ARVs and treatment literacy

This case study outlines and assesses the Khayelitha programme, which focused on ART provision and aimed to document the feasibility of low-cost treatment and primary health care provision in developing countries. The document details the clinical outcomes of the programmes, the strategy used to ensure adherence and the contribution made by Treatment Action Campaign (TAC) to raise awareness and pressurise the government to develop an adequate response to the epidemic. The provision of ART in Khayelitsha had also a positive impact on prevention, making more HIV-positive people aware of their status, reducing stigma, being the catalyst of educational initiatives, improving the morale of health workers and keeping families intact and less at risk. The case study concludes with a comprehensive list of lessons learned and with key recommendations for the future, which include consolidation of nurse-based care, more training activities, integration of HIV/AIDS and TB services, educational programmes aimed at improving adherence to ART and a greater focus on paediatric AIDS and ART provision in rural remote areas

Issue 2 of id21's Insights Health was entitled 'Delivering the goods - HIV treatment for the poor'. It presented new research from key contributors on anti-retroviral (ARV) drug delivery in developing countries. After it was published, a wide range of stakeholders participated in an email discussion. Participants were based in many different countries and included international and national policy-makers, health professionals, representatives of non-governmental and community based organizations and researchers. This is a summary of the email discussion looking at best strategies for HIV treatment delivery in developing countries, which barriers prevent poor people from accessing care, and the role of the international development community. The debate covered a broad range of topics but particularly focused on HIV treatment as a priority relative to other health and development issues, strategies for delivering treatment in resource-poor settings, the role and operation of the new Global Fund to Fight AIDS, TB and malaria and stigma as a barrier to access

The expansion of access to ART is significantly improving the lives of people living with HIV and the wellbeing of communities affected by the epidemic. However, stigmatization and discrimination and poor adherence threaten to weaken the full potential of drug treatment and medical care. This paper looks at the contribution that treatment education can make to maximise the impact of greater ART accessibility and improved care provision. It takes a wide-ranging approach to education, which should include treatment literacy, advocacy and community mobilisation. It takes the view that treatment preparedness can only be achieved through the full involvement of people living with HIV/AIDS. An effective strategy will also rely on inter-sectoral collaboration between governments, the education sector, civil society and development organizations. It argues that the success of interventions will depend on their gender-responsiveness, and in their ability to adopt participatory and interactive methods, targeting different groups and settings in a culturally sensitive manner

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

Family Health International has a series of comprehensive factsheets which offer information on many aspects of HIV/AIDS prevention, care and treatment and mitigation. In relation to care and treatment, titles include:
Care and support for HIV/AIDS: Building capacity
Safe and effective introduction of antiretroviral (ARV) drugs
Nutrition in comprehensive HIV care, treatment and support programmes
Treatment and Care Initiative

ITPC provides detailed information on antiretroviral drugs. There are three different types of fact sheets for each of the following four medications: AZT (retrovir), Nevirapine (Viramune), Nelfinavir (Viracept), 3TC (Epivir). The fact sheets are evidence-based, citing the studies that have been done on a specific drug. They are a short summary and are in a question-and-answer style. They answer commonly asked questions such as: Why am I given this medication? How do I take it? What do I do if I forget a dose? What are the side effects? Can it be taken with other medications? Can I drink alcohol or use street drugs? Can it be taken if I am pregnant or breastfeeding? What other precautions should I be aware of? The factsheets have a range of levels of technical language and make a variety of assumptions about pre-existing knowledge. They also provide information on dosing combinations and schedule sheet for all currently available medications