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Posted: November 26th, 2023
A Holistic Approach to Paediatric HIV/AIDS
HIV is a complex disease that affects different aspects of a child's life, such as physical, emotional, social, and economic well-being. To achieve the best outcomes for children living with HIV, they need a holistic approach to care that addresses their clinical and non-clinical needs. A holistic approach to paediatric HIV care involves providing antiretroviral therapy (ART) and basic health care, as well as supporting the child's development, education, nutrition, psychosocial support, and protection from stigma and discrimination. This blog post will explore the benefits and challenges of implementing a holistic approach to paediatric HIV care, based on evidence from recent studies and reports.
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Benefits of a Holistic Approach to Paediatric HIV Care
A holistic approach to paediatric HIV care can improve the quality of life and health outcomes of children living with HIV in several ways. Some of the benefits are:
- Improved retention in care and adherence to ART: Retention in care and adherence to ART are critical for achieving viral suppression, preventing drug resistance, reducing morbidity and mortality, and preventing onward transmission of HIV. However, many factors can affect the ability of children and their caregivers to access and adhere to HIV services, such as poverty, food insecurity, stigma, discrimination, violence, mental health issues, lack of social support, and poor quality of services. A holistic approach to paediatric HIV care can address these barriers by providing case management, social protection, psychosocial support, nutritional support, and linkages to other services that can enhance the child's well-being and motivation to stay in care and adhere to ART [2] [3].
- Enhanced growth and development: Children living with HIV are at risk of poor growth and development due to the direct effects of HIV infection, malnutrition, opportunistic infections, chronic inflammation, and neurocognitive impairment. A holistic approach to paediatric HIV care can promote the child's growth and development by providing optimal ART regimens that are effective, safe, tolerable, and age-appropriate; nutritional assessment and supplementation; immunization; prevention and treatment of common childhood illnesses; early childhood development interventions; stimulation and learning opportunities; and family strengthening programmes [4] [5].
- Reduced stigma and discrimination: Stigma and discrimination are major challenges for children living with HIV, as they can affect their self-esteem, mental health, social relationships, education, and access to health care. A holistic approach to paediatric HIV care can reduce stigma and discrimination by providing counselling and education for children and their caregivers; creating supportive environments in health facilities, schools, and communities; engaging children and adolescents as peer educators and advocates; and challenging negative attitudes and behaviours towards people living with HIV [4] [5].
Challenges of Implementing a Holistic Approach to Paediatric HIV Care
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Despite the benefits of a holistic approach to paediatric HIV care, there are also some challenges that need to be addressed for its successful implementation. Some of the challenges are:
- Limited resources: Implementing a holistic approach to paediatric HIV care requires adequate human, financial, technical, and logistical resources that may not be available in many resource-limited settings. For example, there may be a shortage of trained health workers who can provide comprehensive services for children living with HIV; a lack of funding for essential drugs, diagnostics, equipment, supplies,
and transport; a scarcity of data systems that can monitor and evaluate the quality and impact of services; and a weak coordination among different sectors and stakeholders that are involved in delivering holistic care [4] [5].
- Low demand: Despite the availability of services, many children living with HIV and their caregivers may not access or utilize them due to various demand-side factors. For example, there may be a low awareness or knowledge of the benefits of holistic care; a lack of trust or satisfaction with the quality of services; a fear of stigma or discrimination; a preference for traditional or alternative healing methods; or competing priorities or opportunity costs that prevent them from seeking or adhering to care [4] [5].
- Contextual factors: Implementing a holistic approach to paediatric HIV care also requires taking into account the contextual factors that may influence its feasibility and acceptability. For example, there may be cultural or religious beliefs or practices that affect the perception or uptake of certain services; legal or policy barriers that limit the access or rights of children living with HIV; political or economic instability that disrupts the delivery or continuity of services; or environmental or climatic factors that pose additional risks or challenges for children living with HIV [4] [5].
Conclusion
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A holistic approach to paediatric HIV care is a promising methodology that can improve the health and well-being of children living with HIV. However, it also faces some challenges that need to be overcome for its effective implementation. To achieve this goal, there is a need for more evidence, advocacy, innovation, collaboration, and integration among all stakeholders who are involved in providing holistic care for children living with HIV.
Works Cited
[1] UNAIDS. "Start Free, Stay Free, AIDS Free: A Super-Fast-Track Framework for Ending AIDS among Children, Adolescents and Young Women by 2020." Geneva: UNAIDS, 2016. Web. 26 Nov. 2023.
[2] Chinyandura, Cathrine, et al. "Supporting Retention in HIV Care through a Holistic, Patient-Centred Approach: A Qualitative Evaluation." BMC Psychology 10.17 (2022): n. pag. Web. 26 Nov. 2023.
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[3] Editorial. "Children Affected by HIV Need a Holistic Approach to Care." The Lancet HIV 5.12 (2018): e667-e668. Web. 26 Nov. 2023.
[4] World Health Organization. "Guidelines on HIV Self-Testing and Partner Notification: Supplement to Consolidated Guidelines on HIV Testing Services." Geneva: World Health Organization, 2016. Web. 26 Nov. 2023.
[5] Elizabeth Glaser Pediatric AIDS Foundation. "Pediatric HIV Treatment Optimization." Washington, DC: Elizabeth Glaser Pediatric AIDS Foundation, n.d. Web. 26 Nov. 2023.
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