Care and support for people living with HIV/AIDS

Care and support for people living with HIV/AIDS1990s that antiretrovirals were dramatically changing the prognosis of HIV infectionfor those fortunate enough to have access to these treatments.As a result, health care for people with HIV has belatedly made its way onto theagenda of developing countries. In Uganda, for example, the new medium-term planon HIV/AIDS for the first time includes a comprehensive section on care andsupport.In parallel, for the reasons discussed below, donor agencies are increasingly lookingon HIV/AIDS care as a good investment.The interlocking benefits of care and preventionActivist pressure is not the only force driving the increased governmental investmentin care and support. There is also growing recognition that care and support for peopleliving with HIV or AIDS help protect the wider community.As discussed earlier (see page 78), individuals who know they are infected andreceive care can break through the denial about HIV by talking with their friends andneighbours and reducing the discomfort associated with the subject. Care providerswho look after HIV-positive people demonstrate to others in the community thatthere is no reason to fear becoming infected through everyday contact, and thushelp dispel misguided beliefs about HIV transmission. Providing diagnosis and treatmentfor tuberculosis and sexually transmitted infections – diseases that are commonamong people with HIV – also helps decrease their spread among HIV-negativepeople.Thus, care has important spin-offs for prevention, in much the same way that preventionmeasures such as voluntary HIV counselling and testing can result inimproved access to care. Recognizing these interlocking benefits, developmentassistance agencies and other financers of AIDS programmes are increasingly seeingcare and support for HIV-infected people as a powerful tool for expanding theresponse to the epidemic.The community is keyIn retrospect, our thinking about how to tackle the epidemic was revolutionized by thecommunity-based groups, nongovernmental organizations and associations of peopleliving with HIV that took up part or all of the challenge of care and support, and oftenthe challenge of prevention too. Gradually, it was understood not merely that thesegroups had become key partners in the fight against the epidemic, but that theirinvolvement would continue to be essential and needed to be strengthened. This is theprinciple known as the greater involvement of people living with HIV/AIDS (GIPA).87