One of the Theni District Positive regular social events which provide relaxation, comfort and support, India © Gideon Mendel for the Alliance A peer education leads a life skills session © Nell Freeman for the Alliance

Treatment, Care, Support

Man taking ARVs © Morl Sarath/PhotoVoice/Alliance  Trained volunteers diagnose and treat common complaints like thrush, Seva Nilayam © Gideon Mendel/Alliance

    Even where treatment is available, safe and effective roll out requires active engagement of communities 

In 2008, 437,995 individuals received pre-test counselling, testing and/or post-test counselling

Introduction

Health and social services should be accessible for everyone living with and affected by HIV.

This includes HIV testing and counselling, treatment, palliative care, support and prevention. All of these should also be available to children and others who have to face the effects of HIV – caring for or losing parents or siblings, for example.

It is especially important that such services are available and accessible for those at higher risk of HIV, especially sex workers, injecting drug users and men who have sex with men.

Impact on communities

Government inaction, the high costs of medicines and diagnostics (including antiretroviral drugs), under-resourced health systems, stigma and discrimination, all act to undermine the rights of people affected by HIV to treatment, care and support. This leaves most of those in need without access to vital services.

The Alliance approach

In 2011 the Alliance reached 2.8 million people with HIV care, support and prevention services.

A key element of many Alliance programmes is ensuring communities are able to access a broad range of services, through fostering linkages and strengthening referral systems between health care providers. By using a rights-based approach that is rooted in public health and development principles, the Alliance aims to increase access to quality health care for all people with HIV, and to advocate for this as a matter of great urgency.

HIV counselling and testing is the gateway to treatment – without an accurate diagnosis, treatment cannot start. It is also the gateway to other forms of support and to supporting preventive behaviours, whether the person is HIV positive or negative. The Alliance is making a significant contribution to the provision of HIV testing, pre- and post-test counselling, and linking communities with testing facilities.

Even where antiretroviral treatment is available, safe and effective roll out requires the active engagement of communities affected by HIV and people living with HIV. The Alliance helps build community structures and community leadership, especially from people living with HIV, to support and endorse the introduction and use of these powerful medical technologies.

This process of community engagement challenges traditional models of health care that are resource intensive and have relied heavily on doctors and other health care workers as the main drivers in delivering healthcare. The Alliance works to strengthen the interface between health systems and communities, and to support the active engagement of people living with HIV and their communities in the provision of safe and effective antiretroviral treatment.

In addition to medical treatment, the Alliance supports community- and home-based care for people living with HIV, their families and caregivers. Interventions include psychosocial support, supplementary nutrition, and assisting and empowering communities to establish support groups.

New tools

2012 has seen a number of exciting developments in the field of treatment, care and support. This includes advances in treatment as prevention, home based testing and pre-exposure prophylaxis (PrEP).

While we welcome these new tools to tackle HIV we know that there is no ‘magic bullet’ in responding to HIV.

For any new technology to work it needs to be part of a combination of interventions which have been proven to be effective and have the biggest impact for specific populations. The Alliance will continue to support communities to prepare for new interventions and to become engaged in the decision making process of implementation of these new interventions in their own contexts.