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18

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20

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21

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22

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23

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24

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117

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119

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120

: Chronic HIV Cane Guide Line Module e3

ART

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HIV Care guideline module d
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122

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e^o&d dot3 130d^ £)ddraris?rroA d^edo^do.
djaeAd cid^EraA (y>ddo/ e»d^o) dcroAdod ddssd djsdodoadode coedo ^Js^dQAlra^.
z333b dax)od3do,
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SdQd^d^
dddote'sbsjdd^
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•

zjoo^d^ct). ^dOod ddoOoO -

•

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^csa^Ort Tjs^oi)

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djaeAd a^ad ^ozaodd^ djadco aaa^dQ^^)^.

^oadode d*d ddd dedjazo d^aod (erouro: Support group) doz^d5 z^dnaA adaoD^

djadde&).
ddd zfod coood djseAod dodod d0*3od ^O^dodd. zaa^ooddSdod Ajzooad e>dd
dodod zad a^ododd. r^dz^edodod cdaeAd znosad emo&azdad.
dasa

:

dj3,e33da

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ddsaddod,

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daacdsad. dasa dj^esadado djacAod d^edd e^ssa dwoozad ^ad ddd^Adzaaddo, HIV

d/aeoad ^jdaaa ei>o dod eddaa dad d/acAodadd doddrd^ dLraedasad. cLraeAod dasa
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q

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z^odo dr^ ds^d^ o^d^Add, esd^ dddo^ra^ddd e^ssa &3do AuadoowdodaAdd

doaootf *doddod)do.

ART

3eodd Aosdoozod Azoododdo. dGosed^ ddododjdo.
—>

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a

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aid

dddo droddcd.

129

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eiddOraadpr^ doajod ^dddrtsd: aedd^d

e>da dOraaddrt^od dds&^dddcd
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•
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ajd€) d^dd drodO^A djd6dd>4 a^edoirohde^.

dro^^d^ ^rdd:d)dD :

^da5e&. ^dOod

provider d,^a^edd^<g ew^dcbd

djsc^K^b d^diseAd

^oaoodd dkQSDrbdd.

escfcajoiraeKrtsb :
- Tjod^FE^ Eocb^ d/adco to’firi'fo 3os3)
-

provider Tj^ab^d ddco ^ardrf

25^)© zodzoai)^.
ddao ^3rdso^)dd.

££ddod droQ&ooQdd rtosarb^de.

- a^od: de^ docAodo dd^ doWdoao

- djad/^o dOoirod decode) ddcd^raoddod ^oaoodd^ dd dad^d^rbdjde.
ddFE^

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e^dd

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doe^6- d&^dd eddd. de^cro^dd ^rodooaododed. &>eh

djseAoio 5% d&^crod.
^oadooaododd),
95%
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dja)eAod) a^odo djse?/' d&dddd
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100%
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edod) Treatment
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ro
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e^od)
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% ^OBdOOZJcS
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1
__________ 2________
^______3________

_________ 4_______
5_______
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_________ 7_______
_________ 8_______
_________ 9_______
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20

2%
3%
5%
7%
8%
10%
12%
13%
15%
17%
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98%
97%
95%
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ddrorad ^e5DdE3sd)
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rtvaddd dded cLr^Aod ^cradooaododd^ tsocroa^
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2^od

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djsdddjd) dodo doeAodd dSsa

ARV Drugs roood£> dc^Dd^d ^djarade) (%) cjD^TddjdD.

e>qjS33

^crodoosodd,

wd/sed^odr^dFcb,

dedpaoirodc^d hod derorbdd.

(Section 8.10; Chronic HIV Care guidelines module)
•

<^3^ dja^^cd^

^d 3 dddg, do^

^hdo^raodo.

djaeAA^h
djad/^d^ dhdd&ooSo ^oaoddd)4
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127

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- t?dQ dOrsadortsd 9
- dDOS^raA sowo sOdoa^do?

- doad/l^od dood Ldo^do?
- odad doae^ sOde^Ad. drt<£)ddo ?5dE3o cro^oddo ? ^s^A ?

- de? ?
-

HIV &eQddo ^ocroA ss^ddoagda?

- ^auadr djaQ&aoQdo^da (£)dOd, do^d sos^) ?
- roodrSe^, dedd M sodoaoOoAi 9

- dedoasod daood doad. drtdddoasddjdo

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- Se^odo
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dsrod,
E3E)CJc)odam
td<5 dodcOood doodrt ^dosrort.
u
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d>d.£fod)
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4
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doadrtsk :
djd^ecxdaroA
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doaertrt^o

dada^^dadd

dado

doad

dadaodartadd. d^dasaA ds?d ^rodoosod doaddodd, CD4d rtrad do^cda^) ^daasD 3oda
sodadd.
(tj^asa
dd^ do<31
ssa^odartadd.
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sSeaaco—'wddrts? eJdatsde)
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daoaod d^odadd.
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adadco 3s?^d zda ddodrts?od4 addd doa^daa^cd.

ART dodo—© HIV/AIDS
sort &Adodo* ^ra aedodjdo - ^dorteEroddoo ^dodoad 3odo
soode).
r\
n
^padoosoEra doaoddrts? ^ajadfdrt daoaodaaartad dsddo ^dodrt^ 3s?^&acdd)cd: doaeArt ojjad)de dda
as&ds?^ sgdd ts^rts? sort daatoad added ^eda^da.

eidd sort ded ^edodjdo.

u^rt ^edo^do
oiracsortodO
deraddoa soderadrg ^dd
dado-O ^cradoosortod
doaoddrt^rt dOaoad^dd
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s3^3c>

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Sea£) s^dod^ soodcbdjdd sort dsSrzb^do dodo yia^rt^ e^dQ^rt^ sort dDcddOoeod ddzb^do.

