The goal of the HIV care and treatment programme in Kenya is to provide a continuum of holistic care that meets the needs of those infected with or affected by HIV and AIDS. This includes not only physical but also social, psychological, emotional and spiritual care.
At present, over 213,000 Kenyans are being treated with antiretroviral therapy (ART), and thousands of others are waiting to start treatment. Policy guidelines are aimed at making ART accessible to all who can benefit from such treatment. Only those with advanced HIV infection and low CD4 counts, which measure immune function, are appropriate for treatment. A person with HIV infection may not need ART for many years; other treatment, however, may be useful to prevent or treat other opportunistic infection.
This complex situation of poverty and destitution causes apprehension among investors, aggravates poverty and increases the risk of HIV being transmitted among the young people concerned.
In the health sector major challenges remain: to provide the more intensive services required by HIV care and treatment throughout the country, to integrate these services into existing programmes, and to attain high levels of quality care, accountability and reporting. All this must be achieved with a limited workforce of health workers, who must acquire new knowledge and skills to deliver the new and more intensive level of services. Nurses, clinical officers and doctors require new knowledge of complex drugs and treatment regimens; they must gain new skills to assess patients clinically and to explain complex treatment. Laboratories must provide new services to monitor HIV treatment.
Care for people living with HIV/AIDS must be comprehensive and continuous and
not simply restricted to treatment. Care focuses on the patient and provides the
patient with not only physical but also social, psychological, emotional and spiritual care. Such comprehensive care
- encourages disclosure of status, thus helping prevent ongoing transmission
- promotes positive living
- promotes good nutrition and encourages living a healthy lifestyle
- manages opportunistic and sexually transmitted infections medically
- provides treatment with antiretroviral therapy
- provides home-based care and end-of-life support
The most important entry point into this continuum of care is HIV testing and knowing one's HIV status. This testing and counselling is now available through VCT centres, pregnancy care (PMCT), and diagnostic testing and counselling in TB clinics as well as out- and inpatient departments.
A well-organized and properly focused treatment programme can go a long way towards keeping HIV-positive people healthy by using preventive therapies along with nutritional counselling and food supplements.
