WHO recommends initiation of ART for all people living with HIV at any CD4 cell count fixed dose combinations (FDCs) containing TDF/XTC/EFV remain the preferred first line regimen for adults, adolescents and older children For the first time, DTG and EFV400 have been included as alternative first line regimens for adults and adolescents. DRV/r is an alternative option as part of secondline regimens, along with LPV/r and ATV/r.
Differentiated care for HIV requires delivery of different care packages for people based on their needs. As more people start treatment it is important to maximise the quality of care and ensure efficient health services.
Adolescents face significant barriers accessing and remaining in HIV treatment and care services. WHO guidelines in 2015 support initiation of antiretroviral therapy for all adolescents living with HIV. Adolescent friendly health services should be developed, including support for adherence and retention in care.
The 2015 WHO consolidated guidelines on the use of antiretrovirals updates the 2013 edition following an extensive review of evidence.
The guidelines include 10 new recommendations to improve the quality and efficiency of services to people living with HIV. In addition, for the first time the guideline includes "good practice statements" on interventions whose benefits substantially outweigh the potential harms. The guidelines will be a valuable resource for health-care providers and should shape the priorities of policy makers. Meaningful engagement of people living with HIV will be essential for successful implementation.
The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) has been operational at country level for the past four years. It prioritizes the 22 countries that, in 2009, accounted for 90% of the global number of pregnant women living with HIV who were in need of services to prevent mother-to-child transmission. This report presents country performance in 2014 and is based on country-developed models using Spectrum software (see “A note on measurement” at the end of the document).
This National Guidelines for Management of HIV and AIDS 5th edition 2015 has taken into consideration the WHO 2013 Consolidated guidelines recommendations of antiretroviral drugs for treating and preventing HIV infection on the use. It provide details on antiretroviral therapy for adults, children, and pregnant and breastfeeding women. In addition, it provides details on the use of ARV drugs (what to do) and operational aspects (how to do it) along the cascade of HIV-care related services.
Our world is also waking up to the reality now that for us to win the fight towards an AIDS free generation, we must fiercely combat TB. What is making the need to double our efforts even more pressing is the growing threat of strains of the disease that do not respond to most antibiotics (multi-drug resistant TB or MDR-TB). The overlap of TB and HIV is a deadly combination with tragic consequences. TB is the leading killer of people with HIV, accounting for one in four HIV-related deaths. Globally, one-third of people living with HIV are also infected with TB, and if left unchecked and untreated, TB can kill a person with HIV/AIDS in a matter of weeks.
The implementation of the National HIV and AIDS Strategic Plan 2010/11–2014/15 enabled the country to continue its progress towards universal access to HIV and AIDS services. The National HIV and AIDS Strategic Plan 2015/2016 –2019/2020 (NSP) will build on the previous efforts, pursuing the same objective, with inspiration from the global targets of “Zero new HIV infections, Zero HIV-related deaths and Zero stigma and discrimination due to HIV”.
As Tanzania strives to reach middle income status, the health sector has resolved to give more attention to the quality of health services in tandem with the pursuit of universal access. At the same time, better health for the entire population will be promoted through the adoption of health in all policies. The overall objective of HSSP IV is to reach all households with essential health and social welfare services, meeting, as much as possible, the expectations of the population, adhering to objective quality standards, and applying evidence-informed interventions through efficient channels of service delivery.
These integrated HIV Management Guidelines provide the standards and recommendations to move Swaziland forward in achieving the Government of the Kingdom of Swaziland’s vision of zero new infections and ending AIDS. To achieve this vision we need a concerted effort from all stakeholders and at all levels of service delivery to translate these guidelines into action while ensuring delivery of quality services and efficient use of limited resources.