Anti Retroviral Traitment (ARVs)

Transcription

1 Anti Retroviral Traitment (ARVs) IEC material for People With Disabilities

2 UPHLS Anti Retroviral Traitment Booklet Produced by AZ MEDIA No part of this publication may be reproduced without prior written permission from UPHLS

3 Anti Retroviral Traitment (ARVs) IEC material for People With Disabilities

4 CONTENTS Acknowledgement... 3 Anti retroviral Therapy... 4 Eligibility...5 Do you know?...6 How long should I take the ART?...7 Who are eligible to ART? Criteria for clinical and immunological eligibility Mandatory Social Criteria...9 Why should you use consistently ART? Because they:...10 What does the health service care do to me before enrolling you on ART?...11 What else?

5 ACKNOWLEDGEMENT We would like to thank the Center for Disease Control and prevention (CDC) which funded the development of this booklet. We are also grateful to the Ministry of Health through Rwanda Biomedical Center (RBC) and participants who were involved into the validation workshop for their valuable inputs into development of the manual. We hope that this booklet will contribute to improve access to ARVs services for Persons with disabilities. 3

6 Anti Retroviral Drugs (ARVs) Anti Retroviral Drugs (ARVs) refer to the medicines themselves and not to their use. Anti retroviral treatment (ART) Refers to the use of a combination of three or more ARVs drugs to achieve viral suppression. This generally refers to lifelong treatment. Synonyms are combination ART and highly active ART. Anti retroviral treatment (ART) for prevention. Anti retroviral treatment (ART) for prevention is used to describe the HIV prevention benefits of ART. 4

7 Eligibility Eligible for ART refers to people living with HIV for whom ART is indicated according to the definitions of clinical and immunological eligibility in WHO treatment guidelines. The term is often used interchangeably with needing treatment, although this implies an immediate risk or an obligation to initiate treatment. Viral suppression Viral suppression refers to the aim of ART to maintain viral load below the level of detection of available assays, generally less than 50 copies per ml. The current WHO virological criterion for treatment failure is 1000 copies per ml or more. Universal access to ART is defined broadly as a move to a high level of access ( 80% of the eligible population) for the most effective interventions that are equitable, accessible, affordable, 5

8 comprehensive and sustainable over the long term; this does not necessarily mean 100% coverage. In Rwanda, PMCT was initiated back in 1999 and nowadays more than 500 health facilities countrywide are providing for the facilities. Do you know? 1. When free and circulating in the plasma; the virus life cycle is very short, with a half life of 6 hours. 2. The virus is reproducing continuously, and an infected person who is not on treatment can produce up to 10 billion new viruses every day, along with a high risk of mutations and drug resistance. 6

9 3. A very small number of viruses can invade and penetrate reservoir cells or sanctuary cells (often macrophages) where they hide and can stay for several decades. These cells do not respond to treatment. 4. Given the very short half-life, ART is a lifetime treatment and should be not stopped at any time for any reason 5. ART reduces the risk of having opportunistic infections 6. ART can be associated with treatment of opportunistic infections and other infections 7. ART is also used in the PMTCT How long should I take the ART? Normally, ART is lifetime treatment thus it should not be stopped. However some pregnant women who are HIV positive or mothers whose husbands are HIV positive enrolled on ART during pregnancy to weaning may stop them when they are advised to do so by doctors. Children who are born to mothers who are HIV positive or from discordant couple may stop them if they are advised by the doctors after the confirmation to be negative. 7

10 Who are eligible to ART? In Rwanda, initiation of ARV treatment depends on three client related criteria: the clinical stage, the immunological state, and the social status. 1. Criteria for clinical and immunological eligibility Confirmed HIV seropositivity and one of the following two criteria: Any client >15 years with WHO Stage 3 and 4 regardless CD4 cell count. Any client >15 years in WHO Stage 1, 2 with CD4 < 350/mm3. Any client >15 years with HIV-TB confection regardless CD4 cell count. Any client with HIV-Hepatitis B confection. Any HIV-Positive Sex partner in discordant couple regardless CD4 and WHO. Pregnant and lactating mothers who are HIV positive. Pregnant and lactating mothers whose husband/sexual partner is HIV positive. Children under 2 years of age/breastfed whose both parents or one of the parents is HIV positive. 8

11 2. Mandatory Social Criteria Having a fixed residence in the catchment area of the nearest HF. Being enrolled in HIV Care program in an authorized HF (accreditation) Having disclosed his/her HIV serostatus to a family member or someone close. Acceptance of home visit by a health care worker. Accept to take medication over the whole lifetime. Be supported by someone trusted in order to improve adherence; this person is called a treatment buddy. Commit him/her self to having only protected sexual intercourse. Not receiving antiretroviral drugs from another program. Accept to make financial contribution if not in possession of a certificate of neediness. 9

12 Why should I use consistently ART? Because they: 1. Suppress the viral load to undetectable; 2. Increase the number of CD4 cells so as to improve the immune reconstitution; 3. Reduces the transmission of HIV; 4. observance and adherence minimizes the risk of cross resistance and long term toxicity 5. Slow down the evolution and the progression of HIV virus 6. With ART, PLWHA can live a health and long life because it improves improve the quality of life of PLWHA by improving his/her clinical status; 10

13 What does the health care service provider do to me? I. During the session 1. They give me counseling; 2. They do a systematic screening for active TB, for STIs and an biological assessment to check whether these organs are very well functioning: kidney, liver and immunity. 3. They carry out a Clinical history and full clinical exams to exclude possible OI? 4. They do a psychosocial assessment to assert: a. The psychological experience of the client vis-à-vis the infection, disease and treatment; b. Barriers to adherence anticipated by the counselor; c. The specific problems which need to be focused on during the patient follow up. II. The guidance made after the session 1. They give me ART which I will take everyday till the medics advised otherwise, 2. They will give my baby some medicines which will enhance the chance of remaining negative, 3. They make a follow up of my baby and till weaning. 11

14 What else? Use always a condom to prevent new infection, co infection or to prevent you sexual partners from HIV &AIDS; It is advisable to consult a medic when you have got any side effects. Him or her alone is able to decide how to deal with them. December

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