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Care, treatment and support unit
ART Programme
In 2005 when CAAP started providing ART to the HIV/AIDS patients it was the only
organisation to do so. From that period CAAP has become the ray of hope for a
number of patients who were able to live their lives longer than expected. At
present, with 119 (please put the current figure) on ART CAAP has the ability to
treat 500 patients with the experience and expertise of their staff their
well-established diagnostic and treatment facilities. In a successful ART
programme, all patients should remain on the 1st line treatment for as long as
possible. This goal can only be achieved by emphasising on quality of
counselling and treatment! One of the indicators of this could be good drug
adherence. The drug adherence rate of patients receiving ART from CAAP is very
good with more than 90% adherence. CAAP tries to find out the root causes for
non-adherence and address the problem accordingly. CAAP programme for ART
includes all investigation necessary for ART, adherence counselling for drug
compliance, follow up and management of side effects of ART as the very
important tasks.
HIV/AIDS/ART is probably the most difficult and challenging chapter of
infectious diseases: HIV is a systemic disease which can affect any organ, ARVs
are of the most toxic drugs used in medicine, and ongoing research at a very
high pace and on a large scale makes things changing continuously! That is why
every ART programme needs a backup of an experienced HIV clinician because it
has to be based on clinical requirements and needs. In respect to that CAAP has
a clinical review committee consisting of representative from national AIDS and
STD Programme (NASP, GOB), experts from donor agencies and national experts, who
meets once a year or whenever needed to review the treatment protocol.
PMTCT
The majority (90%) of children infected by HIV acquire their infection through
parent to child transmission of HIV (PPCT), which can occur during pregnancy,
delivery and through breast milk. Infected children die early if no preventive
measures are taken. Early diagnosis of HIV infection, ART, safer obstetric
practice and safer infant feeding can reduce the risk of HIV transmission.
CAAP provides antenatal care services to HIV positive pregnant mothers through
its out patient clinic. Both pregnant mother and their neonates are treated with
Anti Retro Viral Drugs as prophylaxis during pregnancy and labour to reduce the
risk of HIV transmission. For safer management of labour and delivery, CAAP
refers the HIV positive pregnant mothers to either government hospital or to
Marie Stopes Clinic Society for delivery. In such cases CAAP bears the expenses
of treatment. Breast milk substitutes are provided to babies born to HIV
positive mothers in order to minimise further chance of postnatal HIV infection
according to National guideline.
A. Out patient clinic
The centre provides treatment; care and counselling to HIV infected persons and
their families through out patient clinic in order to prevent further spread of
the disease, to give them relief of illness they suffer and to live a healthy
life. HIV positive persons have free access to this clinic at a scheduled date
and time and whenever they need it. Support for management of opportunistic
infection/STI and other inter current infections including medicines are
provided free of cost. Positive living educations on healthy living hygiene and
nutrition are provided to people living with HIV/AIDS (PLWHA) routinely.
Clinical services for any other diseases and syndromic management of STI with
minimum charge are provided for poor who displays risky behaviour. Service
provided by the out patient clinic are:
• General health care of PLHIV
• Management of opportunistic infection (OI)
• OI prophylaxis
• ART with follow up care and adherence counselling
• Syndromic treatment for STI
• Treatment of any other diseases of any patient
• Positive living education
• Prevention of mother to child transmission (PPTCT)
B. Indoor clinic (stabilisation ward)
A mini indoor facility/clinic with provision of 5 beds are maintained by CAAP
for patients who needs intravenous rehydration/blood transfusion and
hospitalised treatment of comparatively less complicated opportunistic
infection, side effects of ART and other ailments. Complicated cases are
referred to IDH at Dhaka and other government/private hospitals. A referral
mechanism has been developed for treatment. The indoor Health Care Clinic
provides the following services:
• Intravenous Hydration, Blood transfusion
• Intravenous antibiotic treatment
• Treatment for complicated OI
• Treatment of side effects/complication of ART
• Treatment for any other HIV related sickness
• Referral of complicated cases to support hospital
C. Mobile VCT service
The twice a week mobile VCT service by CAAP enabled people to be aware about
HIV/AIDS and to know their HIV/AIDS status at their doorsteps. Rapid tests for
HIV/AIDS and pre and post-test counselling are the key activities of the mobile
VCT services. CAAP is collaborating with various government and non-government
organisations dealing with patients to organise VCT at their STI clinics in and
around Dhaka. In addition, health camps are organised at different slums and
provided treatment where most patients complained about general diseases e.g.
peptic ulcer, weakness, burning sensation and dizziness. Following are some
services provided by the mobile VCT service:
• Site specific health service delivery
• Voluntary rapid testing of blood for HIV
• Pre-test and post-test counselling to encourage behaviour change
• Promotion of use of condom
• Group discussion to improve the perception of risk
• Information material distribution
• HIV stigma and discrimination reduction
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