128

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adad) da^ddodd ^dcaaodd^a dad eaacOaod Tjod^rdodaoiaartadd. rtadda^qdd dada odaeS da^$ad^
djae£)Ajd d,rad^od ^aaeod ^Euaod^aOodaddjda.

daaoO. ddod

□

djOh^A dddad draedd^dd (T^d, d,ra) HIV dddad dos^d ddda^d. sadra e^oh^

daadrd^ dajao^ dddad daaedd^dad d^d<£
dd^odd^ d^ddarde) HIV d.dx^ ddd
a-o
M
d^daaeadcgdadd. dada /
e^dd daja^e^ad<gdad d,fad^ daaaed d^d^d^a d^dra
daaodadd.

HIV dddoa d&3) t?dd^ drorir^hd. HIV fart dddwaddd.
• ;too^od ?todd d^dd>4 d^od deddja^ ^eda^dood,
• TdaeoS^od ^co^zdaod ^daA/l^od,
•
•

j&aeod^od dadd djad, ^dozsWod (e>o d.droradgddja dad)
doeudd, dodajad Tdaeo&d d^dod ^QD^ddraod ^dafy^od

stedrs :
rSjaeo^od &oQd sacOd/i es^rfod 1/3 dd^ da^b HIV dL^eridd^ djaodasad. sacOacCood dard^rt
d^ert ddddod drodo)
^odrri^d^ drod^hd.
I4cd4 rtd^A,)

3acto rjjaeo&z^ s^^rvadd, darddrt d^drj^H^ dddradj d2pF”r§oijaAdde5az1 (eua^otsa dxiao^) ^rao^arddd.
dz3d tjsuaod dododartasart d)da doriodacoari erao&artdd.

139

:

aocrt HIV

HIV ds OfvB ddda^de?

• dedd ded ddd^od .aodd x^ecb, zdaex), ddcd dodo dx/ad.
• djOd$?$ dozood - 23D0dod dace5 daad dacd^cd, dddaddjcd,
dcod^da.
•
dozaod - ^od djacdd de^, srodri^cg, dddJD, deeded ^dnacd^dOod
• deed
rre^odod - Ateda^cd, ^ddas^dd, d^z^^ja^Ood, dzddd,dg dsasa^dOod
• ^adjad ddart^ dod^rdod - dda., d^zjaood, dded, d/aezd, esadd ^jad^
• Sewri^od - djatf ^aoda^dood,
^ewrt^od

HIV ctood

ddo±od

HIV oi)dD4 ^cxto^ja)
•

dSd os^Do.

djsdco

z3ed en)#7jco HIV d^dodrorid dddo W30 en)o£3d drocdd ^ddOraDddri&ja ^d.

dd^risb SdQd^d d^d^cd d^&aodd dtScbdd.

•

•

23^d ^ddja, HIV odd^

HIV odd^ dodo^dco

ddd ods^de

woddd^do.

dx&d esozWod 3#dD2odDe§deE3odd HIV oddd4 ^oido^b^dd ©adxa^nd edodd.

djsehoiradd wdjser^ ssodr^drcb djaeri ^odod,fe>d emdedritf zori

£>edde& dddd dz3Fdde&.

"Patient education Flipchart" zTp'fO, e^dcd^r^A
ddari HIV djaeod caoed 3$cd&ao9cdd z^drisd (HIV/AIDS Sod zotfco-Bdad d^ ^qto PLHAd^)

HIV djaeri^ ^Fda.zopd ddddod ddoda^ddo/a d.darad djaoOdded. ssdOod “Esa^t»

dda

d^dodc^” eroo^arbdd. ds PLHA
^odo3^a^)caahd. e daariFritfodd:

EuaAjdad ^dodc^dO HIV d^dradda^ t5>de^ daadFrt^od

•

e^ohtf daadFOod HIV d^dra ^odod.ra.

•

^djOAtf djariFdod HIV d^dra £odod,ra.

•

dosawde^ dad_P dBaoza odaezad.

•

PPTCT ^o&eddoded - t9d)rt^<£)co ddsrod
dod £aad z^^rdaoQdadd.
_fi 5
_o

•

ddaaoaoddg ^oda^eeoarbdjda, ^ddda HIV dddradda, ddodad sad daadad)dd(g
erodcddadjdD.

^,dod^d<2

/ PLHA ritf Tdd^d zSedd ^do ^^rtooQd. qdOod e>dotf ^dd STI,

TB, $ed, sbdeOoiro d^os^d ^oeod^od sotfco^dd ddodd. (Chronic HIV care guideline
moduled

11.4 ridoa^).

140

zjadaad^A desto^dodd, daa&X ao&dartsfodd :

~

•

dfodrdjadA e^asa cdjae£) zja^dd/ad^ ziod^r^ zjaddod 3doda^da

•

zaaoaa, 3d4 ts^aaa odae^cda da^ ziod^r enxa&artdod d&zb^da.

caeg PLHA rtSnaA, zbd^d d^oA^ dcdd dodo d^drad esEjacdod Sabod^d zari zba^ ziud Scdodjdo
(Patient education flipchart

•

ART o&dddja,

•

^do& Z)ona3o3jadd dsa^ d^Zj&a^ dodo odasuartcua saodjaedd

•

^ado ^Euaod^aoodad d^oA^ daodd^ dda.

•

STI rttf v&pM eori 3s? desd^do, draeA ^eadEsaAdd zba3

•

HIV ^raeo^, d^dra dash z35dod zaAAd e)ddod^A^ djad daadde^a.

