Report on the Global HIV/AIDS epidemic

Care and support for people living with HIV/AIDS
1990s that antiretrovirals were dramatically changing the prognosis of HIV infection
for those fortunate enough to have access to these treatments.
As a result, health care for people with HIV has belatedly made its way onto the
agenda of developing countries. In Uganda, for example, the new medium-term plan
on HIV/AIDS for the first time includes a comprehensive section on care and
support.
In parallel, for the reasons discussed below, donor agencies are increasingly looking
on HIV/AIDS care as a good investment.
The interlocking benefits of care and prevention
Activist pressure is not the only force driving the increased governmental investment
in care and support. There is also growing recognition that care and support for people living with HIV or AIDS help protect the wider community.
As discussed earlier (see page 78), individuals who know they are infected and
receive care can break through the denial about HIV by talking with their friends and
neighbours and reducing the discomfort associated with the subject. Care providers
who look after HIV-positive people demonstrate to others in the community that
there is no reason to fear becoming infected through everyday contact, and thus
help dispel misguided beliefs about HIV transmission. Providing diagnosis and treatment for tuberculosis and sexually transmitted infections - diseases that are common among people with HIV - also helps decrease their spread among HIV-negative
people.
Thus, care has important spin-offs for prevention, in much the same way that prevention measures such as voluntary HIV counselling and testing can result in
improved access to care. Recognizing these interlocking benefits, development
assistance agencies and other financers of AIDS programmes are increasingly seeing care and support for HIV-infected people as a powerful tool for expanding the
response to the epidemic.
A The community is key
In retrospect, our thinking about how to tackle the epidemic was revolutionized by the
community-based groups, nongovernmental organizations and associations of people
living with HIV that took up part or all of the challenge of care and support, and often
the challenge of prevention too. Gradually, it was understood not merely that these
groups had become key partners in the fight against the epidemic, but that their
involvement would continue to be essential and needed to be strengthened. This is the
principle known as the greater involvement of people living with HIV/AIDS (GIPA).

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