HIV antiretroviral therapy in resource-limited settings: experiences from Haiti.
An unprecedented international effort to expand high activity antiretroviral therapy (HAART) to resource-poor nations has been launched. The World Health Organization (WHO) has created antiretroviral (ARV) treatment guidelines adapted to resource-poor settings. The first-line regimen is two nucleoside reverse transcriptase inhibitors (NsRTIs) and one nonnucleoside reverse transcriptase inhibitor (NNRTI). Therapy is initiated by clinical staging and CD4 T-cell counts when available. Adherence is the responsibility of health care workers. The use of ARV therapy in resource-poor settings faces several challenges, including the poverty of patients, political and social upheavals and violence, social stigma associated with HIV/AIDS, unreliable pharmacy systems, tuberculosis, and lack of trained health care workers. Using our experience in Haiti, we describe how we have addressed these challenges with the goal of increasing access to care for the poor with HIV/AIDS.
Krain
Alysa
A
Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, New York 10021, USA.
Fitzgerald
Daniel W
DW
D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D006205:Haiti; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D017410:Practice Guidelines as Topic; D014376:Tuberculosis / Q000150:complications
D044966:Anti-Retroviral Agents