•

SpSacda eaAAd diaeAcda ^zpaja.odrt^ zaA 3dd dad^oddde?b.

dsAeua HIV dddzjdodo.

ddodoo saSe^

PLHArttf ztona^rted^ d5zb^c±> :

dracAcxb ^odd / riod
ziorrodd^b dsnaride HIV zbaeo^d ZotfnaAcrodoiK eaodd
d^asaAd.
^dd^r diaertd ^cbdfodd^ zaodoo^zbd zjA cadOifod «d ziod dolb ztonaarttf djacd do%naA

*

Spda^m d^esad ^eddesaAd.

dz3d HIV sua^dEd d^rteb 3da& Zjona3ri<& ^naAde zSjaeoSA ^naAcaad caozo 3edaard^ woddasad.
^da oijassaAora z^asaAda^do. ^da z^oda 3oda zadad zjadaad^ zioA^cdaaAd eaodd ^edpda
dod3A<£<g ‘Discordant’ ^dadd ^ddq^r z^zoda sjaWaa* ^dd, ^cdra^zoda dsAoja AAt^ ^da^ad.

dod3As?<g HIV AAdad ^daddod zbaeoSA z^naAad ^asacdasao ztodzpr dz3da3d. t?dOod
dod3As?edrd ^auaod ?>QdaAjas?zbd oiraezodAs/da^ djadzided dada 3da& zaas?Z)Ona3 ^aaa dpA^

dtato
djsert zoSodorisiasb^de^
guideline module Annex 5 si)^

Spi^eo

sSjs.esDSo^f^.
(Chronic HIV Care

sdocg sijaazteo

9.5^ en^otoA^)

•

djaert zokdori^azb^dd

•

djaeAoix) doiyDOoiroAcjd,
rido&ri ^Epsdzt)

•

Zjorroa sjOegd ed^essSozi^e^ s&dd ^dds§

en^oiQeris&i) z&Srxb^rid.
<\)c^&5c?k). (d-Q^e/sj? - edj^csc)^^

Patient Education Flip chartritfgoi) Prevention
en^oSjaeA^ocfc djaeAri
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z5ed
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jdxatoaA
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HIV+ risk) dodo dzmdrod6' (^ao ziorrod + ^dj^zoob -ve ^dossd)

djseArt^ ezbd^d djofi^cto
djadzbz^do.

^dozt>d)cb dosb

eisroab dAzbd c&aeKAoddo.
A
<

•

HIV a^zidfad e^daodd zoA / dpA^ zjod^rd eadradodoo&saAod zbaeoSd zoA 3gra (beda^da.

•

dsAd dpdrad tjauaoddda^ da^a Ajaco^da^ e^rzb^da dada dbaeAA d^cda^ dada /
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•

e>ddda4 dada odd donadodda^ dgzbd odd^dodda^ dddzb^da.

•

SIT As^Ed, adaodad osuaodA^da^ ddOzb^da

•

ART od^dcba, HIV d^dra enao&aAadd ^oda z^d deeded.

141

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• dorrodrt^ dde^obda^ d/a^sa&jdadjda dada odadjdaad^jada^da.
• daaertd zaddoddQdad^obda^ daa^sadda^da dada dd^odad^da.

• draed Sobodpd zari

dada dod aeda^da.

• doddrttf oauaob ^ddaztra^dad obae^dobda^ o^Fdadjda, dj^esahda^da dada ddsad
Seda^da.
• $£)3^d dz^aFddob zad dada dataaoza obaezsdob zart doddrt^ obaezsdrt^da^ o^FdasJcb.

• dataaoza obaezsdob zad dod £edad)da o^d dzad za^1 d^abdaajda.

• doddrt^a dartadda^ daaodoa gz^ddd oddda, PPTCT A dsb&>da^)da gode dod ^eda^da.
z^oda des? doddrtsb Q^rodFo^ ohdd
•
o

•

HIV ddd^ dorrodd droeo^rbd osroobdda^ doddris?£) zddFda^da, dada d^esrobda^da.

•

osraob 3Qdadjas?dad d.z^rob droriFrttfda^ dddda^da
o saodroedaW adodd zas?3

o

da<sDdda4 ded daadFdod ddoba^da eracro: dddd dd dadad
hQoaaod)

o

deddedobarta^da.

o

STI ri#d z^d.

•

$£)^d rtz^F da da bBaoza oiraez^d zad doddrttf c&aezsdobda^ o^Fda^jda

•

bwaoza oiraezadoi) zod dod ^edazgda gode dzsd zj$ ^Zoda^jda.

•

dosiari® sbi^fc ^raodw ga^dd, asrooin^ sort ^oad
daadadida

•

sjad/aeosjWda^ ddFdda^da dada adodd dod ^edadddeda.

4°^^

£

PPTCTri Sapscto

dja&zb^co erocsa^d^rteb :

^abzi/aq?^ olrae^dobd^

1. bdrsba^d HIV d^drad ^sraobri^d^ e>?dF^bE§cb :

•

riod/dodd e)$E3a ^ona3rt^

•

rt$rf3,

•

rood/aedy sosd go ts^saa SdoddssaAo.

rtja^o ^dsro discordant

Ssbari d/aeo^d^ doodad tssjaob.

• dona^obod saocbaedy zo^Tb^d^U z^dodtD zaddcbd d^odd.
2. z^ds^d djacrt d^dradd^ ts^FTbaJcb.
cj

•

da^da, djaodad gd,

•

dzpaFd^.

^oi)o3,re)d

3. HIV

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144

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187

Annex A

spSdO

Annex B

djaenoi; s&Jsa

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189

Annex A:

3.3 ttpi/sezTsoak

3.1
"^da d/acte ffi&lc&aAdg":

3.2

---------------------

Oaduadd^^OrroA daaOtf ooSeoeJ
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3.4

In all patients:

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191

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doacAod ddda :______________________________________________

edjacrtj fcoc^dg zasstodd^ ts^dQdcc djaeAoid 7

1.

HIV

- OsOd

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3J30O ART

ART

ID ^0J3a aJerescs’r

1. rt&afl £5^3 (xtodrarer

Date of Registration:

/

/

/

E&sQd

:

WHO clinical

Weight

/

______________________

Treatment status at registration: On ART

Name of ART Centre / City:

/

ztoaSj:___

ART

Not on ART

Date

Height

Functional

At 1st visit in clinic______

Name of patient:

At ART medical eligibility

/

/

(date of birth:

Age:

)

Sex:

TG/TS*

Female

Male

At start of ART

Patient’s phone number:

At 6 months ART

Address:

At 12 months ART

City/village:

District:

At 24 months ART

State/province:

Caregiver's name:

At 36 months ART

Caregiver’s address and phone number:

At 48 months ART

6. Antiretroviral Treatment (Summary)

/

Date confirmed HIV+ test:

/

5-Paediatric

6-PPTCT

7-STI clinic

Patient transferred in on ART from:

