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Rehabilitation : a crucial component in the future of HIV care and support

NIXON, Stephanie
et al
June 2011

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"Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years"
Southern African Journal of HIV Medicine, Vol 12, No 2

South African national HIV prevalence, incidence, behavior and communication survey 2008 : turning a tide among teenagers ?

SHISANA, O
et al
2009

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"South Africa has the largest burden of HIV/AIDS and is currently implementing the largest antiretroviral treatment (ART) programme in the world. It is therefore fitting that South Africa is the first in the world to conduct three repeated national HIV population-based surveys to help monitor our response as a nation to the HIV/AIDS epidemic. This report is the third in a time series of population-based HIV seroprevalence surveys which started in 2002 and were repeated in 2005 and again in 2008"

Towards universal access : scaling up priority HIV/AIDS interventions in the health sector : progress report 2008

WORLD HEALTH ORGNAIZATION (WHO)
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
2008

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This report provides in-depth information on: treatment and care for people living with HIV; HIV testing and counselling; health sector interventions for HIV prevention; scaling up HIV services for women and children; strengthening health systems and health information; and towards universal access as the way forward

Genocide by denial : how profiteering from HIV/AIDS killed millions

MUGYENYI, Peter
2008

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This open access book charts the spread of AIDS and its impact on people in villages in Uganda, sub-Saharan Africa and the rest of the world and the unnecessary numbers of deaths, particularly among poor people that it has caused. It also looks at the campaign to gain universal access to anti-retroviral therapy and the limited level of response from the rich world. The author challenges pharmaceutical companies to develop more ethical and humanitarian ways to trade, involving crucial life-saving drugs, and calls for a new world order to ensure entitlement of the poor to rapid humanitarian relief

Pain relieving drugs in 12 African PEPFAR countries : mapping current providers, identifying current challenges, and enabling expansion of pain control provision in the management of HIV/AIDS

HARDING, Richard
et al
January 2007

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This study aims to identify current opioid prescribing services and regulatory bodies within 12 African PEPFAR (Presidents Emergency Plan for AIDS Relief ) countries, and to examine the barriers to, and appraise the potential for, expansion in the number of opioid providers, for people with HIV and AIDS according to the World Health Organization pain ladder. It concludes that while there are common issues raised by services and International Narcotics Control Board competent authorities, it is clear that these key stakeholders have concerns regarding the potential roll-out of opioids

Changing children's lives : experiences from memory work in Africa

HEALTHLINK WORLDWIDE
2007

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This publication aims to share learning from the memory work that Healthlink Worldwide and six other NGOs across sub-Saharan Africa have developed in response to the HIV epidemic. The focus is on learning and analysis in the theory and practice of memory work as well as demonstrating its effectiveness as an HIV response. It is aimed at international and national level policy makers who design and support HIV initiatives, as well as practitioners, who implement responses to the HIV epidemic directly at a local and national level

Treatment literacy : empowering communities to access AIDS treatment

DUNN, Alison
October 2006

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This paper explores the contribution of information and communication strategies to universal access to anti-retroviral treatment. It suggests that people taking antiretroviral drugs and their supporters need to understand new and complex ideas around drugs, side effects, nutrition and positive living. Treatment literacy aims to help individuals and communities understand why ARV treatment is needed, and what it can and cannot do. Effective treatment literacy, developed by or with people living with HIV and AIDS and those taking ART, can lead to improved health outcomes, better adherence to drug regimes and higher uptake of voluntary counselling and testing. Current resources and community capacity to understand and support antiretroviral therapy are not sufficient

Healthy babies, happy mothers : prevention of mother-to-child transmission of HIV (PMTCT). Training manual

CAMEROON BAPTIST CONVENTION HEALTH BOARD
May 2006

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This is a comprehensive manual on prevention of mother to child transmission of HIV. It is designed to help meet the needs of both the mother and the child in all critical stages of maternity and perinatal care. Places a great emphasis on psychological support and counselling, to enable HIV-positive mothers to make informed decisions and healthy choices. Include an overview of key mother-to-child transmission issues. Topics discussed also include: basic principles of HIV counseling; voluntary counseling and testing; confidentiality; instructions for nevirapine treatment of HIV-infected mothers and for HIV-infected mothers during antenatal, labor, delivery, and postnatal periods; counseling and support for safer infant feeding; follow-up and care of an infant born to an HIV-positive mother; follow-up and care of an HIV-positive mother; PMTCT support groups; laboratory HIV testing; universal precautions; PMTCT programme supervision and monitoring; reporting and management information system (MIS). This training manual is intended as a tool for health care workers who desire to know more about HIV and to help train counsellors who work in PMTCT centers

