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35 Pages·2012·0.65 MB·English

by  Randy Emerzian

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R Managing HIV & Antiretroviral Medications
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R Author: Kayla Reish, R.N.
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Design: Neil Ruda
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R © 2012 Global AIDS Partnership
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Reproduction: This manual may be reproduced in any form without permis-
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sion from the Global AIDS Partnership. Credits to the Global AIDS Partnership
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A Translation: To translate this information, please contact the Global AIDS Part-
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nership for permission. This is to avoid duplication of effort, as GAP has estab-
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lished a list of available languages. GAP does ask that if a translation is done, it
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S would be made available for use by other organizations in the same language
area.
A Global AIDS Partnership Publication
1445 North Boonville Avenue
Springfield, Missouri, 65802 USA
Phone: [phone], Ext. 2079
Email: [email protected]
Website: www.globalaidspartnership.org
2 • Managing HIV & Antiretroviral Medications
TABLE OF CONTENTS
Chapter 1: Introduction and Teaching Helps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1. Preface: Using This Unit ....................................................... 5
2. HIV/AIDS, Antiretroviral Therapy, and the Church ............................... 5
3. Adult Learners ............................................................... 7
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4. Teaching Strategies ........................................................... 7
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Chapter 2: About HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 T
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1. Background of HIV/AIDS ..................................................... 9 C
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2. HIV Transmission ........................................................... 10 D
3. HIV and the Immune System ................................................. 11 E
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Chapter 3: Health-Care Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 A
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1. Common HIV/AIDS-Related Tests ............................................ 16 I
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2. Patients’ Rights and Responsibilities ............................................ 16
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3. Questions to Ask Health Care Providers ........................................ 16 R
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4. Who Is Involved in Caring for the Person With HIV/AIDS ........................ 17
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Chapter 4: Antiretroviral Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
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1. First-Line, Second-Line, and Third-Line Treatment .............................. 19 A

2. When to Start on ART ....................................................... 20 D
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3. Drug Adherence and Resistance ............................................... 20
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Chapter 5: Opportunistic Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 H
1. Tuberculosis ................................................................ 22 G
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2. Pneumonia and Other Bacterial Infections ...................................... 23
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3. Fungal Infections ............................................................ 23 G
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4. Hepatitis B & C ............................................................. 23 N
5. Parasites .................................................................... 24 A
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Chapter 6: HIV/AIDS and Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 8

1. Telling Someone Your Status .................................................. 25 T
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2. How to Share HIV Status ..................................................... 26 N
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3. Mother to Child Transmission ................................................. 26
4. Sexual Activity When HIV Positive ............................................ 27
Chapter 7: Common Side Effects of ART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
1. Lactose Intolerance .......................................................... 29
2. Nausea & Diarrhea .......................................................... 30
3. Loss of Appetite and Loss of Weight ............................................ 30
4. Fatigue ..................................................................... 31
Table of Contents • 3
5. Anemia .................................................................... 31
6. Bone Loss .................................................................. 32
7. Trouble Sleeping, Restlessness, Nightmares ...................................... 32
8. Liver Damage ............................................................... 33
9. Heart Disease ............................................................... 33
Bibliography and Suggested Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
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4 • Managing HIV & Antiretroviral Medications
CHAPTER 1
Introduction and Teaching Helps
Key Points
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• This unit can be used by individuals or groups to learn how to success- N
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fully live with HIV and manage HIV medications.
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• Christians have a biblical responsibility to show compassion toward T
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those affected by HIV. C
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• Adults learn differently than children and special focus should be given D
to interactive activities and group discussion. E
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Using This Manual L
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This manual was designed as a guide for those with HIV or who are working I
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with those who are HIV positive. This manual is a tool with suggestions based O
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on research and recommendations from groups such as the World Health Orga-
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nization (WHO), United Nations AIDS Council (UNAIDS), and the Centers for E
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Disease Control (CDC). These are just guidelines and will have to be adjusted to
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individual situations or regions.
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Not all foods, medications, and tests mentioned in this resource are available
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in all regions of the world. Some investigating may be needed to identify local N
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resources.

