8 Major Components of HIV Care in Kenya Flashcards
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1.3. Standard Package of Care for PLHIV
Consists of 8 components:
- Antiretroviral Therapy
- Positive Health, Dignity, and Prevention, G B V / IPV & Health Education and Counselling
- Screening for and Prevention of Specific Opportunistic Infections
- Reproductive Health Services
- Screening for and Management of Non-Communicable Diseases
- Mental Health Screening and Management
Nutrition Services - Prevention of Other Infections
- Antiretroviral Therapy
• All PLHIV are eligible for ART irrespective of CD4 cell count or percentage, WHO clinical
stage, age, pregnancy status, or comorbidities • ART should be initiated as soon as the patient is ready to start, preferably within two
weeks from time of HIV diagnosis (except for patients with cryptococcal meningitis
or TB meningitis)
- Positive Health, Dignity, and Prevention, G B V / IPV & Health Education and Counselling
• All patients should be counselled and supported for disclosure of HIV status; partner/
family testing and engagement; condom use; family planning; sexually transmitted infections screening; and treatment adherence services
• All females aged 15-49 years and emancipated minors accessing HIV care services
should be screened for Intimate Partner Violence (IPV) as part of the standard package of care
• All PLHIV should be provided with HIV education and counselling
- Screening for and Prevention of Specific Opportunistic Infections
• All PLHIV should receive lifelong cotrimoxazole preventive therapy (CPT) unless they
have allergy to sulfa drugs or develop toxicity from CPT • During pregnancy, CPT should be initiated irrespective of the gestational age and
should continue throughout pregnancy, breastfeeding, and thereafter for life • When dapsone (as a substitute for CPT) is being used as PCP prophylaxis, it is only
recommended for patients in WHO Stage 4 and/or absolute CD4 count ≤ 200 cells/mm3 (or CD4% ≤ 25% for children ≤ 5 years old), and should be discontinued once a patient achieves viral suppression and a sustained CD4 count of > 200 cell/mm3 (or > 25% for children ≤ 5 years old) for at least 6 months
• All PLHIV should be screened for TB at every visit using the Intensified Case Finding
(ICF) tool and assessed for Isoniazid Preventive Therapy (IPT) if screened negative for TB
• All adolescent and adult PLHIV with a baseline CD4 count of ≤ 200 cells/mm3 should
be screened for cryptococcal infection using the serum CrAg test
- Reproductive Health Services
• All PLHIV should be screened for STI at every clinic visit
• Pregnancy status should be determined for all women of reproductive age at every visit
and their contraception need determined and met • All HIV positive women between the ages of 18 - 65 years should be screened for
cervical cancer
- Screening for and Management of Non-Communicable Diseases
• All PLHIV should be screened for hypertension, diabetes mellitus, dyslipidaemia, and
renal disease • Lifestyle modifications are always the first line of prevention and management for
hypertension, diabetes mellitus, and dyslipidaemia
- Mental Health Screening and Management
• All PLHIV should receive basic screening for depression before initiating ART, and
annually thereafter, and whenever there is a clinical suspicion • All adults, adolescents should be screened for alcohol and drug use before initiating ART
and regularly during follow-up • All caregivers should also receive baseline and follow-up screening for depression and
alcohol/drug use
- Nutrition Services
• All PLHIV should receive nutritional assessment, counselling, and support tailored to
the individual needs of the patients • All infants irrespective of HIV status should be exclusively breastfed for the first 6
months of life, with timely introduction of appropriate complementary foods after 6
months, and continued breastfeeding up to 24 months or beyond
- Prevention of Other Infections
PLHIV (including children) should receive vaccinations as recommended by the
National Vaccines and Immunization Programme