ARTC

1-VCTC

8-Private practitioner

12-Sex worker outreach

11-IDU outreach

Treatment Started

Place of HIV Test:

Entry point (services referring the patient for HIV care):

2-TB/RNTCP

3-Outpatient

9-Other NGO

10-Self referred

13-PLHA network

14 MSM

4-lnpatient

15-other

Private

Name of previous clinic:

Q 1 Heterosexual
2 MSM
3 Injecting drug use (IDU)
4 Blood transfusion
5 Mother to child
6 Probable unsafe injection
7 Unknown

STV + LMV + NVP
STV + LMV + EFV
ZDV + LMV + NVP
ZDV + LMV + EFV
Others :

Substitution therapy

Y

Single
Divorce/separate
Live-in

Family members:
partner/children

Age
/ sex

Estimated monthly
household income:

HIV
+//unknown

ART
Y/N

Regist. No
if in care

New regimen

Reasons STOP: 1. Toxicity / side effects, 2. Pregnancy, 3. Treatment failure, 4. Poor adherence, 5. Illness hospitalisation,
6. Patient lack of finance, 7. Patient decision, 8 others:

Disease class (tick)

TB Regimen (tick)

Pulmonary TB

Category I

Smear-positive
Smear-negative

Extrapulmonary

College & above

Category III (if applicable)

O Other specify:

No Occupation:

site:

Were ARVs received ?
Yes
No

Initial CD4 count No.%

Place of ART:

Private

Govt

TB Unit:

Health Centre:

NonDOTS

TB number:

Rx for MDR

Treatment outcome:

Date start TB Rx:
/

NGO

Cure

Rx failure

Died

I

/_____

Date:

I

O Rx completed

O Default

Transfer out

8. Reasons for Stopping ART

Drugs and duration:

ART

TB registration
District:

Category II

Past history of TB

4. Antiretroviral treatment history

PMTCT
PEP

Date restart

7. Tuberculosis treatment (RNTCP) during HIV care

N

Q Secondary school

If yes,

Reason
(code)

Reasons for SWITCH only: 1. Clinical treatment failure, 2. Immunological failure, 3. Virologic failure

Non-literate

Yes

Substitution,
switch or stop

Date

Reasons SUBSTITUTE: 1. Toxicity / side effects, 2. Pregnancy, 3. Newly diagnosed TB,
4. New drug available, 5. other reason (specify)

Primary school

Employed:

~

3. Family History

Marital status:
Married
Widowed

If yes, type:

Education:

____

SUBSTITUTION within 1st line, SWITCH to 2nd line, STOP, RESTART

Date transferred in :

2. Personal History (tick all applicable)

For IDUs

%

No.

State

Risk
factor for
HIV

CD4 count

ART Centre Code

Death

Transferred out
On medical advice

I

Date of death:

J

Date last visit:

.//
/
/

Date:

New ART centre name:

Instruction: Sections 1-3 to be filled by Counsellor. Sections 4-13 by Physician/Doctor.
Lost to follow-up (>3 months)
Date last visit:
_________ J
I
________
‘ TG/TS Transgender/Transexual
** Functional status: W -Working = able to perform usual work in or out of the house, harvest, go to school or, for children, normal activities or playing
A - Ambulatory = Able to perform activities of daily living but not able to work
B - Bedridden = Not able to perform activities of daily living
© National AIDS Control Organization (NACO), Ministry of Health and Family Welfare, Government of India, February 2007

1S3

9. Patient Follow-up

SI.
No.

1

2

Date
of
visit*

CD4
count

3

4

5

6

7

Hb

Weight
(kg)

Height
(cm)
of child

Func
tional
Status
WAB**

WHO
Clinical
Stage

9
Oppor
tunistic
Infections
(code)*

|

1 o~

Drugs prescribed for Opportunistic
Infections
Prophylaxis (Dosage)

CTX

Other

Adher.to
Any
ART* (No
other
of doses
medicine
missed)

Antiretroviral
drugs and
dose
prescribed

Rx

13

12

11

|~7T~

15

16

17

18

19

20

retreat,

ART Side
effects
- code*

Concurrent
condition
e.g. STI

Pregnancy
(y/n)
orFP
method***

Condoms
given
Y/N

Remarks /
Referrals

Staff
Signature

ment
Y/N

1

2

3

4

5

6

7

8

9

10

11

12

13
Instructions and codes:
' Date: Write the date of actual visit starting from the 1" visit for HIV care - ALL DATES: DD/MM/YY
** Functional status: W - Working = able to perform usual work in or out of the house, harvest, go to school or. for
children, normal activities or playing A - Ambulatory = Able to perform activities of daily living but not able to work/go to
school/play B - Bedridden = Not able to perform activities of daily living
’** FP: family planning: 1 condoms. 2 oral contraceptive pills. 3 mjectable/implantable hormones. 4 diaphragm/cervical
cap. 5 intrauterine device 6 vasectomy/'tubal ligation/hysterectomy

I

I

I

# Opportunistic infections: Enter one or more codes Tuberculosis (TB): Candidiasis (C), Diarrhea (D); Cryptocococal meningitis (M). Pneumocystis Carinii Pneumonia (PCP),
Cytomegalovirus disease (CMV): Penicilliosis (P): Herpes zoster (Z): Genital herpes (H): Toxoplasmosis (T): Failure to thrive (FTT) Recurrent respiratory infectious (ARI).
Mycobacterium avium-lnfracellulare complex (MAC), Cardiomyopathy (CMP), AIDS-Nephropathy (AN). Molluscum contagiosum (MDL). Parotitis (PAR). Lymphoid interstitial—
pneumonitis (LIP). Lymphadenopathy (LAD) Hepatosplenomegaly (HSM). Delay in or missing developmental milestones (DEV). Other-specify
m Adherence: Check adherence by asking the patient if he/she has missed any doses. Also check the bottle/blister packet Write the estimated level of adherence (e.g >95% = <
3 doses missed in a period of 30 days: 80-95% = 3 to 12 doses missed in a period of 30 days; < 80% = >12 doses missed in a period of 30 days)
$ Side effects: Enter one or more codes . S=Skin rash: Nau-nausea: V=Vomiting: D=Diarrhoea: N=Neuropathy:J=Jaundice. A=Anemia F=Fatigue: H=Headache: Fev=Fever.
Hyp=Hypersensitivity. Dep=Depression. P=Pancreatitis: L=Lipodystrophy: Drows=Drowsiness: O=Other Specify

