06c arv treatment guidelines (community)
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PHILIPPINE NATIONAL CONVENTION ON AIDS
CROWN PLAZA HOTEL, ORTIGAS, PASIG CITY
OCTOBER 25, 2014
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History of ARV in the Philippines
Administrative Order No. 2104-0031
PLHIV PERSPECTIVE - Then and Now
Recommendations
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Start ARV for Pregnant Women in the form ofMonotheraphy
Cocktails Combination were given to PLHIV Clinical Trials from different research groups Positive Community together with NGOs,
Stakeholders rallied inside the compound of SLHand DOH to pushed DOH for FREE ARV for PLHIVs PAFPI thru SIDA-France availed ARV for their staff Generic ARV from India for 4 Pinot Plus volunteer
donated by Australian Network Buyer Club of APN+ where ARV are sourced out
from different network partners
1990 to 2003
2004
2005 GFATM Round 3 included ARVs up to the present GFproject and the budget from the Department of Health
Govt procured ARV in a subsidizedscheme
1990
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Subject: Policies and Guidelines on the Use ofAntiretroviral Therapy (ART) Among People Livingwith Immunodeficiency Virus (HIV) and HIV-exposed Infants
Objective: To provide guidelines for the use ofAntiretroviral Drugs (ARV) among PLHIV and infantsexposed to HIV in the Philippines
Scope and Limitation: This guidelines is intended
for physicians from the govt and private healthfacilities managing PLHIV with establishes referralnetworks to DOH designated treatment hubs.
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THEN other Laboratory tests are not
necessary required only CD4 to the newly DXand before the ART initiation
NOW before initiating ARV Treatment PLHIVshould submit the result of CBC, TBScreening(Chest xray, sputum smear/geneexpert) Pregnancy test for Females of Repro.Age, Hep B Screening and CD4 Cell Count
THEN - If CD4 is below 200 ARV is given withoutany counseling
NOW - If CD4 is below 350 and
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THEN the ART we only knew then is Triomunefrom India, Thailand and Combiver (Triple
combination) NOW there are recommended regimen for
adults and adolescents (> 10 years of age)-(A)First line regimen: 2 NRTI (AZT)+ NNRTI
(B)Second-line regimen 2 NRTI +Lopinavir/ritonavir
THEN Prophylaxis and other OIs medication isnot available in the Tx Hubs
NOW With the GFATM these drugs are availablefor PLHIV and FREE medication for TB Co-Infection
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THEN There is no Government Insurance thatcaters the indigent PLHIVs on ART,
NOW PLHIVs on ARV enrolled at the Philhealth-Outpatient HIV/AIDS Treatment (OHAT)Package .P30,000.00 a year are allocated to every PLHIVfor CD4, other lab. (Php7500/qtr)
THEN PLHIVs residing from outside NCR
sometimes missed to pick-up their medicationbecause of financial problem (for transportation)
NOW Under the GFATM Project, indigent PLHIVwho are not a member of OHAT can avail
enablers funds for transpo, CD4/laboratory testup to Php5000.00/pax /yr.- Prevention SitePhp2580.covers the Baseline lab.
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THEN there are only 5 Treatment Hubswhere PLHIVs can be referred and access ART
NOW There are18 Treatment Hubs(2 PrivateHospitals), Selected Social Hygiene Clinicsand Private Clinics that monitor and dispenseART to PLHIV (+ ARV Card)
THEN PLHIVs who are on ART sometimesmissed the medication advise from theirpeers and some information they need neverreach them-(NCR/Provinces)
NOW with the Modern Technology (MobilePhones) PLHIVs can exchange information(thru Texting) with their Peers like: date oftheir CD4, ARV and other health concern
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Respondents were asked about the proportion of
ARV medicines they managed to take during thelast month. Among the current users: 88 (770) were able to take 95-100 of their ARV
(complete adherence) while 12 (103) managed to take less than 95 of their drugs
(partial adherence)
Respondents were also asked about the reasons of
missing their appointments with their HCP: busy schedule out-of-town travel bad weather and fear of being arrested
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Philhealth (PHIC)-OHAT package must also include thosePLHIVs indigent who are not yet enrolled on ART-(CD4,Chest Xray other Lab. Test)
PHIC-OHAT package must increase the yearly allocation
from Php 30,000.00 per year per pax to Php50,000.00 tocover the cost of Viral Load laboratory diagnoses like CTScan, Ultra Sound, MRI and other OIs infections (CMV)
Full Implementation of OHAT Package to all Tx Hubs must
be monitored by the National AIDS Program includingprivate clinics not belong to the Tx Hubs
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Improve the Doctor/Patient Ratio in the
Treatment Hubs
Management of ARV Stocks Inventory Monitoring Dispensing Protocol and Frequency of Dispensing Schedule
Last recommendation
DOH AIDS Program must monitored the fullimplementation of this Administrative Order 2014-0031to private hospital clinic were PLHIV preferred to bemonitored (not Tx Hubs)
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Reduced Morbidity and Mortality &Onward transmission of the Virus* (Hall, 2012) Associated with
Early diagnosis of HIV
Prompt Linkage
Sustained Care
Anti-Retroviral Therapy
HIV Testing Linked with Care Services
Gateway to Treatment and other Support Services
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You can download the result of the CommunityAccess to Treatment, Care and Support Study
in the Philippines from: www.pnac.org.ph orEmail us at : [email protected]
For further information, please contact:
http://www.pnac.org.ph/http://www.pnac.org.ph/ -
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