1. Office of Overseas Programming & Training Support (OPATS) Care and Support Services and Principles HIV Care, Support, and Treatment

2. Review: Definition of Care and Support A comprehensive, wide range of services for PLHIV and caregivers (other than ART) that meet holistic needs

3. Review: The Continuum of Care

4. Review: Continuum of Care: Definition  A network that links, coordinates, and consolidates care, support, and treatment services (provided in homes, communities, and health facilities) and is also the group of services themselves

5. Review: Care and Support Services In the Overview of CST session, you learned that care and support services can be categorized under two broad headings:  Clinical care  Psychological and social support (psychosocial for short)

6. Clinical Care and Psychosocial Support Activity, Part I:  Distribute names of service cards to the left side of the room. These cards have the name of a clinical care or psychosocial support service.  Distribute the explanation of service cards to the right side of the room. These cards have the explanation of a clinical care or psychosocial support service.  “Match the name of the service to its explanation

7. Clinical Care and Psychosocial Services Activity, Part II:  Now decide if your cards (service + explanation) fall under CLINICAL care or PSYCHOSOCIAL support.  Stand under the appropriate sign.  Discuss with others WHY you are standing under that sign.  A few of you will then explain for the large group.

8. Clinical Care  Addresses physical suffering and needs of PLHIV  Includes: – Prevention and treatment of Opportunistic Illnesses (e.g., TB, Sexually-transmitted Illnesses, Hepatitis) – Malaria prevention and treatment – Positive Health, Dignity, and Prevention (supporting PLHIV to prevent spread of HIV)

9. Clinical Care  Includes: – Palliative Care – Adherence Counseling (adhering to antiretroviral treatment) – Harm Reduction: preventing harm associated with use of drugs (e.g., needle and syringe programs and opioid substitution therapy – Nutrition – Water, Sanitation, and Hygiene

10. Psychosocial Support  Addresses the non-physical needs of PLHIV and their caregivers  Includes: – Mental Health Screening and Referrals – Counseling and Peer Support Groups – Positive Living (PLHIV learn to stay healthier through diet, exercise, illness prevention, stress management, decision-making in their illness, etc.)

11. Psychosocial Support  Includes: – Spiritual care – Economic support – Legal support

12. Guiding Principles  Confidentiality  Respect for PLHIV autonomy  Addressing barriers of stigma and discrimination, gender inequity  Beneficial disclosure  Sensitivity to culture, gender, age, and vulnerabilities of PLHIV

13. Theory and Practice  What strikes you about our discussion?  How do these lists and descriptions of services and the guiding principles compare to the reality of what you observe in your situation?