Annex C
si\rao IMAI
Jiddraclraeh ^ddf^aaddjlra.^rVaod
c<

-6

eJ

edjafri.&
53odr^drd7d3d,

surfed Mdddri, ^e^ea&Frisb 2 rto^risk d,3M d:& l r>o^

ade^oi) sSjade

£>ea3) 33rt3odg 3^3dd3, zsa^p^od ^dora cirsefi ^dde&croddja^ ^z^/j droda) ^ocd drohr^d. ^dcradcU) PLHA rtvshcd adjadeS HIV

d,3drad (djseAod) 3dd 3t3dco djs3 3ddf3 ddddosfiddssd. ^odd £3^3rttf<£) ^edj tsdjaert ssodr^drasfidd^o esddd HIV ?3jaeo3d diae/W ddd
dd7i)33d. FJ3^3d
adDn
^Qdd33d. ^odd ^Taed^^dd, £ed £dd3, 3€)ae>eO
aj3,oif3ch3^ri dd^r^eo Qrudo5j3^&r^d?& ^ud
decode, ^edsoed dtddU^odsfid. aed) ^dd os# ddodde&.
3ed:r ^edd^dd^ tsdd^ SesJ
^q3rd€) drido&Qtfded). ^ed
^ed^dd 2d>rta53A ssudr djscdddd dL3odd3 ^dddd. e>dd^
ddridodg drododed. d^edrri^ ddfe3 ^drsd
SdQod d^Qdddd. ^>dd^ djs3
wddri<te3ri zi0eddde&. ^,ed deded^Ed, £>dd& 3<£)3od zsD^dd^ dz^&Q^CD ^od: erod3dradF53A zo^&^ded).
^ed^ddO ddsad ^dodd / ^ddd

zodoarort ^ad 3e^ ^d, djaefirte a3rad Flip Chart rt^dD4 addodd d^. ^add ^dd^arad ra,dd dsbrisb ^ed ^edad afcezSd afee^ddefe.

V

2

sac^r £G)cazjz3c&)

‘4

1-10

•

HIV 3^3ed TjesiTd
(c>3rarttfdd,
/ drfrttfdd
tJ
x <-)>
< '
oo
A.
dj3eQ;&z§dd)

3
4

11-20

21-30

tzs&s*'^4

23333r4

C&

HIV <*>
3^3^ Xteorf
3e3
eJ

TB ^3, ^Qjdo^ra, ^zoo^^jsesraoi)

•

TB dde3,
d3d<'J ad do-C aradrae^ad
C-Jl

•

^dQri^ dddo, ^d.dedFd

^.C13eoi>
0ajF^, AiCTO^OOEO^,
ART soixO.
d 6
<p

•

ade&cd ad do-c added
^ddOraaadd^o
o
a

ART SciroO, ART ecvdQ3. t5^3jOra3^rt^d
r^T\
a
&D35fc)o^oi)eik
c^cjr^^dd.
Q
A
‘SJ

(SEodad^ 1st Line Regimenri sdacQdo^do)

ti^rWo ^^3 z333, ART

•

____
5

31-40

£9d ajOreaadd^ 233d (3^3ed e^^aaf SEh
zdae^^j)
sacdr drae^dz^sado.
Qn

196

SKILL STATION ioddfSc Orf (gczbrteb 1-10)
5C7? ZJoala

■^o±>£

W&&

u

£53 P*

aSe^Ad?

&

1

753?

3,4,5

2

eJ

oj

3,4,5
3

TjSS*'
tJ

rM

3,4,5

4

7^
u!

r-j

3, 4,5

djaehoOd 27 sSalF OoOTjd. HIV + aoortTO
rfdO
Orf rfadarf «d<0 wod«£ sadra
&do sSjactefcroAd.

HIV

olfarf djaeA. e5>rf#ri 32 sd^r, HIV + sooATi) 4 Sorts? Ood dorfd

Joo^
srtda&as&Scb^dD rfadAooda e>ds?a
zaoddad sadra ART sort
□5253 S«?da^fas?od
d333
tsdsto
t5drf3.
ddodzodddc
330dd
Ozsad&oa zaodusa^.
a___________ V________ ±______________ <_____________________________________________ Q______

djaeArt 35 ddr, HIV + dortTk z^oda ddrd Ood rtjasaooda e>ds?frt rtzpr^
tsdsa^A
ejoOgtos?. ^do «3ds? rfjads; zpfts.
ojacA, 32 ddr dortda, HIV + ^ods rtjasad dxd 2rfe $el3. y>ds?o HIV
^Sodd^ oda&rtja des?d£)ex rtod^rtja &ad. y)d«?o

«5ds?a Co-trimoxazole £)ddrt ao^dsto e>ds?o
z.s?ooda idcda desfrsas?.

5
3,4,5

rfjadc $ft3, ^3^
tjrftf rtoc3 rfozjad

ART naA zaodsd.

zartn ^escsatfod
esddaa ART
q
V_________________________________ -D_______________________________________________________________________________________________________

d/aeA HIV +45 ddF dod^rf saa^sjao, &waoza dd^diazada esdrfd^
darfcoaod adda&aoda zaoddda.
zadads da^rt OOdOdzof^a,
4 Sorts?a
Q
Q
cuOOrtddrtja dEJaAcaarfod. eid^rt daadoa z^ed dadaaaacsada. d^da rfaaeO,
W53) Sdd ^ra^da. tsrfodd «ddrt daacd eO sod l ^jae7?F ^oLSzaodd^.
^otodjOSaeooaac? ddd dzsa sua^coaa TSeOdea dc^dda. esad ^eO75ea
df^dda.

