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Knowing about HIV/AIDS and Role of Anganwadi Workers

HIV Testing and

Treatment

Session objectives

• To learn the protocols of HIV testing.• To learn about the treatment procedures for

PLHIVs• To explore the role of Anganwadi workers

towards HIV testing , counseling and treatment services

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HIV TestingHow does a person know if he/she is HIV positive

The only way to know if one has HIV or not is through a blood test.

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HIV Testing• It is simple to get HIV testing

done• Blood tests for HIV are done free

of cost at the Integrated Counseling and Testing Centres (ICTC)

• ICTCs are located at Community Health Centre (CHC) or District Hospital

• Counselor provides – pre-test counseling and – post-test counseling

to all persons being tested for HIV

• Identities of the person getting tested are kept confidential

You can help women and men in the village with information

aboutICTC centres.

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What is an HIV Test? • ELISA or Rapid are the two commonly done

tests to detect HIV in our body• These tests detects for antibodies in the

blood, produced as a result of HIV infection• During window period, HIV tests give

negative results• In suspected high risk cases, the test need

to be repeated after three months• There are three strategies followed for

testing , done based on the contexts , common being three different tests with a single blood sample to diagnose HIV

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Counseling during HIV testing

• The Counselor helps the person to understand:

the importance of taking blood testto know his/her HIV statusthe importance of taking treatment if HIV positivePlanning for children and the use of condoms to protect the partner from virus

• Help women/spouses and other family members to get tested for HIV

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If the test results are negative ?• If one or both partners have a high-risk

behaviour in the past three months and test negative for HIV, they should be advised to repeat the test after three months.

• Counsel them to avoid any high-risk behaviour during the window period even if the test is negative.

• Counsel about using condoms consistently and correctly

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If the test results are positive?

• Advise the HIV positive person to register at an ART center and take the CD4 count test.

• Ensure the information is kept confidential• Develop their social support though family,

friends and peer group.• Ensure they follow-up regularly at the ART

Center• In case of pregnant women, ensure they

deliver at the hospital, and receive Nevirapine (NVP).

• Discuss issues related to diet, nutrition, exercise and risk reduction.

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WHO clinical Staging of infection based on CD4 count

CD4 count Stage Symptoms (OI)800 – 1200 Normal Nil

> 500 Stage I Minor fever

350-500 Stage II Common cold, Respiratory Tract Infections,skin infections , Fungal infections

200-350 Stage III TB, Oral candidiasis, wt. loss > 10%, Diarrhoea > 1 month, Fever > 1month

<200 Stage IV Extra pulmonary TB, Meningitis, severe wasting

CD 4 count decreases

ART

Viral load increases

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Provide information about:• Avoiding unwanted pregnancies

( through safe sex and family planning – condoms and sterilization options), coercive sexual behaviour of the partner

• Sharing and caring for each other• Delivery and breastfeeding

practices• Using condoms for prevention of

HIV transmission• Staying healthy

AWW can play an important role by disseminating HIV prevention messages to the community in general and women in particular; services available through ICTC and ART Centres and services for HIV positive pregnant mothers and how they can prevent HIV

transmission to their baby

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PLHIV should remember:• Must not donate blood, semen

or organs• Must inform the sexual partner

and always use condoms• Must consult the doctor at the

nearest medical centre• Must plan pregnancy carefully,

and seek advice of the doctor at the ICTC

• Must seek early treatment at PHC or CHC if suffering from any other infections

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• ART is the combination of 3 drugs Given to a HIV positive person having CD4 count below 250 cells

• ART medicines are given free of cost at ART Centers

• ART medicines are to be taken 2 times a day, regularly for the rest of the positive person’s life

• Discontinuation/irregular intake of medicines makes treatment ineffective after sometime

• HIV/AIDS has no cure but with proper treatment, the PLHIV can live a long productive life.

HIV treatment

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Helping PLHIVs1. Ensure that the woman and her spouse

and children go for HIV testing.2. Help them in getting their HIV test results3. Encourage all those diagnosed as HIV

positive to get themselves registered at Antiretroviral Treatment (ART) centres

4. Advise them to get the CD4 test done at the earliest

5. Ensure that PLHA are regularly taking ART medicines as advised by the doctor.

6. Ensure they visit the ART centre regularly and earlier if they experience any symptoms

7. Ensure that PLHA are taking the diet as advised by the counselor

Along with medicines, a positive attitude helps the person and the family to overcome the trauma of having this infection. You can be as source of support and guidance for HIV infected couples and women and making informed decisions about treatment and care.

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Helping PLHIVs• Eating healthy and

nutritious food• Exercising regularly• Stopping alcohol and

tobacco use• Getting regular health

check-ups• Taking medicine as

prescribed by the doctor for opportunistic infection (OI)Provide moral and psycho-social support to PLHA and keep them motivated with

positive attitude. Don’t let anyone stigmatise and discriminate against them.

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Preparing patients for initiating ART

Key messages• It is not curative, but prolongs life• Treatment is life long, expensive• High level of adherence is critical• May have short or long term side

effects• Safer sex still essential• Do not share with friends, family

members

ART must be started only when the person living with HIV is ready

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Opportunistic Infections - OI

Common OI s are Diarrhea ,TB Herpes zoster, Candidiasis and

Pneumonias

Most important treatment /drugs need to know are• Cotrimoxazole treatment and prophylaxis, • Fluconazole and • Acyclovir

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HIV and Tuberculosis• Tuberculosis (TB) is one of the most

common opportunistic infections among PLHIVs

• More than half of the PLHIVs develop TB as their body’s immunity weakens

Common signs and symptoms are:Constant cough for three monthsLow grade fever lasting for more than a monthMore than 10% weight loss within one yearAny enlarged/swollen lymph node in the body

• Refer to the nearest DOTS centre/DMC available in all hospitals

• DOTS treatment lasts for six months

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How do you think this information will be useful in

your working situations? (Open for discussion)

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THANK YOUContent Courtesy:Shaping Our Lives- Learning to Live Safe and Healthy; A Booklet on

Women and HIV/AIDS for ANM, ASHA, AWW and SHGs; NACO, 2007

Adaptations : SAATHII (Solidarity and Action Against The HIV Infection in India)Technical Assistance Partner to Jagruti (APSACS-WD&CW Dept) ProjectGandhi Nagar, Hyderabad- 500080, Andhra PradeshTelephone: 040 27674757; Telefax: 040 27654688http://www.saathii.org/orc (India's comprehensive HIV resource

centre)