HIV/AIDS in resource-poor settings: comprehensive care across a continuum.
BACKGROUND
The scale of the HIV pandemic in many resource-poor settings (RPS) has overwhelmed the already impoverished health and social support systems.


OBJECTIVE
To propose a feasible and applicable model of care which can be used at district level in RPS faced with the prospect of caring for increasing numbers of persons living with HIV and AIDS (PWA) requiring care, and to outline some of the immediate challenges and directions for research.


METHODS
Using Zambia as a test case, a review of existing community and health institution-based care programmes and facilities was made, and opportunities missed in meeting the demands of PWA were identified.


RESULTS
Many opportunities have been missed both in encouraging PWA to enter the care continuum and in strengthening existing care services. An affordable and accessible model of care at district level that is not dependent on expensive drugs or medical interventions is suggested, using Zambia as an example. The model requires changes in the structure, function and HIV/AIDS care messages that are in line with new knowledge about the disease.


CONCLUSIONS
This model of cooperation and sharing between health and social public/private and voluntary systems can be developed over time at a district level within existing resources, even as the pattern of the epidemic alters and resources become more available and better managed.
Osborne
C M
CM
Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia.
D003153:Community Health Services / Q000639:trends; D015658:HIV Infections; D006801:Humans; D012959:Socioeconomic Factors; D015024:Zambia