197

£)dc&3c
SezFofczjd:

6

sioodo^OBrf
__________ &_
^3^ 3, 4, 5,

5As, 7.2

u

7j2t 3, 4, 5,

7.2

z^fzjCd eso^rt^o

dJseh 50 asSr, HIV +
sSaSFrttf &od 3s?c£o3d.
e>dd
djsde
tsddd adori soe^oss^. ^L3h^ Tdd d,rart*?d, &dd& gd. tsddo

dja^

7

ssaazFzScssArf
—*«

^adjods/'t^d
derofid.

esocb

e>dd3

ART zotf

^«?crod,

eda

djaeA 36 ddr dortto, 3eJd) saod kod HIV + caoda ztradacoada. 6 3ortV£i
4 zaad z^eiM/afeJcaatf. drade $et3rte£>
dezs^d^dsto. aoa>3 z^edcda
d^saoddod ART nah zaodca^.

8

^2r
3,’ 4,’ 5
ui

daaeh 47 ddr dodd)

dad/^S.
tsdd djado

9

3, 4, 5, 6,

HIV + =aodd <adda ddrd kod 3#dada. Sfd,

doodah djafrta^o. ART nah 3s 83

zaodda. ^da

daa^A 26 ddr doh^a. HIV + daaada ddrd &od Posada 2 &or& kod

7.2

zaodtfa. tsdtfa HIV + <aoda odaOrtaa de^e.

83 zaod^a. eidsp/i

ART dcsaAd. tsd^/d ^8 dad qd.

10

3, 4, 5, 6,
7.2

^C^F

daaeA 25 ddr. dortda HIV + ?f^d ddr ^coada ddrd 3aado£> esdsri
Herperzoster tscdada.

83

d^daaf^s^d zaoBcaas?.

WHO ^3^ z^zs* (3.4)

ziraeB^cS

198

SKILL

3

11-20)
Sex*

a
ZSSfg

£

11

35 3^r, rtocto. HIV +

3, 4, 5,
6, 8.1

ddr d^djsc^cdjs 2 zroo

droQ^dd). t5dd 190 «A&.

ddr rVssDcoo^)
-X
aro^A dd^od

4»a^
u
css^Zj zScsafirf?

djaeftd. ^d

tJ

ddddd ?5dEd CD4

ART toA zoodcro^.

___________________________________ 21_____________________ 2_____________

12

ojseA 22 ddr aaorfrd. HIV + 2 ddrd &od ArassoMd. Pulmonary TB naA

3, 4, 5,
6, 8.1-4

13

cbacA 40 ddr dortzd. HIV + 3 ddrd 3od ^de

3, 4, 5,
6, 8.1-4

14

2333 ddd£). (^d #<£)3do^ + ve ) 4 aoritf Sood
z^^^Acsa^. TB 23S3
djadad djadco tj>d^ 3ja£, djaed ddrd djadexg 7 ^.d. ^adaodsA^a.
(©odd
0 s.d.coaod 53 &£.)
S3
dart zaodna^.

djacAoda 2

aort^ddK Pulmonary TB d£d dddtfo ©dda4 ^d^o^ca 2 zia^r smear
does daadcaod^a. S^d z^ctood 3o3d oa^r^ S«?oSo^d3a. ©d^
zaodcsas?.
___________ Q____________________________________ ____________________________________________________________

?j2?

daaeA 38 ddr dortda. 5 3oritf &>od Cryptococcal Meningitis zaad dddsfc.

3, 4, 5,
6, 8.1-4

ed^odOdaaaart

15

zaodda^. HIV daad
3dcd e$da&atfz3eSod.

daad©aA

HIV + doda rVasaodSa.

d/aeA 50 ddr rtodda, eed, dac^da^ ddaaedz? ©Ad.

3, 4, 5,
6, 8.1-4

33

doda ©dsM 39od3od. ©s^rte zart dz33
HIV + Ss?d ddr

zsaoaez^ ©Aid. dSd saao^odaASa. ©
3©^ ARV SddrWda^ 3©d)
3oAs?ddnaA Sodda.
33 ^eod,^ zaodda ^da ©dd daad© zjSed.

199

3e3e Qn daaodadddd.

Tioaiu

16

o€’oOd

zsar^
&
Xz?'

3, 4, 5,
6, 8.1-4

17

tj

/»

3, 4, 5,
6, 8.1-4
18
3, 4, 5,
6, 8.1-4

19

dd:
u
wz^zSesaArf.

ojaeh 46 ddr sorted.

HIV + S^d 3ort«& rwsaodsd.

dodo

z^ds^A csaWed TkOcrort rtfasacCodD. ts^od^dadart Extra Pulmonary TB nah

TB
dado djaduacCoda. tsdjaer^ Seod,^
zoodda^. t5d<&
cuestosu^. e)de?d daoz^a esoda ^dadaddodod e>d^ wdJaf^d drt d^odzSf^od.
djaeA 23 ddr do/l7d HIV + 4 3ort<£ &od rtra^aodda. gc^ri zooddad sadra
e>d«-/d odaed ^d dads oifaf^odg dd wotsaAdaddodod.
c^eh 25
aoortTt). HIV + ?j^d ddr
^30233 7137j^rdadodO3. ^d3 «d^ slradc; z^d.

zood zradra.

KL

dja?h 40 ddr dort^a, HIV + 3 ddrd food d^o^ada.

3, 4, 5,
6, 8.1-4

jDdjd/k^^rrod^a. tsdda^ NGOd ^daadaod e^djaeK saodr^dr^n d^^d^a dada
Xa^DdaAd^a. edaaert saojap^drd ^cadcdaod
dd ^djaed, seod.# zaod^o

d/aeQ,

ART ddodzadada do da zaoddasa^. ^da tsd^ 2dc z^ed.

20

daafA 34 ddr dcATia. HIV + 2 ddr £ood djasacoada. ezrod adaaeA^ j?eod,^

3, 4, 5,
6, 8.1-4

zodadda^.

2

dadd

kod

esd^

Pulmonary TB

naA

dnda^jaod

d$d

daaAcoada. edaae^ zracdargdFda tsdtfda^ ART za/d ddFAea zadca de^dda.
dsA tsdsd T^o^daAdcrfcda d^datf. tsdtfd ART dd^

doda e>ctabdc3.

