Facilitator Guide - EngenderHealth

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Case Study #3Anand, a person living with HIV who discontinued treatment and thenrestartedFacilitator Guide2Adherence to Treatment for HIVAnand was diagnosed as being positive in 1994. Three years later he began totake an ART drug, which was being imported by the NGO that he was workingfor. This was done with no advice from a doctor and no understanding of ART.When Anand stopped working with the NGO, he stopped taking the medicinebecause he found it too expensive in the open market.Later he began experiencing a lot of infections and lost a lot of weight. He wentto a doctor and found that his CD4 count was 40. The doctor put him on a 3-drug combination. After six months, his CD4 count had increased and he beganto feel better; he decided to stop the ART on his own as he found it expensiveand difficult to monitor due to the fact that he lives alone and travels a lot.A couple of months later Anand suffered severe headache and was diagnosedwith Cryptococcal Meningitis in a private hospital. Soon after, he resumed hisART, but he still misses his doses. The doctor has recommended second-linetreatment to fight his ART resistance; however, he does not have the resourcesto afford that.Discussion Questions• What were the main reasons for Anand stopping his treatment?• What could have been done in order to prevent this fromhappening?54
2SECTION 2HIV, AIDS AND CHRONIC CARESession 2.3 : Principles of Chronic Care in the Client-CenteredHIV ContextTrainer's notesObjectivesBy the end of this session participants will be able to:Facilitator Guide• Identify the general principles of good chronic care.• Explain the relevance of key principles of good chronic care2MethodologyLecture, group discussionRecommended Time60 minutesMaterialsAdherence to Treatment for HIV• Flip chart, markersPreparation• A flip chart to show the principles of good chronic care (Activity A).• Written instructions for group work (Activity B).Activity A10 minutes1. Explain that you are going to introduce a few general principles that apply to theprovision of good chronic care, including chronic HIV care. Show these principles ona flip chart or slide:A. Develop a treatment partnership with your client.B. Focus on your client's concerns and priorities.55
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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
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ABBREVIATIONSARTCD4GFATMIVDUMSMNNRT
Page 13 and 14: ABOUT THE FACILITATOR GUIDEThe Faci
Page 15 and 16: The steps give detailed, step-by-st
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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
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Page 42 and 43: 1SECTION 1Facilitator GuideFACTS AB
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Page 46 and 47: Facilitator Guide5. On a chart writ
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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
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Page 75 and 76: 2SECTION 3THE ELEMENTS OF COUNSELIN
Page 77 and 78: Negative nonverbal cues• Reading
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Page 103 and 104: Gender and Sexuality1. It is more a
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Page 111 and 112: Activity B15 minutes1. Facilitate a
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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 4SUPPORTING CLIENTS ON ART
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4SECTION 4SUPPORTING CLIENTS ON ART
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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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