Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000.:

For instance, possible expansion of community-based care and home care is not
taken into account, nor are considerations of more efficient referral patterns. A further
limitation is that they omit health sector activities that are not specific to "care and
support".
In addition, even when resource constraints are very serious, health services everywhere should provide care for sexually transmitted infections, family planning services, HIV testing of blood for transfusion, and the promotion of universal precautions
Table 1. Care and support packages, according to resource availability
The essential * voluntary HIV counselling and testing
package * psychosocial support for HIV-positive people and their
families
* palliative care and treatment for pneumonia, oral thrush,
vaginal candidiasis and pulmonary tuberculosis (DOTS)
* prevention of infections with cotrimoxazole prophylaxis
for symptomatic HIV-positive people
* official recognition and facilitation of community activities that reduce the impact of HIV infection
The intermediate All of the above PLUS one or more of the following:
package * active case-finding (and treatment) of tuberculosis
among HIV-positive people
* preventive therapy for tuberculosis for HIV-positive people
* systemic antifungals for systemic fungal infections (such
as cryptococcosis)
* treatment of Kaposi sarcoma with essential drugs
* surgical treatment of cervical cancer
* treatment of extensive herpes with acyclovir
* funding for community activities that reduce the impact
of HIV infection
The advanced All of the above PLUS:
package * triple antiretroviral therapy
* diagnosis and treatment of opportunistic infections that
are difficult to diagnose and/or expensive to treat, such
as atypical mycobacterial infections, cytomegalovirus
infection, multiresistant tuberculosis, toxoplasmosis,
and HIV-associated cancers
* specific public services that reduce the economic and
social impacts of HIV, to supplement community efforts
that reduce the impact of HIV infection

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