ART dodadnaA ^da tsds? 2dc z^etS.
ssc^r
zi^eaxj
c^)Ad

TB/HIV sau^r dado ARV

oodda / wzadcdp*'

200

4 (3cxjert<& 21-30)

SKILL STATION
^zf ztoai
3
_____ &_

21

^3- 4>
5, 6, 8.9

3^3
Zi

uj^fhcxto 45

rtoc^zb. HIV + 3 33rd kod

zodd^DD^.
CD4 —ISO
stacteftrf. ^cra^eozo^ ^otoaoofcigcbsscjrt

ART ^eod,dg

^33^ ^od,dO zoa^
rod

zjsO

ds

Q3 dodd srodcd zodde^odd sookF^ddo^ ds dd zoodda ART sbda roadeo
z5z3rd€>5s,h.
_________ £________________ _____ _______________________________
22

d.?eA 47 ddr rtodzd. HIV + 2 ddrd dod rtiaroc^dx esddd d&roA food

5, 6, 8.9

ART de^Ado^. tsdd t3dj2ed6 sao^FddFdd t5dd ddQdddo, ddd^oda
de^ddo^. ydjsezt ^eod,d<g xJodrroddd^ tfodda ds ^jscddroA erosro dd^d
3pd roda <!>gra dddda. ds/3 tsddd dro/irod. e>ddo 3d3d34 3s?d rodd
e^roccoot^roo^d ^«?d3a. dad: CD4 s^od* sTOdcroGddd. ydda ds

03 zjod aadra ART dado arodzoa^doro
diaeA dz^dc deOzO^rod.
ozdra t?d3 dod^ doda ddrd &od dzdre djsodd^o.

_

23

3, 4,
5, 6, 8.9

Q

diaeA HIV + z^oda ddrd Ood c^dd ^e3B^A 3dafe ddd zoodrod. zodad

d»od djadc secdd^,
HIV odda.al_______________
drrtd dada
dradco dc«?ddod. «>d3d
—'
CO
Q

dodoTOAd. e^dda ^o3d rortd<g oro&rtja AIDS e?Ad doda de^e. eidda
AIDS Bdd ^Mcd5ja^od)dEd4 <3edcd dJacdDs^da tsddrt
<god doro 3s?odco diacAoda fcod,^ zaodda.

24

25

/fc>
Ei PM

^dz arb^de

3, 4,
5, 6, 8.5

d-acA 30 ddr dortzb HIV + dsrtrofc 8 3orttf rtzprrS 43e 3orteod e>d^b

3> 4,
5, 6,
8.12

ddeA 26 ddr
HIV + Aodzd. ART z<>oda eoA^od. e»o z^d dada
^cd.rodoa/3^o yd aadra ydJaeA, 3cod^ zoodda.

i g> a

i/'

d
fev-8
\\^v " 5/o^
>>

CxS
M

ART (d4T+3TR-NVP) dddd^<&3ros?.
rtz^r^ d/aodd ^jawod 33zd
scd^a dodoTOAd eddod edjacp ^eod.^ zaod^a.

ellsllils 06

201

4?3c ad sioocdddad.
doaio
233
&
tfOoijoo

26

3> 4-

5, 6, 8.12
27

Tj^j4- 3, 4,
cJ

’

5, 6, 8.12

u

d/seA 32 ddr ^oiiTud HIV + ^ortTi). ART stojacb eort^ocJ
37to&atfD3c3a^.
23$drJ
■-■-•Md
dddod•
dOodsA ad
V-C
Q
_. 2Jd:3o.
—’
_£<-O
(J
gdar&o dc^gd, ^dood
dosarbad. «dood
aa t)od<&.
&aeA 41 ddr dort^h HIV +
sad ART sbcb djaQd (d4T-3TC-NVP)
d^a^sssAdedoGb tsa^^d. wddja e>d<& ad
drodoae;. io
dddod des zb^ahda^. ydjaert ^od,^ ddco adrOA)ds&.
_£) '“■'■?

28

29

30

ffscs^rrt^b

3 - 45, 6, 8.12

d/aeA, HIV AodTb. ART dx£)dad. (d4T-3TC-NVP) 6 dadrt^od djado 2
dad
ddodaAdad. &adA ^^daAoadoda ^^odaAdad.
^adaad, z2edd ddda3dad. dd/a^do^ d^djaetsd^A dda^oad. tsdda adad
de^dda zad^ ^bTjarta^d doda tsdd d^&a^da df^?ddo^ ?5dd ^raartsb
ao^dodaAdoiao^.
ra

^3’ 4’

5, 6, 8.12

daacA 54 ddr do/Vb. HIV + 6 dad/A<?od ART cda^da^. adjaert,
xsacdariteFda de^dos Sdd 3Ada^tfo3da<£. wdcUa tsdsto d^^OdaAe
tj-d^Ach doddaAa^d.
sadraa^A tscbaert, $eod^ aaod^a.

3, 4,
5, 6, 8.12

d/afA, dcxbAa 40 ddF dortTb. HIV + ART cxb&na^. (d4T-3TC-NVP)
cjo<aa, >soA^od, ei>d^A ddjae tsdoS tsddod tsdraert^ ^cod,^ zaodVa.

oddOgsadortsfr asa^d

y>d dOFsadarttf az^otozb^ - djaonar^odart^d.

202

SKILL STATION 5f3c
Sesf Zjo^5ot

31-40)
^ooazj

zsaf^
_____ &

31

32

3’ 4-

5, 6, 8.9

d^eA 37 3534F TiocSzk HIV + ART
srodaod. d/adco stocto droacrori
eid^ri zdzjaodsod. tsdodd dOairaeodd:, tsddjs
zacdd sanartdd dada
eodazj^rddd. ^dood dS3Z) oirsezid ddodeo Sdaro/d^dc&odd ^dazf
desddo.

