Patient Support and Caring for People Living With HIV (PLWHIV) EXPLORE if any of the participants has a professional experience with PLWHIV. If any responded affirmatively, ask him/her to share his/her experience with the floor, especially regarding the attitude, concern and style of life PLHA are leading. Patient Support and Caring for People Living With HIV (PLWHIV)

Learning Objectives By the end of this unit, participants will be able to: Define patient support Describe the role and activities of lay counselors in regards to patient support Explain the concept of comprehensive care

Why should we care for PLWHIV and how are we supposed to support them? ASK why should we care for PLWHIV and how are we supposed to support them?

What is Patient Support? Patient Support = All activities aimed at supporting the patient, beyond purely medical aspects Three main actors involved in patient support Patient Caretaker or guardian Health worker  THIS IS YOU! EXPLAIN that a patient is anyone who is ill or unwell and desires support physically, emotionally, spiritually and psychologically NOTE As lay counselors, they are a critical part of patient support!

Components of Patient Support (1) Patient education The infection and evolution of the disease Transmission of the disease Risk reduction Treatment

Components of Patient Support (2) Emotional support Loss of self-image and good health Psychosocial support helping patients solve their social problems to improve their adherence to treatment EXPLAIN that ‘Emotional Support’ refers to helping the patient deal with their feelings regarding their self-image and loss of good health. In addition you’re helping the patient deal with -the stress caused by the evolution of the disease, the perspective of death, uncertainty of the future and the reduction of capacities -the relational changes with his close relationships and occupational environment -the changes brought by the treatment, which include: counselling (individual and group) and support groups Psychosocial support -risks of precariousness: financial resources, incapacity, loss of employment -risks of isolation, stigmatization by family and community, which includes social consultations, home visits, networking etc

Patient Support Activities (1) Individual sessions individual counselling (pre-test, post- test, follow-up, adherence etc.) Group sessions Health talks, education talks, ART preparation sessions, etc.

Patient Support Activities (2) Community and family activities home visits, home based care, defaulter prevention and tracing and other community activities

Lay Counselor Activities Linkages from diagnosis to HIV care & treatment Adherence counselling and patient education for: Initiation and continued adherence support for patients on ART; EAC Patients on medication for treatment of drug-sensitive TB and multi- drug resistant Pregnant and breastfeeding women Adherence Counseling in addition can include: -(MDR) TB, TB prevention (e.g. isoniazid preventive therapy) and contact tracing -Other common medication for prophylaxis (e.g. cotrimoxazole) and treatment (eg for noncommunicable diseases)

Lay Counselor Activities Prevention through facility-based health education Paediatric & adolescent disclosure counselling Facilitation of community-supported models of ART delivery Support for monitoring and evaluation

What is Comprehensive Care? HIV treatment involves many other components besides taking ARVs It involves many types of information, resources and services to address a range of needs – not just medical needs.

Goals of Comprehensive HIV/AIDS Care Improve the quality of life of PLWHIV Improve the lives of families and communities affected by HIV/AIDS especially pregnant women and children Prevent further spread of HIV EXPLAIN that as a lay counselor, you need to know about all the aspects of comprehensive care so that you can best help PLWHIV and their families to understand and get the services they need

Components of Comprehensive Care Pre- and post-test HIV counselling, HIV testing and follow-up ART initiation Adherence counselling and support Palliative care, including pain management PMTCT, antenatal, and reproductive health services Ongoing follow-up of babies that have been exposed to HIV EXPLAIN there are many components of comprehensive care, above are just a few. Others include: -Early infant diagnosis for babies -Prevention, diagnosis and treatment of opportunistic infections and other illnesses, such as malaria -Support for exclusive breastfeeding Ongoing monitoring of health status (through lab tests and physical exams) Regular immunizations for babies

Key Messages Patient support is more than purely medical Patient support is comprised of patient education, emotional support and psychosocial support Lay counselors are involved in patient education and counseling tasks for HIV/TB Practicing comprehensive care improves the lives’ of our patients