Report on the Global HIV/AIDS epidemic

Care and support for people living with HIV/AIDS

Care for people with HIV involves the health system at several levels.
* Does the reform respect the three principles of health-care organization:
- integrated care achieved through teamwork by care providers of different
disciplines?
- continuity of care throughout the levels of the health system?
- a focus by the care provider on the client's priorities?
Inclusion of HIV-positive people in society starts at the health centre and the
hospital.
* Does the health reform focus on the personal development of health personnel?
* Does it enable them to feel more comfortable about HIV/AIDS issues in their private life?
* Does it help them avoid discriminatory and judgemental attitudes when caring for
HIV-infected patients?
People with HIV have a great deal to contribute to the organization of the
health care system.
* Do key clients have a say in the design and implementation of health reforms?
Psychological and social support and other measures to
alleviate the impact of HIV/AIDS
People living with or affected by HIV need support in confronting the multiple challenges of a chronic, incurable and generally fatal condition that can result in social
ostracism (see page 38) and economic disaster (see page 27).
Psychosocial support - an essential element of the care and support package (see
Table 1, page 98) - ranges from purely psychological support to the social measures
needed to create an environment in which those affected can cope and thrive. Some
types of support straddle the line.
Family members, representatives of religious communities, health-care providers
and counsellors are important sources of psychological and spiritual support for
coping with HIV infection in oneself or the family. However, they are often in need of
support themselves. There is growing evidence of the great stress associated with
care-giving, particularly in relatives who form the majority of front-line carers in
developing countries. While ways of managing this stress are becoming better
understood, it is unclear how these coping mechanisms can be financed.
An important goal of social support is inclusion - enabling affected people to live
without fear and to continue functioning as normal members of society. Among the

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