Manage HIV earlier rather than later

South Africans are living longer, with life expectancy increasing from 56 years in 2009 to 60 years in 2011.

So said President Jacob Zuma in his 2013 State of the Nation Address. A big factor in the dramatic increase in national life expectancy is more effective management of HIV.

However, the President went on to warn that we cannot become complacent in the HIV battle. A critical weapon in effective HIV treatment is early management.

“Even if you feel healthy and have no opportunistic infections, if you are HIV positive, it is best to seek treatment and consult regularly with healthcare professionals who will help you maintain your state of wellness,” says Siraaj Adams, a pharmacist and Senior Manager for the HIV YourLife programme from Metropolitan Health.

Early management of HIV makes such a difference to health outcomes that Metropolitan Health has created to a confidential web tool to streamline the process for doctors enrolling patients on HIV programmes.

Patients wait until they’re ill

Adams explains that far too many individuals put off enrolling on HIV management programmes until they become seriously illness. By that stage, their CD4 count has dropped and their chances of responding well to antiretroviral treatment has decreased.

Adams says, “Even if the person does not require antiretroviral medication in the early stages, enrolment at the point-of-diagnosis offers the individual immediate access to the benefits of the programme, and CD4 count and viral load can be carefully monitored.”

A CD4 count test checks your number of CD4 cells. CD4 cells are the body’s fighter cells against infecting viruses or bacteria. The more CD4 cells you have to fight infection, the stronger your immune system. Viral load is another important test that checks the amount of virus in your body, and whether it is increasing or decreasing.

If you put off joining the programme until you start getting sick, your CD4 count will have decreased by the time you join and your chances of responding well to treatment will also have reduced. The best time to join an HIV management programme is as soon as you know you are HIV positive.

The role of a health care practitioner

The healthcare practitioner who delivers the HIV diagnoses has a critical role to play in educating the patient on the benefits of early enrolment and encouraging them to join an HIV management programme.

To streamline this process, Metropolitan Health developed a completely secure, confidential web tool that makes it quick and easy for doctors to enrol their patients on HIV management programmes as soon as they are diagnosed HIV positive. However, patient consent has to be provided before the process commences.

Results so far are most encouraging. According to Adams, “As a result of the web tool, the number of people joining the HIV management programme following their diagnosis has jumped from less than 30% to 80%. Baseline CD4 readings of those joining have also increased.”

However, before anyone can manage their HIV, they need to “test” to know their status. Unfortunately stigma and fear of discrimination remain strong deterrents for testing, particularly in the workplace.  Adams explains, “Whether you participate in HIV testing through a workplace-based programme, at a clinic or at your doctor’s rooms, the results will remain confidential.

Joining an HIV management programme

Should you join an HIV management programme funded by your medical scheme or employer, interaction between you and the independent healthcare professionals who run the programme is completely confidential.

Information on your status and anything you share will never be passed on to your employer, colleagues, family members or anyone else without your consent.”

Modern treatment for HIV and Aids means that living with HIV is the same as living with any other chronic disease such as diabetes or high blood pressure.

When HIV is closely managed, regularly checked and receives the right treatment, HIV-positive people live long, healthy, productive lives.  Adams encourages anyone who is HIV positive to join the relevant HIV management programme as soon as possible, and not to wait until they become ill.

(Press release, Metropolitan Health, February 2013)

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