Final Facilitator Guide - EngenderHealth

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Section 2Steps1. Ask the group if they have ever heard the term “CD4count”? Allow any volunteers to explain how they understandit and correct any misinformation. Tell that we will explain thisin more detail in a moment.CD4 cells are white blood cells that play important role in theimmune system. Doctors use a test that ‘counts’ the numberof CD4 cells in a cubic millimetre of blood. A normal count ina healthy, HIV-negative adult can vary but is usually between600 and 1200 CD4 cells/mm.3. It is useful to have your CD4count measured regularly for two reasons :• To monitor your immune system and help you decidewhether and when to take ART and treatment to preventinfections.Facilitator’s Guide1Adherence to Treatment for HIV• To help monitor the effectiveness of any ART you aretaking.2. Ask the group if they have ever heard of the term “viralload”? Allow any volunteers to explain how they understand itand correct any misinformation. Explain that we will discuss thisin more detail in a moment.Viral load is the term used to describe the amount of HIV inyour blood. The more HIV in your blood, the faster you loseCD4 cells.3. Explain that a person’s CD4 count and viral load are crucialindicators of the condition of a person’s immune system andhow far along a person’s HIV infection have progressed. Doctorsuse this information to help determine when a person needs tobegin ART. Doctors also use this to monitor how a person isresponding to ART.35
Section 2Facilitator’s Guide14. Pass out Handout A: ART Specifics. Review the concepts of CD4count and viral load using the diagrams provided. Check to makesure the participants have an understanding of the concepts.5. Share some basic information on how doctors determine whena person should begin ART (based on NACO treatment guidelines)by explaining the following points :Adherence to Treatment for HIV• After the doctor has made a detailed study of the patient’s pastand present medical history, it will be decided whether the patientrequires antiretroviral therapy (ART).The decision will be based on the following :• Identification of current and past HIV-related illnesses.• Identification of other medical conditions that might influence thetiming and choice of ART.• Current symptoms and physical signs of other medical conditions,such as TB or pregnancy.• The CD4 count of the person.• The NACO treatment guidelines state that the criteria to beginART for a person is that he or she has a CD4 cell count < 200/mm3.• Cost incurred to a person for ART in 2006 is around Rs 700-1000 for the first-line drugs from the class of Nucleoside ReverseTranscriptase Inhibitors (NRTI) and Non Nucleoside ReverseTranscriptase Inhibitors (NNRTI). If drugs from the class ofProtease Inhibitors (PI) is involved then it increases the cost.• The fact is that CD4 count facility is only available in selectedcenters in the country.36
Page 1 and 2: Adherence to Treatment for HIVA Tra
Page 3 and 4: © 2006 EngenderHealth Society.F-6/
Page 5 and 6: TABLE OF CONTENTSPREFACEACKNOWLEDGE
Page 7 and 8: PREFACEWith funding from the Global
Page 9 and 10: ACKNOWLEDGEMENTSWe acknowledge with
Page 11 and 12: ABBREVIATIONSARTCD4GFATMIVDUMSMNNRT
Page 13 and 14: The Facilitator Guide consists of:
Page 15 and 16: How to use the facilitator guideThe
Page 17 and 18: This symbol indicatesthe questions
Page 19 and 20: 8This box should becut and pasteona
Page 21: This symbolindicates the triggerque
Page 24 and 25: 1SECTION 1Section 1INTRODUCTIONS AN
Page 28 and 29: Section 1Then read out this definit
Page 32 and 33: Section 1Summarize the results as f
Page 34 and 35: Section 22. During the discussion,
Page 36 and 37: Section 2Where does HIV come from?N
Page 38 and 39: 1SECTION 2Section 2HIV AND ANTIRETR
Page 40 and 41: Section 210. You cannot contract HI
Page 42 and 43: Section 2The list may include the f
Page 44 and 45: Section 2• If you do not take you
Page 48: Section 26. Tell the group that to
Page 52 and 53: 2SECTION 3Section 3RESISTANCE AND A
Page 56 and 57: Section 3most appropriate. Creativi
Page 58 and 59: Section 34. Provide 15 minutes for
Page 60 and 61: Section 3Case Study #2Devi, a perso
Page 64 and 65: Section 37. Finish the session by r
Page 66 and 67: Section 32. Ask for a volunteer to
Page 68 and 69: 2SECTION 4Section 4PREVENTION PRACT
Page 70 and 71: Section 4Reasons include• Parents
Page 72: Section 4Case Study #2Usha, A women
Page 76 and 77: 3SECTION 4Section 4POSITIVE PREVENT
Page 78 and 79: Section 45. After all four role pla
Page 80 and 81: Section 4Group ThreeReinfectionYou
Page 84 and 85: Section 4pouch is called the inner
Page 86 and 87: Section 4Choose four or five that y
Page 90 and 91: Section 4HIV status. Disclosing one
Page 92 and 93: Section 53. After, provide the foll
Page 94 and 95: Section 5Some examples could includ
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Section 57. Tell the group that we
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Section 5and have them draw or writ
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Section 5Characteristics of a Poor
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Section 52. Ask for six volunteers.
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3SECTION 5Section 5COUNSELING ON AD
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Section 55. Begin a discussion with
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SCHEDULE FOR DAY 4Day Four : Care a
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Section 53. They should write their
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Section 54. Adherence to treatment
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Section 5III.Issues specific to men
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Section 54SECTION 5COUNSELING ON AD
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Section 64SECTION 6CARE AND SUPPORT
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Section 64SECTION 6CARE AND SUPPORT
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Section 6(List these tasks on the f
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Section 73. Assign each group one o
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Section 73. Review Handout 7.2 : He
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Section 82. Participants will now d
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Section 84SECTION 8SERVICES FOR PLH
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Section 94SECTION 9SKILLS FOR PEER
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Section 97. After all groups are fi
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Section 9• A good relationship wi
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Section 9bottle with the label so t
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Section 10110CLOSINGSESSION 10.1 :
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Section 104 SECTION 10CLOSINGSESSIO
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Section 104 SECTION 10CLOSINGSESSIO
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Section 10As you go around the circ
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12. Number of people living with HI
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13. HIV cannot be transmitted by :
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150Notes
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Final Facilitator Guide - EngenderHealth

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