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HIV/AIDS, ART, and the Church H

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Questions for Discussion N
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• What is the church’s role in responding to HIV? A
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• What are some actions that the church or community can take to help
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those with HIV/AIDS get treatment?
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• What could your church or community do to help those with HIV man-
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age the daily task of living with HIV? I
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Activity
Read Matthew 25:34–40 as a group. Ask:
• According to this passage, what is the correct response when a Christian
sees someone hungry or thirsty?
• What does this passage tell us about how God views physical needs in
people’s lives?
Chapter 1—Introduction & Teaching Helps • 5
Jesus told His disciples a story about those who served God and those who
served themselves. In Matthew 25:34–40 (NIV), Jesus told His followers,
Then the King will say to those on his right, “Come, you who are blessed by my
Father; take your inheritance, the kingdom prepared for you since the creation of
the world. For I was hungry and you gave me something to eat, I was thirsty and
you gave me something to drink, I was a stranger and you invited me in, I needed
clothes and you clothed me, I was sick and you looked after me, I was in prison and
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Then the righteous will answer him, “Lord, when did we see you hungry and feed
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you, or thirsty and give you something to drink? When did we see you a stranger
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and invite you in, or needing clothes and clothe you? When did we see you sick or
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The King will reply, “Truly I tell you, whatever you did for one of the least of these
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brothers and sisters of mine, you did for me.”
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Jesus highlights the importance of serving others in
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N both spiritual and physical ways.
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N Jesus highlights the importance of serving others in both spiritual and physical
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I ways. Jesus did not say, “I was hungry and thirsty, and you preached to Me.” In
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E those times, the need was physical, and as Jesus’ representatives, He expected
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His followers to respond to these physical needs with physical help. Ultimately,
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the lostness of persons will always be forefront in the minds of those who follow
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I Christ, and somewhere in the process, telling of the good news of Jesus must
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physical and spiritual needs around them as the disciples with whom Jesus was
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There are many ways that a church can reach out to people living with HIV and
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• Transportation to and from clinics. Just because antiretroviral therapy
(ART) is freely available in many parts of the world does not mean that a
person has easy access to it. A person with HIV may need transportation
to or from clinic appointments and/or to the pharmacy.
• Watching children. Persons may be able to get to and from the clinic,
but may need someone to watch the children while away.
6 • Managing HIV & Antiretroviral Medications
• Accountability partner. To help individuals stay on their medication
regimen, it is sometimes helpful for a friend or family member to check
in on a regular basis (once a week or so) to make sure medications are
being taken and appointments being kept up with, etc.
• Household help. Someone weak from HIV infection may be unable to
perform daily activities like food preparation or clean up. Members of
the church could stop by families’ homes to help with these chores.
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• Teach classes on ART, opportunistic infections, or side effects. Short O
classes in the evening or weekends are great ways to pass on information I
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about ART and other related subjects. These classes also can be a way to
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introduce people who would not normally come to a service to a church I
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and its members. E
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People learn through different methodologies. R
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Questions for Discussions R
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• How do adults learn new information? R
• How are adults different from children? TI
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• How do adults learn differently than children?
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Adult Learners
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There is a Chinese saying that states, “Tell me, and I’ll forget. Show me, and I
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may remember. Involve me, and I’ll learn.” This means that for most people, I
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simply telling them information does not mean they will remember it or do
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anything with it. N
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People learn through different ways. Often, being a part of an activity or project A
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or seeing a demonstration helps people remember things better than just listen-
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ing to someone talk about a subject. This is especially true of adults. M
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Teaching adults requires creativity. Adults need to be included in the teaching 8

process by discussion questions, activities, and role plays. Adults already may T
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have knowledge about the topic from life experience. This knowledge must be N
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respected.
Teaching Strategies
Role plays
Role plays are spread throughout the unit to help demonstrate concepts and
spark discussion among participants. If using this unit to teach a group, have
members of the group come to the front and act out the role plays. Then take
Chapter 1—Introduction & Teaching Helps • 7
time to ask questions of the group following the role play to help them under-
stand the topic.
Questions for discussions
These questions are to prompt critical thinking about the topic. Take time to dis-
cuss these questions with the group. If you are working through this unit alone,
stop and think about the questions and what your answer would be. There are
no right or wrong answers to these questions; they are there to start you think-
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Activities
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than just reading about something, makes it much easier to understand and
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G Goals of the book

