Empowering People Living with HIV/AIDS. World AIDS Day mesage

[Guest guest]

Empowering People Living with HIV/AIDS

December 1 is here again. There will be many functions to mark this World AIDS

Day in 2009. The focus in HIV/AIDS care and support has centred on making

medical treatments especially ART available for PLHAs besides other areas of

prevention and care and support.

Even as we have been working towards increased access to ART, there is a subtle

paradigm shift taking place among PLHAs. Project based experience is beginning

to show that what PLHAs need is empowerment to help them manage their own

situations. Based on community based care and support of PLHAs, there are five

areas that are beginning to emerge as necessary for empowerment to take place.

We have known all these areas for a number of years and have promoted them.

However when these interventions are promoted in a comprehensive manner in each

PLHA there appears to be a synergistic effect much beyond just a cumulative

effect. The areas are:

1. Reduce stigma both self stigma and from outside so that the PLHAs are

accepted by their families and the community they live in.

2. This helps them to have the necessary food and nutrition from their own homes

even though it may not be the best quality food.

3. Shelter and food helps them to live a positive life which can be further

enhanced by counselling and psycho social support activities provided by NGOs

and the government.

4. With the above three areas taken care of some PLHAs will need no further

support. Some others will need support with OI management and treatment

including chaemo prophylaxis.

5. In addition if PLHAs can be linked up with an appropriate livelihood

activity, this is the final act in PLHA empowerment

From the observations from the field setting in Tamilnadu, there are a number of

PLHAs in Tamilnadu living with three or more of the four above interventions for

a number of years without starting ART.

With the above interventions it is possible to set a goal of delaying ART

initiation as long as possible till clearly indicated clinically for each PLHA.

Before it can be generalised into broader policies for HIV/AIDS care and support

there is a need for institutions with resource base to carry out community based

research with different research designs to measure the level of impact of each

of the above four interventions.

With clear research data in hand it should be possible alternate strategies to

empower PLHAs.

In the coming year let us make efforts to empower the PLHAs in a comprehensive

manner so that they can take care of themselves and live long with or without

ART.

Rajaratnam Abel

Public Health Consultant

e-mail: abel_rajaratnam@...