Palliative Care and Support for Persons with HIV/AIDS in 7 African Countries: Implementation Experience and Future Priorities

Palliative Care and Support for Persons with HIV/AIDS in 7 African Countries Implementation Experience and Future Priorities

To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both p...

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Bibliographic Details
Published in:American journal of hospice & palliative medicine Vol. 29; no. 4; pp. 279 - 285
Main Authors: Alexander, Carla S., Memiah, Peter, Henley, Yvonne B., Kaiza-Kangalawe, Angela, Shumbusho, Anna Joyce, Obiefune, Michael, Enejoh, Victor, Stanis-Ezeobi, Winifred, Eze, Charity, Odion, Ehekhaye, Akpenna, Donald, Effiong, Amana, Miriti, Kenneth, Aduda, Samson, Oko, John, Melaku, Gebremedhin D., Baribwira, Cyprien, Umutesi, Hassina, Shimabale, Mope, Mugisa, Emmanuel, Amoroso, Anthony
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01-06-2012
Subjects:
Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - prevention & control
Acquired Immunodeficiency Syndrome - therapy
Adult
Africa - epidemiology
Child
Female
Forecasting
Health Policy - economics
HIV Infections - prevention & control
HIV Infections - therapy
Humans
International Cooperation - legislation & jurisprudence
Male
Nursing
Palliative Care - economics
Palliative Care - legislation & jurisprudence
Palliative Care - organization & administration
Palliative Care - trends
Social Support
United States
United States
Africa
HIV/AIDS
care and support
resource-limited
PEPFAR
education
palliative care
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Summary:To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programing and funding priorities shifted to assure staffing for care delivery sites; laboratory and pharmaceutical infrastructure; data collection and reporting; and financial management as individual countries are being encouraged to assume control of in-country funding. Given infrastructure requisites, individual care delivery beyond ART management alone has received minimal funding yet care remains necessary for durable viral suppression and overall quality of life for individuals. Technical assistance staff of one implementing partner representing seven African countries met to clarify domains of palliative care compared with the substituted term “care and support” to understand potential gaps in on-going HIV care. They prioritized care needs as: 1) mental health (depression and other mood disorders); 2) communication skills (age-appropriate disclosure of HIV status); 3) support of care-providers (stress management for sustainability of a skilled HIV workforce); 4) Tied Priorities: symptom management in opportunistic infections; end-of-life care; spiritual history-taking; and 5) Tied Priorities: attention to grief-related needs of patients, their families and staff; and management of HIV co-morbidities. This process can inform health policy as funding transitions to new priorities.
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ISSN:1049-9091
1938-2715
DOI:10.1177/1049909111419292