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Medical care of PLWA. Medical care is only one aspect of care Medical care must be linked to and supported by other forms of care ARVs are only one aspect of medical care Other forms of treatment can also prolong & improve quality of life. General aims of medical care. Curative Preventive
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Medical care of PLWA • Medical care is only one aspect of care • Medical care must be linked to and supported by other forms of care • ARVs are only one aspect of medical care • Other forms of treatment can also prolong & improve quality of life
General aims of medical care • Curative • Preventive • Palliative
Aims of medical care for PLWA • Relief of symptoms • Curing or preventing opportunistic infections • Curing or controlling cancers • Controlling the HIV virus
Relief of symptoms • Keep the person as comfortable as possible • maintains dignity • reduces stress • Simple, inexpensive medicines: e.g., • aqueous cream for dry itchy skin • loperamide for chronic diarrhoea • Management of mental problems • Management of pain • Traditional remedies
Opportunistic infections Treatment: • Many infections in PLWA can be treated • Can often be treated with drugs that are widely available & inexpensive e.g., skin infections, pneumonia, STIs, candida
Opportunistic infections Prevention: Cotrimoxazole: PCP, bacterial pneumonias, toxoplasmosis, GI infections WHO indications: CD4 count < 500 Total lymphocyte count < 2000 PLWA with symptoms (WHO stage 2- 4) PLWA with TB HIV+ pregnant women in 3rd trimester
Opportunistic infections Prevention: • INH – tuberculosis • Intermittent presumptive treatment for malaria in pregnant women