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As soon as the Malawi government issued an authorisation to bring treatment into the country on May 31, 2001, the triple therapy programme for AIDS patients was set up. This programme was developed within the MSF AIDS project in Chiradzulu hospital-medication support, medical and paramedical team, materials, financing and reestablishment of a nutritional centre, and an anonymous, free testing centre.
A few HIV figures from Malawi
Some 800,000 are thought to have HIV/AIDS, of which 40,000 are children and 420,000 pregnant women. About 10% of the population is HIV-positive. (UNAIDS figures, end 1999)Triple therapy programme
Patient inclusion criteria:
- Medical criteria: CD4 count below 200
- Non-medical criteria: patients must live close enough to the hospital to be able to go once a week; each patient must be accompanied by a guardian, i.e. a person close to him/her who can accompany him/her throughout the treatment and who can be present at the weekly meetings at the hospital for the first eight weeks.
Intake per month: 20 people, or five patients a week.
- Anonymous free testing centre in the hospital
- AIDS consultation: as soon as a person has tested HIV-positive, a first meeting is organised. Consultations take place in the hospital and local health centres, and are managed my MSF doctors and Malawi medical personnel from the Ministry of Health.
- Counselling sessions are organised by HIV-positive patients, whether they receive ARV treatment or not. These include information on HIV/AIDS, opportunistic infections, treatment, prevention, condom use, lifestyle.
- Medication: for the first eight weeks, the patient comes to the hospital once a week to take the medication, accompanied by the guardian. They are asked about their physical state, side-effects, difficulties in taking the medication, etc.
- Home visits: a home visit takes place one week after the start of the treatment. It's a chance to see how the patient lives, to get to know his/her environment and see how (s)he is reacting to the treatment.
- Patient group: a group of HIV-positive patients came together a year ago
- PLA, People Living with AIDS. The group was started up by a counsellor named Angela, and brings together HIV-positive patients, some of whom are already receiving ARV treatment. They get together once a month and talk about their illness, quality of life, prevention. They also put on plays for prevention and information in local health centres. Some members of the association also distribute condoms in the villages.
At the end of September, 27 patients had benefited from triple-therapy.