HIV/AIDS Treatment and Care : Clinical protocols for the European ...

STI/RTI agent STI/RTI
agent
dosage
Metronidazole
(Flagyl)
Sufamethoxazole
Trimethoprim
(Trimpex)
ARV ARV
dosage
— APV Oral
solution
(containspropylene
glycol)
— LPV/r Oral
solution
(contains
alcohol)
— RTV Oral
solution
(contains
alcohol)
and capsules
1000 mg
x 1 dose
200 mg x
1 dose
ddI 200 mg
(bufferedformulation)
x 1
dose
ddI 200 mg
(bufferedformulation)
x 1
dose
↑: increase; ↓: decrease; QID: four times daily
Source: HIV InSite (19).
support for sexual and reproductive health in people living with hiv
Agent
effect
on ARV
levels
ARV effect
on agent
levels
Potential
clinical
effects
— — Propylene
glycol
toxicity
(acidosis,
CNS depression)
— — Disulfiram
reaction
(hypotension
headache,
nausea,
vomiting)
— — Disulfiram-like
reaction
(headache,
hypotension,
flushing,
vomiting)
No significant
change
ddI
AUC: no
significant
change;
Cmax: ↑
17%
No significant
change
TMP AUC:
no significant
change;
Cmax: ↓
22%
Management
Do not
coadminister
with
APV oral
solution
Do not
coadminister;
consider
LPV/r
capsules
Do not
coadminister
— No dose
adjustment
necessary
— No dose
adjustment
necessary
Suggested
alternative
agent(s)
Amprenavir
capsules
4. Violence related to gender and sexuality
Gender- and sexuality-related violence has a detrimental effect on a victim’s physical, emotional
and social life. By understanding the range of complications he or she may be experiencing, health
care providers are able to offer more effective HIV/AIDS treatment. In many cases the victim, who
is most often female, will not only be infected with HIV by the perpetrator, but also, due to feelings
of low self-worth, socioeconomic factors or oppressive tactics, she will not be diagnosed until a
later stage of the disease (39, 40).
Treating PLHIV who have been subjected to violence requires the provider to do the following
things (39, 41–44):
• Routinely evaluate the possibility of violence for all female (and male when indicated) HIVinfected
patients.
• Keep the health and welfare of the patient as the first priority. “Safety first” and “do no harm”
should be guiding principles.
• Avoid retraumatizing the patient with questions that are likely to provoke a strong or emotional
reaction, cause distress or insinuate a negative judgement.
• Be prepared to respond to distress and highlight the patient’s strengths.
• Be prepared to provide appropriate care, follow-up and support services (referrals).
• Maintain confidentiality.
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