NOTE: I am unable to post or add a file in the HASH facebook page. But this is a good reference material.((Not an original post, downloaded from the International AIDS Society page))
This Nobody-Left-Behind Guidance on ARV Universal Access (as attached) is for anyone who provides HIV testing, treatment, prevention and care services either in a traditional healthcare setting or within the community. It provides a concise signposting to other existing guidelines, frameworks and best practice guidance in order to assist healthcare providers counsel individual clients on HIV testing, treatment and prevention in a way that is supportive, respectful, equitable and non-discriminatory, and mindful of ethical, legal and operational issues.
Some direct quotes from the attached:
The 2013 WHO guidelines recommend the following:
Before people start ART, it is important to have a detailed discussion with them about their willingness and readiness to initiate ART, the ARV regimen, dosage and scheduling, the likely benefits and possible adverse effects and the required follow-up and monitoring visits…
Adherence interventions, such as text messaging, should clearly be provided as part of a total package of several interventions. Many individual level adherence interventions are indicated for reasons in addition to improving adherence to ART. For example, nutritional support, peer support, management of depression and substance use disorders and patient education are vital components of routine
health and HIV care
HIV healthcare providers should recognize and respect their duty to protect the confidentiality of their patientsand should only disclose highly personal information, such as HIV status, with the informed consent of the patient. Failure to maintain confidentiality may cause harm and is therefore in direct confrontation with the Hippocratic Oath provision to do no harm.
Mothers known to be infected with HIV (and whose infants are HIV uninfected or of unknown HIV status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriate complementary foods thereafter, and continue breastfeeding for the first 12 months of life. Breastfeeding should then only stop once a nutritionally adequate and safe diet without breast-milk can be provided
If you are faced with an issue of dual-loyalty (if the law in your jurisdiction is in conflict with your ethical obligation to serve all patients fairly), it is important for all healthcare providers to prioritize their core obligation and their Hippocratic Oath.
***Do read the attached document, especially for our friends from other civil society organizations
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