HIV and AIDS treatment education technical consultation report

UNITED NATIONS EDUCATIONAL, SCIENTIFIC AND CULTURAL ORGANIZATION (UNESCO)
WORLD HEALTH ORGANIZATION (WHO)
March 2006

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This is a report on a technical consultation on treatment education held in Paris November 22-23, 2005, which aimed to assess the current state of HIV treatment literacy and community preparedness, identify needs and recommend strategies for the future. The effectiveness of antiretroviral therapy (ART) and medical care relies on timely HIV testing and treatment adherence. Treatment education interventions addressing issues of stigma and complacency, have been shown to contribute to a wider uptake of testing services and to improve adherence to ART. The report calls for an integrated and synergetic collaboration between all stakeholders, including people with HIV, and for the adoption of a participatory, person-centred approach. It also acknowledges that while there is a wealth of initiatives aimed at improving community preparedness, there is also a need to scale up programmes that have shown to work. The report concludes with a number of key recommendations for future activities. Those include: providing support to partnership and inter-sectoral collaborations; integrating treatment education across HIV education programmes and health systems; differentiating and customising approaches according to settings and audiences; involving affected communities and individuals; monitoring and evaluating treatment education initiatives

[Treatment literacy materials]

TREATMENT ACCESS CAMPAIGN (TAC)
2006

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The Treatment Action Campaign (TAC) campaigns for greater access to HIV treatment for all South Africans, by raising public awareness and understanding about issues surrounding the availability, affordability and use of HIV treatments. It recognises the importance of treatment literacy and has produced a series of booklets, posters and factsheets on treatment aiming to encourage treatment literacy in the general population. A TAC publication "HIV in our lives" is a book of information sheets for clinics. There are opportunistic infections posters available in five different languages, nutrition fact sheets and short guides on a range of treatment issues such as treating opportunistic infections, pregnancy and HIV/AIDS, mother to child transmission of HIV/AIDS, and TB and HIV/AIDS. They can be found on the treatment literacy section of their website

Q&A : the pharmaceutical industry and access to ARVs in Africa

HEALTH ACTION INTERNATIONAL AFRICA
December 2005

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To mark World AIDS Day 2005, HAI Africa has prepared a simple, concise fact sheet on the pharmaceutical industry's role in access to HIV/AIDS treatment. The document, written in a question-and-answer format, addresses the impact of generic competition, compulsory licences and what the industry can do to increase access. It asks questions such as 'Are pharmaceutical companies involved in initiatives to increase access to ARVs?' and 'Do patents on medicines have an impact on access to ARVs?'

Missing the target : a report on HIV/AIDS treatment access from the frontlines

INTERNATIONAL TREATMENT PREPAREDNESS COALITION (ITPC)
November 2005

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The ITPC is a global alliance of over 600 treatment activists that include people living with HIV and AIDS and their advocates. This report is the first systematic assessment of treatment scale up based on the research of people living in communities in six countries where the epidemic has hit the hardest - the Dominican Republic, India, Kenya, Nigeria, Russia and South Africa. The report is based on their experiences and first-hand knowledge of the situation on the ground. Each country used a case study methodology, emphasising interviews with key informants. The report identifies barriers that could prevent efforts to make treatment more widely available and makes concrete recommendations for governments and international institutions

Delivering antiretroviral therapy in resource-constrained settings : lessons from Ghana, Kenya and Rwanda

RITZENTHALER, Robert
July 2005

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This publication is aimed at governments, development partners, and public and private health facilities seeking to provide ART as part of comprehensive care and support for people living with HIV and AIDS. It describes valuable lessons learned from several ART learning sites throughout Ghana, Kenya and Rwanda. By the end of April 2005, more than 5,800 new patients had initiated ART through this treatment and care initiative. Strategies, challenges and key recommendations are presented and comments by national and community leaders, providers and patients appear throughout the text to give readers a sense of the programs as they progressed. The lessons may not have direct relevance to all health facilities providing or planning to provide ART; it should be used or adapted depending on the epidemiological, political, social, cultural and economic context of each setting

