Recommendations from State level public hearing held at Trivandram, Kerala on treatment issues of Women living with HIV

[Guest guest]

Dear Members,

We are pleased to share with you some of the recommedations from the State

level Public hearing which was help on March 5th 2009 at Trivandram adressing

the concerns on Treatment Issues of women living with HIV/AIDS in Kerala.

The hearing was attended by 24 KPWN+ members representing the districts of

Kozhikode, Malappuram, Alapuzha, Eranakulam and Thiruvananthapuram. The other 21

representatives were from State Commission for Women, Retired Chief Judicial

Magistrate, KSACS (Kerala AIDS Control Society), Kudumbashree, Counsellors,

social work students and professionals.

Kerala Positive women Network (KPWN+) is an exclusive state network of women

living with HIV that represents issues affecting women and children across the

state. It is a community based, non-profit organization of women living with

HIV/ AIDS which was formed in 2006 by twelve people living with HIV in Kerala.

In order to generate a response from the Kerala Government to end the unhealthy

trend, the Kerala Positive Women’s Network (KPWN+) organized a State level

Public Hearing to address the ‘Current gaps in the existing health systems and

health care discrimination against Women Living with

HIV/AIDS and facilitate a positive response towards the issue’.

After various round of discussionsand presentaion of individual cases the

following recommendations were made.

1. Counselling and testing issues

Ø KSACS should ensure that pre and post-test counseling is carried out

at ICTC centers as per the guidelines laid down by NACO.

Ø ART centers should also have female counselors with quality time in

providing treatment and counseling.

Ø Government has to take necessary steps to improve the quality of

counselling provided by counselors as well as doctors. WLH/A need to be provided

comprehensive counselling on safe sex practices, contraception and reproductive

health issues, as well as on nature of treatment, side effects, treatment

adherence, management of infections, diet and other related issues.

Ø In particular, WLHA need to be informed about Vasectomy and Family Planning

facilities, hence to avoid unnecessary abortions.

Ø Health personnel should receive suitable training for such

comprehensive and patient-centred counselling.

Ø Husbands should be provided with counselling on condom use, and the

responsibility for informing and persuading husbands for safe sex should not be

left to the women.

Ø WLHA may be appointed as peer counsellors for HIV counselling to help provide

need-based and empathetic counselling

Ø Government should ensure that HIV testing takes place in the early

stages of pregnancy so that those desiring to terminate their pregnancy can do

so within the legally permissible time of gestation.

2. Treatment issues

Ø Many WLHA are not able to access treatment in government hospitals

because of the absence of female doctors at STD clinics and ART centers.

Suitable steps may be taken to redress this situation.

Ø At times, female doctors are available on specific days but WLHA do

not know about this. An effort should be made to inform WLHA on the days of

availability of female doctors at government hospitals.

Ø All Medical College and Government Hospitals should have a Neurologist either

on staff or as consultants available on specific days, because many WLHA have

neurological disorders after taking ARV.

Ø Medical and nursing colleges should include training on HIV and

stigma-free approaches, and there should also be in-service training for all

staff of health facilities to ensure a stigma-free environment.

Ø Government should pass an order against stigmatizing and

discriminating WLHA in health facilities. Stern action should be taken

against those who violate this order.

Ø Confidentiality of test results is an important right that is

guaranteed as per normal procedure ensures. However, it is not uncommon for the

WLH/A HIV status to be publicly displayed in medical prescription sheets leading

to isolation of the individual and at times, even violence. And so Government

ensures that the Confidentiality of the Women should not break at any cost at

any time.

Ø There should be privacy in Link Centers, since women hesitate to

visit link center to collect medicines.

Ø The side effects of ARV Drugs are not treated properly for women and

children. Health departments needs to address side effects experienced by WLH/A

and help cope with these, and also provide medicines for opportunistic

infections.

Ø At present, children are given the same ARV drugs as adults and

mothers are asked to break the tablets and give the appropriate dosage for

children. Children should get pediatric doses or syrups.

Ø At present, only BPL persons get free services in government health

facilities. But much of the tests and drugs are not affordable to many WLHA and

children. Government should bring an order saying that, APL card holders can

also avail free testing facility related to HIV Treatment at General Hospitals

and Medical College Hospitals.

Ø Health Department should ensure that all the CD4 machines at Government and

Medical College Hospitals are in working order.

Ø Government should ensure that the IInd line ARV drugs and certain

drugs like Fluconocole, Batrim D.S, Vitamin tablets and cough syrup should

available at any time in all Dist. Government hospitals and Medical College

Hospitals.

Ø Drugs given in ART centres are often changed, and different company’s products

(of the same composition) are given to WLH/A. WLH/A suffer varying side effects

as a result. Government should take necessary steps to not to change the

company.

Ø It would be desirable if doctors in ART centres are not frequently

changed but are posted in the same center for 2 years, so that WLHA can

establish rapport.

3. Support services

Ø We request KSACS to provide us with training on sexual and

reproductive health issues, treatment adherence and care as .WLH/A.

Ø Children may be provided with nutritional diets when on ART.

4. Other issues

Ø Government should take steps to protect PLHA/WLHA from spurious HIV

drugs provided by quacks, causing much harm to WLH/A.

Ø We request for separate Drop in centers for WLHA in all districts

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Kerala Positive Women Network (KPWN+)

50/ 2733, First Floor, Pulickal House,

Bank Road, Vyttila,

Cochin 19

Phone 0484- 2112068

Website: www.kpwnplus.org