1. GLOBAL CARE OF HIV + CLIENTS/PATIENTS PRESENTER; JOANNA LAURENT- BLAIZE CLINICAL CARE NURSE AT THE INFECTIOUS DISEASE CLINIC AT PMH IN DOMINICA

3. MEMBERS OF THE DOMINICA CLINICIAL CARE TEAM Ms. Allison Samuel- NAP Coordinator Dr. Cheruserta Joseph- Clinical Care Coordinator Mrs. Joanna Laurent- Blaize- Clinical Care Nurse Ms. Mary Williams- Counselor/HIV Testing and Counselling Coordinator Ms. Jennifer Joseph-PMTCT Coordinator with Responsibilities of M&E & Social Worker Ms. Valentine Ambrose- Pharmacist Mrs. Catherina Jemotte- Lab Supervisor

10. TREATMENT PLAN This invloves weight taking, blood pressure, RBS for Diabetics at every visit TB status, screening for other common- co infections ( Hep B, C, RPR) Potential side effects of drugs Importance of Nutrition in maintaing positive living Adhereance issues

11. TREATMENT PLAN Education : Assess client knowledge of virus Basic HIV education, prevention measures, disclosure Prevention – safer sex (condoms, female condoms-, house hold precautions ( what is safe), positive living, testing of partners, shared confidentiality, reproductive choices, prevention of MTCT. Alcohol, drugs and sex Myths are explained

12. TREATMENT PLAN Progression Treatment Progression of the disease Opportunistic infections which they may develop and reasons for antibiotics, (prophylaxis) Importance of follow up appointments and the role of the Clinical Care team

13. TREATMENT PLAN Adherence preparation indcation visits Clients must be ready for ART discussion held with individual Clinica Care Team members. Support in monitoring of ART Explain dose, when to take RX, what to do if one forgets dose, what to do when travelling, Adherence plan ( schedule, aids, diary, alarms, adherence buddy) Support groups

17. PSYCHOSOCIAL CARE PROVIDED TO CLIENTS Psychosocial Issues related to HIV Psychosocial Assessments Adherence counselling Prevention for positives Disclosure Nutrition Counselling and Nutritional Support Sexuality and Reproduction Referrals to other psychological/psychiatric and social services

19. CO- MORBIDITY TB, Diabetes, Hypertension Family support Involvement of District Nurse in patient care Teaching session : spread of the disease, yearly screening of 0- mantoux clients, exposure to TB, infections DM & HTN : Signs and Symptoms, Risk factors, personal hygiene, diet, exercise, complications, importance of keeping appointments, lifestyle at home, remedies