Care for those with HIV/TB: HBC, palliative care, CPT, IPT, STI, nutritional and psychological support. All the interventions should be considered within.

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Presentation transcript:

Care for those with HIV/TB: HBC, palliative care, CPT, IPT, STI, nutritional and psychological support. All the interventions should be considered within a package of care. Collaboration between TB and HIV improved quality of service delivery.

Care for those with HIV VCT has to be offered within a package of care which includes nutritional and psychosocial support, poverty alleviation, STIs. More comprehensive than IPT and CPT only. The shape of the PC is country and resource specific. Referral system essential. In particular, a package of care helps to increase uptake of VCT of HIV/positive who are sick. PC also empowers HC staff to offer VCT and reduces stigma among HCW Development of PC for HIV-pos who are well and not well.

Care for those with HIV IPT is of individual benefit and part of the PC. PH intervention if offered to prevent a second episode of TB (operational research needed) Role of IPT within the PC when ARV is offered to be determined. Investigation required on how to improve adherence. Monitoring. CPT, operationally easy to do. National policy for CPT in TB pts available in Malawi and SA. Good adherence and reduces mortality? Interaction with Malaria and role of ARV?

Care for those with HIV Where HBC is present, this facilitates the delivery of the PC and ProTEST helped to link it to the health system. 3) To do them better and to scale: Human and financial resources. Research to improve adherence and monitoring. Strengthening the health system (ProTEST suggested a way to improve collaboration). Technical expertise and cross-visit would be useful.

Care for those with HIV 4) We think that measuring adherence is important not for these interventions in particular. Instead, it plays a role for the impact of CPT on TB mortality and to develop a model for ARV. How many people start IPT and how many complete 6-month course over 1 yr. Monitor CPT is more difficult after completion of TB treatment. There is a need to upgrade the monitoring system.

Care for those with HIV 5) To address lack of adherence we should look at different models (non-infectious diseases). The model will make the pt good to adhere. Operational research to determine if equity is maintained or not.

Care for those with HIV 6) Nutrition is part of the package of care, rather than for IPT only , and ways to link with other departments or NGOs to provide it should be explored.

Care for those with HIV 7) All the interventions must be considered within the PC. Countries/districts to decide how to shape the PC. IPT to prevent 2 episode requires more evidence and models for adherence (also for CPT).

Care for those with HIV 8) ARV should be part of the package because different people will be eligible for different interventions. Sequential approach depending on the stage of disease might be applied