^,3? 3, 4,
5, 6, 8.5

doeA 25 ddr HIV + aaodzd. ART odda, daed sBort^od drtdd^a«d^c3a^.
ydsrt zddjd djOAS z5cdd dddco dod dcduaodds. saoctedd

wzSu
eszi^jdcsaAd

de^uaoddd. edd e>d<& daadSo. e»dtf<g ART(d4T-3TC-NVP) sddddjadnM
ssdsb
deed 3d<gd^. e>dsd Sdad de$d<& tsdtf
dzaaAdodod, (gs4^odod, ds dd
zaod^a.
rtzprfS esAdedoda ddcbacro^.
33

34

^3’ 4>

5, 6,
8.12
3, 4,
5, 6, 8.9

35

45,6,
8.12

d^eA 25 ddr HIV + dortzd 2 ddrd kod. z^odo ddrdod ART odOcro^.
CO
Q
djadco d^A^, ^ds? dedd<g zjd^add esAd. esd^d zodoadd ^odoadd:.
tsdOod edjaeA ^eod,^ zooScsa^.

d/aeA 42 ddr HIV + dortdx ^d ddrdod ART od€>cro^.
duadc^<~>
r-i
Q
d^ASz. 2 <BoA<od ydy sezj zodoaod^d^d. 3srt
dpdara djadoapy?.
yd&od SdpA^dd ziOodroA eddD&atfe^rbao. ^dz diaodd erootd
djodz^dod: dja^a. edpod esdjaer^. 3?od^ zood^d.

dJaeA 40 ddr HIV + dortzd d4T-3TC-EFV 8 3oA«?od ^ddd&asdtos?.
v_c a
?5d^d TB dSs ddodaaroAde ^dda, &3a djadoac&y&. ART dacb drodcjart
odapjdf d&oddrt#d£e.
^dadodacdasa. eddja 5^d Sortsd dd
djaodd <g&. aaeaA^o z^o<ddo-Bdd). cro3,od<2 eraooda.Bsb.. tsd^d ^d daad.
PjedcaccaSa. iradcSjafAssad^e. e»d«?n £d dcaaAd. tsd&od $s aadraa^A
esdraeA^ ^fod.5, zaoduja^.

203

5e3c Sei stooc&wdarf
ztoaio

GO 23^

233 r*
______ fe

36

37

3, 4,

Carrico

z5csc>ae3.

2 eoAs? koti ART (AZT-3TC-

dJacA 35 £ar. rtoc^ HIV +2

5, 6,
8.12

NVP)
ART stcb
l/a^Ara 7Jo^jaf2iSTOc03^. sSjado
sjadd<g
fS^3dsoja^cto^). Xod^rd^ zood sadra
eoiro^srordadodo^, t5dFi) 23«z3^faoQdfEo ^ocd exada Iraoacro^o^ z^ocd sroddod dcrrort^dodo^.

3, 4,
5, 6, 8.9

d/aeA 39 ddr dodTd. HIV + ART sadodsaQ 6 3odwo^dd. djada
diaoddrteo. djad£Aod dsd ddsah^ ts^adado^. esdd ^Bdozo j^dtf
oikradjae^dgoadod.
dads djad 5 ddraroo^dod. d^d deidod
docdn ART ^(g^^Adadod. draeA sadja ART dgd^dade «aoda ^e^dda.
oadra tsddfn dda,Arffdoda e^da^dcdaod.
________________________________ Q_______________________°<
_B
___________________________________________________

38

39

5, 6, 8.9

djaeA 41 ddr HIV + ART dado dsaa 4 eodyaccoda. djadco cdsadjdf sped
3&;&ddOe. daeo^ 3odV dodd 2 zaad dddsaA d^d^o.
zoodda Sdd
ddda&aoda dja?/dea.

3, 4.

djaeA 22 ddr dadoA HIV + ART ^oda ddrdod. ART dada dadad

5, 6, 8.9

djadco dVAd
sadra dada saao^ad
daoAd sadra. &dd^a tsdsri AIDS eAd
VO —D
Q

3> 4'

iaoda

daasad^jastoddod

ART

dada

daadd

dae£)£)od

esdtf

ydjaert

daqrob^dodod, yds? d/aS za ds? zfekAcjodod. ed ds A yds?da, daacd AIDS
eAc ^oda ^as?sadod. dedaaoda sacoadc^aod yds?a_ dda zaodc3as?od. rtodda
yds?da4 dadadodaAadcdoda df^uaadod. yds?d HIV + ^aoda dsA 3s?ccadod

yds?ri daozaa deddaaaAd. dad dad HIV aaoda ^cs?ea ydsPrt dcdddod
yddod z^iSri XdodaA zadaddSe;.

40

3, 4.
5, 6,
8.9,
A cute
Care

daacA 37 ddr. HIV + dodda Ss?d dods?ad^od ^sacoad dacAds?a.
ydsPAert
Q
AIDS za^d Xdojagdoiaod z^edz^addod zads? df^d daaodcaas?. sada dda
zsddcdoda ^zldaddsPa.
sadra
yds? ui G) _rzads? ^tanaAda.
yds?<$ de
W -o Q
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co
aS
dadsdcdodaAd. ydddraadadod z^oda Sdd zad€)ddcsaAd. eds?o ds
Sd^rt^od vadoJaacd^e caoda dodcaas?. y^ds?da, ddodaA ddda^aasPa^de.
Gdassad ydaaeA ?raodr^drdM aoas daadzsaodod yd sadre ydd ydaaed.
sacdF^dFda daaddsPda^ aar^XcaaA. ydda des/deja.
daadAs?a yasPCad”
doda.

204

ANNEXE D:

206

Sebert ART oi^aeo.
eo o>

Stavudine

d4T-3TC-NVP__________
Lamivudine nevirapine

i
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iJ Vol/,,
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d^^dd. zodoaoddzjadcd.

dd 1-14

15 ad - do3d

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dd&&>eJ

ztert d4T-3TC-NVP

ds?d

(jjoo±d£ drod)

dooic^ d^a,

dod dTT dddd

dod d4T-3TC-NVP

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ded)
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208

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(dooiotf dJD^)
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214
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