Expanding access to HIV treatment through community-based organisations

SIDACTION
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
WORLD HEALTH ORGANIZATION (WHO)
July 2005

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This UNAIDS Best Practice Collection document aims to highlight and advocate for the work of civil society, community based organisations in particular, in responding to the AIDS epidemic in Africa. The paper describes a ground breaking survey by Sidaction, a Paris based treatment rights group, which supports community responses to AIDS in low and middle income countries. In 2004, Sidaction, in cooperation with the UNAIDS secretariat and WHO mapped treatment and care efforts by community based organisations in Africa. Many community based organisations are already dispensing ARVs on a significant scale. The survey confirmed that community efforts to provide treatment represent an important opportunity to enrol more people in antiretroviral therapy. To seize this opportunity, national governments and the international community need to quickly provide support to expand the coverage and impact of community based treatment. The aim is for CBOs to work closely with the public sector so that each reinforces the efforts of the other

Engaging local non-governmental organisations (NGOs) in the response to HIV/AIDS : Community REACH Programme

PRIVATE AGENCIES COLLABORATING TOGETHER (PACT)
CORNMAN, Helen
et al
July 2005

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This paper draws on an extensive literature review of local NGO engagement, the direct experience of Pact's rapid response HIV/AIDS grants programme known as Community REACH and formal and informal interviews with the grantees highlighted in the paper. It considers the lessons learned from the programme and the authors hope that these will assist other organisations to successfully engage local partners and provide guidance to donors and national decision-making bodies. The paper is divided into four sections: the first outlines some successful strategies of local NGO engagement; the second examines local NGO strengths and weaknesses; the third provides advice to donors on effective and sustainable partnerships; and the fourth describes four funding models that harness the strengths of local NGOs to effectively respond to HIV/AIDS

Progress on global access to HIV antiretroviral therapy : an update on "3 x 5"

WORLD HEALTH ORGANIZATION (WHO)
JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
June 2005

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WHO and UNAIDS launched a strategy for ensuring treatment for 3 million people living with HIV and AIDS in low and middle income countries by the end of 2005 - the "3 x 5" target. Since late 2003, coverage of antiretroviral therapy (ART) has more than doubled from 400,000 to approximately 1 million receiving treatment by the end of June 2005. 14 of these countries are providing ART to at least 50% of those who need it, consistent with the 3 x 5 target. This interim report highlights progress made to date and the major obstacles that remain to the rapid scale up of HIV treatment. It looks primarily at the reasons for the successes and failures of scaling up HIV/AIDS interventions in different settings. The report also makes recommendations concerning the approaches needed to overcome bottlenecks as well as the need for sustainable financing mechanisms and greater harmonisation of effort by technical and financing partners at country level

Guidelines for establishing community-led antiretroviral treatment through a human capacity development approach

SALVATION ARMY
April 2005

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These guidelines for delivering anti-retroviral therapy in communities describe a set of principles, based on the Salvation Army's belief that an effective response to HIV relies on a combination of drug treatment administration and human capacity development. A number of agents can be involved in the successful delivery of antiretroviral treatment, and these include patients, families, neighbourhood, religious congregations and clinics. An integrated approach, engaging with all members of the community and committed to the development of human capacity, would ensure equitable access to treatment, support for all people affected by the disease and higher levels of adherence

Paediatric ARV roll-out in South Africa

HORIZONS PROGRAM
CAPE TOWN UNIVERSITY
2005

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The Horizons Program of the Population Council and the University of Cape Town are conducting a study to identify successful programme strategies in paediatric HIV treatment in South Africa and to determine priority knowledge gaps to be addressed by operations research. This report summarises key findings from the initial consultative workshop of expert practitioners and stake-holders, focusing on the status of providing antiretroviral therapy to children in South Africa and strategies to expand and improve services. It includes providing services to under six year olds

Anti-retroviral therapy (ART) information kit

AIDS RESOURCE CENTRE
2005

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This infopack includes five inserts, which provide background information on antiretroviral therapy (what it is, challenges to implementing safe and effective antiretroviral programmes); antiretroviral therapy (ART) in Ethiopia, including details of where ART is available and eligibility for treatment; general health indicators for Ethiopia, including demography and health service statistics; a statement on the impact of HIV and AIDS in Ethiopia, from societal to community and individual level; and a glossary of words related to HIV and AIDS treatment

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