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Readers will:
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A • Interact with their health care professionals and be informed and in-
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volved with making decisions concerning their health.
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• Understand what ART is and the criteria for starting ART.
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I • Understand what antiretroviral medications (ARVs) are, their different
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E types, how they work, and the possible side effects of ARVs.
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• Know the most common opportunistic infections, their symptoms, and
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8 • Managing HIV & Antiretroviral Medications
CHAPTER 2
About HIV/AIDS
Key Points
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• HIV is a virus that causes the AIDS disease. There is no cure for AIDS, N
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but people with HIV can take actions to live longer, healthier lives.
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• HIV is spread through blood, sexual fluids, and breast milk. It cannot be A
spread through casual contact like hugging or shaking hands. C
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• HIV attacks the part of the body responsible for fighting disease—the D
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immune system. M
• There are many things that determine how healthy or weak a person’s L
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immune system is.
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Questions for Discussion
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• What comes to mind when you think of AIDS? T
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• What do you think of when you think of a person who has AIDS?
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Background of HIV/AIDS N
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The HIV/AIDS epidemic was first identified in the early 1980s in the United D
States. Since then, it has affected every region of the world. Millions of people N
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have died from the disease; millions more are currently living with it. Africa
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is the most affected region, with some African nations having infections rates I
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greater than 25 percent: 1 out of 4 adults in those countries is infected (UN-

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AIDS, Fast Facts About HIV Treatment). N
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In places like Africa, AIDS affects the whole population in some way. It is gen-
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erally spread through sexual contact between men and women or from an in- N
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fected mother to baby. In other parts of the world, the epidemic has mostly been
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contained within certain groups of people like homosexual males or intrave- —
nous drug users. 8

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Governments and civil groups have made great efforts to stop the spread of N
HIV/AIDS. In many parts of the world these efforts, combined with personal U
choices to abstain from sex before marriage and be faithful within marriage,
have reduced the numbers of new HIV cases. However, in other parts of the
world, the numbers of new cases are still growing.
Questions for Discussion
• What is the most common way for people in your country or commu-
nity to contract HIV?
Chapter 2—About HIV/AIDS • 9
• What factors in your local community or the culture of your country
impact the spread of HIV?
• Are there practices in your culture that discourage the spread of HIV?
(For example, is faithfulness in marriage important for both men and
women? Are young people encouraged to wait until they are older to
become sexually active?)
• Are there practices in your culture that facilitate the spread of HIV? (For
example, do people have easy access to illegal drugs? Is it acceptable for
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The good news is HIV is not easily spread. There are
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HIV Transmission
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into a person’s body: through breast milk, blood, and sexual fluids.

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The first mode of transmission is through breast milk from a mother to child.
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A If a mother is HIV positive and breast feeds her baby, it is possible for the baby
N to get HIV from the milk. If a woman who is HIV-positive has a baby, there are
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I several options she can take to keep her baby from getting HIV. She can give her
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E baby a milk substitute such as formula (made with clean water), but this can be
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expensive. The World Health Organization (WHO) recommends that a mother
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baby off breast milk, so the baby is not taking breast milk at all by the time he is a
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year old. A mother can also transmit HIV to her baby during the pregnancy and
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E The second mode of transmission of HIV is through blood. If HIV-infected
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blood enters another person’s body, the second person is exposed to the virus
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and may become infected. The most common way for this to happen is through
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inside it, so that the next person who uses the needle is exposed to the first per-
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son’s blood. Blood can also carry HIV to another person if a medical or dental
facility reuses needles or other medical equipment without properly cleaning
them or if a person uses some kind of sharp object (like a razor) that has another
person’s blood on it.
To prevent the spread of HIV through blood, people should not share needles.
In most parts of the world, a person can buy his own needle and ask the doctor
to use it if he does not think proper needle disposal is being followed. A person
10 • Managing HIV & Antiretroviral Medications