Medical care of PLWA

1
Medical care of PLWA

• Medical care is only one aspect of care
• Medical care must be linked to and supported by
  other forms of care
• ARVs are only one aspect of medical care
• Other forms of treatment can also prolong
  improve quality of life

2
General aims of medical care

• Curative
• Preventive
• Palliative

3
Aims of medical care for PLWA

• Relief of symptoms
• Curing or preventing opportunistic infections
• Curing or controlling cancers
• Controlling the HIV virus

4
Relief of symptoms

• Keep the person as comfortable as possible
• maintains dignity
• reduces stress
• Simple, inexpensive medicines e.g.,
• aqueous cream for dry itchy skin
• loperamide for chronic diarrhoea
• Management of mental problems
• Management of pain
• Traditional remedies

5
Opportunistic infections

• Treatment
• Many infections in PLWA can be treated
• Can often be treated with drugs that are
• widely available inexpensive
• e.g., skin infections, pneumonia, STIs, candida

6
Opportunistic infections

• Prevention
• Cotrimoxazole
• PCP, bacterial pneumonias, toxoplasmosis,
• GI infections
• WHO indications
• CD4 count lt 500
• Total lymphocyte count lt 2000
• PLWA with symptoms (WHO stage 2- 4)
• PLWA with TB
• HIV pregnant women in 3rd trimester

7
Opportunistic infections

• Prevention
• INH tuberculosis
• Intermittent presumptive treatment for
• malaria in pregnant women