Directions In Hiv Service Delivery Care

These guidelines provide new and updated recommendations and good practice statements in the following areas: starting ART, including initiating treatment outside the clinic and support for same-day ART start; frequency of clinical visits and ART refills; measuring adherence; tracing and re-engagement in care for all populations; psychosocial support for adolescents living with HIV; task sharing for diagnostic services; and service integration. This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030. WHO is currently in the process of collating all HIV normative guidance developed since 2016 in order to publish the third edition of the consolidated HIV guidelines in July 2021. This updated version will include the new service delivery guidance presented here.

he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

These consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring bring together existing and new clinical and programmatic recommendations across different ages, populations and settings, bringing together all relevant WHO guidance on HIV produced since 2016. It serves as an update to the previous edition of the consolidated guidelines on HIV. These guidelines continue to be structured along the continuum of HIV care. Information on new combination prevention approaches, HIV testing, ARV regimens and treatment monitoring are included. There is a new chapter on advanced HIV disease that integrates updated guidance on the management of important HIV comorbidities, including cryptococcal disease, histoplasmosis and tuberculosis. The chapter on general HIV care, contains a new section on palliative care and pain management, and up to date information on treatment of several neglected tropical diseases, such as visceral leishmaniasis and Buruli ulcer. New recommendations for screening and treating of cervical pre-cancer lesions in women living with HIV are also addressed in this chapter. Guidance on service delivery was expanded to help the implementation and strengthening the HIV care cascade. Importantly, this guidance emphasizes the need for differentiated approaches to care for people who are established on ART, such as reduced frequency of clinic visits, use of multi-month drug dispensing and implementation of community ART distribution. The adoption of these efficiencies is essential to improve the quality of care of people receiving treatment and reduce the burden on health facilities, particularly in resource limited settings.

Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.