06c ARV Treatment Guidelines (Community)

8/10/2019 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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06c ARV Treatment Guidelines (Community)

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