Facilitator Guide - EngenderHealth

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2SECTION 2HIV, AIDS AND CHRONIC CARESession 2.2 : Adherence to HIV TreatmentTrainer’s resource ‘A’ : Adherence Case StudiesFacilitator Guide2Adherence to Treatment for HIVCase Study #1Devi, a person living with HIV who has quit treatmentDevi came to know of her status in early 2002. After a few months she approacheda doctor who advised her against beginning ART due to its toxicity. She thenwent to another doctor who started her on ART; her CD4 was 200 at that time.In a few months, her CD4 count went up and she started feeling better.During this time, she met other PLHA and families of people on ART who haddied. Many of these people gave Devi incorrect messages about ART, which wasa result of their own misunderstanding or limited knowledge. After theseconversations, Devi thought that people on ART died earlier. Therefore, aftertaking ART for a year, she discontinued.Devi did not consult her doctor before stopping. However, the doctor had neverconveyed the consequences of discontinuing the medication.Discussion Questions• What were the main reasons for Devi stopping her treatment?• What could have been done in order to prevent this fromhappening?52
Case Study #2Satish, a person living with HIV on regular ARV medicationIn 1999, when he was first diagnosed with HIV, Satish came in contact witha doctor working in Chennai. At that time, ART was not available in the country,but Satish learned a lot about it from him.In 2002 his condition started deteriorating and he started getting more symptomssuch as skin infections, weight loss, and diarrhoea. He approached an NGO andafter some tests, including a CD4 count, he was put on ART. Over time helearned a lot about ART and adherence through different training programsthat he attended.Satish had a lot of side effects in the first two months, but he had an extremelyinvolved doctor who took time to explain things to him. This same doctor evenprovided home-based care for him. He also served as a counselor, helping himwith emotional problems and encouraging Satish to disclose his status to his wife.Satish understands that ART is not a permanent solution. He says it is goodto wait as long as possible before starting ART, since there is no second lineof drugs available. He fears resistance due to this reason. He has an extremelysupportive and involved family who reminds him to take medicine on time,including his children.Facilitator Guide2Adherence to Treatment for HIVDiscussion Questions• What factors have helped Satish adhere to his medication?• How has Satish’s doctor played a critical role?• Why did the doctor encourage Satish to disclose his status tohis wife?53
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Adherence to Treatment for HIVA Tra
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© 2006 EngenderHealth Society.F-6/
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TABLE OF CONTENTSPREFACEi - iiACKNO
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PREFACEWith funding from the Global
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ACKNOWLEDGEMENTSWe acknowledge with
Page 11 and 12: ABBREVIATIONSARTCD4GFATMIVDUMSMNNRT
Page 13 and 14: ABOUT THE FACILITATOR GUIDEThe Faci
Page 15 and 16: The steps give detailed, step-by-st
Page 17 and 18: This symbol indicatespoints to be c
Page 19 and 20: ABOUT THE PARTICIPANT MANUALThe Par
Page 22 and 23: SCHEDULE FOR DAY 1Session Title and
Page 24 and 25: Facilitator Guide1Adherence to Trea
Page 26 and 27: 1 SECTION 1Facilitator GuideSession
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Page 40 and 41: Facilitator Guide1As the drugs redu
Page 42 and 43: 1SECTION 1Facilitator GuideFACTS AB
Page 44 and 45: Activity A :Facilitator Guide20 min
Page 46 and 47: Facilitator Guide5. On a chart writ
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Page 51 and 52: 2SECTION 2HIV, AIDS AND CHRONIC CAR
Page 53 and 54: 6. Explain thatGood chronic care is
Page 55 and 56: • Rapid treatment scale-up in res
Page 57 and 58: Activity A :15 minutes1. Adherence
Page 59 and 60: 2. Facilitate a brief discussion (1
Page 61: • Therefore in a client-centered
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Page 71 and 72: one category of clients. Ask some p
Page 75 and 76: 2SECTION 3THE ELEMENTS OF COUNSELIN
Page 77 and 78: Negative nonverbal cues• Reading
Page 83: minutes. The "observer" will facili
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Page 95 and 96: 2. Brainstorm "Closed" and "Open-en
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Page 103 and 104: Gender and Sexuality1. It is more a
Page 105 and 106: Sexual Behavior1. It is acceptable
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Page 109 and 110: 3SECTION 4SUPPORTING CLIENTS ON ART
Page 111 and 112: Activity B15 minutes1. Facilitate a
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3SECTION 4SUPPORTING CLIENTS ON ART
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8. Clap every 30 seconds, and if yo
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2. Prepare four risk-level cards, u
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Key Messages• Prevention and care
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SCHEDULE FOR DAY 4Session Title and
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Steps1. Explain that in this sessio
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2. Divide the participants into thr
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2. Before the session, you will hav
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It is difficult to assess adherence
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4SECTION 5EVALUATION AND CLOSURESes
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Closing the Training1. Closing of t
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4SECTION 5EVALUATION AND CLOSURESes
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16. What drug combination are recom
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136Notes
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Facilitator Guide - EngenderHealth

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