joint initiatives to meet the diversity of needs of PLHIV and affected communities.

We provide and/or advocate for comprehensive treatment, care and support programmes.

Generally, NGOs provide only some components of comprehensive treatment, care and support services and programmes, most often home-based care and support programmes, although there are NGOs that provide a wider range of services, including clinical services.

We need to provide and/or advocate for a comprehensive and integrated range of treatment, care and support services and programmes, including:

  • accessible and high-quality VCT services
  • tailored health information on ARV treatment, including side effects and adherence issues; treatment for opportunistic infections; and available HIV prevention, care and support services and related health issues, including TB, STI and HIV prevention programmes
  • tailored support programmes, including counselling, discussion groups, peer support and spiritual support
  • care services, including home-based care, nursing care and palliative care
  • HIV treatment programmes, including clinical management of opportunistic infection and HIV-related illness, monitoring and management of disease progression and access to ARV therapy
  • treatment and prevention of TB and STIs
  • support and assistance in relation to non-clinical aspects of treatment, including peer support, adherence and nutritional needs
  • information about household hygiene and sterilisation precautions
  • a range of support programmes including food, clothing and legal assistance and socio-economic support, and
  • support, respite and training for family members and carers of PLHIV.

We enable PLHIV and affected communities to meet their treatment, care and support needs.

When providing treatment, care and support services for PLHA, we need to:

  • involve PLHIV, their families, partners, dependants and carers in programme design, implementation and evaluation. This includes the process of building literacy on ARV treatment and HIV health in preparing communities for access to ARV treatment, to ensure that treatment service providers understand community beliefs, knowledge and needs
  • provide individual assessment of the treatment, care and support needs of PLHIV, taking into consideration the needs of their partners, children, other family members and carers
  • provide tailored support programmes that enable people to deal with the consequences of HIV and make informed decisions about their treatment, care and support needs, and
  • ensure that the social, economic and psycho-social affects of HIV on PLHIV, their family and carers are addressed

An essential part of the response to HIV has been, and will continue to be, home- and community-based care. Our care and support programmes need to support partners, other family members, and friends and volunteers providing care and support for PLHIV by:

  • providing training and resources to ensure carers have appropriate information about HIV prevention and care and knowledge of available health services
  • supporting carers to develop and maintain the necessary skills to provide quality care, and
  • ensuring carers are supported to avoid burn-out, through counselling, peer and social support and respite.