Transcript Document

Provision of Substitution Maintenance
Therapy Combined with the
Antiretrovial Therapy in the Frames of
the ‘Overcoming HIV/AIDS Epidemics in
Ukraine’ Programme supported by the
Global Fund to Fight AIDS,
Tuberculosis and Malaria
Elena Gulevich,
Infectious Disease Specialist
Odessa Oblast AIDS Prevention Center
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The Group of Patients
 25 patients are enrolled to the ST
program in Odessa region as of
11.02.2006. Out of those 25:
 11 – PLHA enrolled to ART
 14 – PLHA getting ready to start ART
 25 – immunosuppression of different
level (CD4 less then 250)
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The Group of Patients (II)
 Patients
with
opportunistic
infections
(candidosis, chronic herpetic infection, etc.)
 Opiates consumption during 5 – 10 years
 23 patients have co-infection of Hepatitis В
and С
 7 patients are also diagnosed tuberculosis
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The Process of ST Provision
- Selection of the potential patient (from the AIDS
Center register, through the Community Center,
etc.) by the NGOs’ social workers
- Directing the patient to the infectious disease
specialist at the AIDS Center
- Clinical and immunological inspection,
consultations of the infectious disease specialist
- Re-directing of the patient to the narcological
dispensary
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The Process of ST Provision (ІІ)
• Multidisciplinary approach (team work: infectious
disease specialist – social worker – narcologist)
provides for more qualified provision of ART
combined with ST
• Continuous medical observation of the patients by
the infectious disease specialists and narcologists
• Peer counseling, consultations of the TB
specialists, surgeon, other doctors and a lawyer
when required
• Psychological and social support (social workers,
NGO)
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Clinical Observations
• Improved health status (lower sickness rate)
• Improvement of tuberculosis treatment, no
tuberculosis relapse during the period of ST
provision
• Stabilization of psychological and emotional
status (in particular, adequate perception of the
HIV-status, socialization, desire to find work,
etc.)
• Increased ART adherence, motivation to
treatment
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Perspectives for ST Scaling-up
• Enrollment of more IDUs to the ART (ST –
one of the methods to develop adherence
to ART)
• Provision of ST combined with ART
motivates the patients to go back to
healthy, abstinent life style (rehabilitation
programmes)
• ST – one of the methods to prevent
HIV/AIDS epidemics spread
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