BMJ Study Looks at Providing Health Services for HIV-Positive People in Developing Nations

Universal access to comprehensive health services is needed in developing countries to effectively fight HIV/AIDS, and these services must include HIV prevention, testing and counseling programs; antiretroviral treatment; and diagnosis and treatment of opportunistic infections, according to a study published in the Oct. 26 issue of BMJ. Researchers from the University of Washington Center for AIDS and STDs and the MacColl Institute for Health Care Innovation analyzed research on HIV programs and other health services provided in developing nations. The study cites the World Health Organization strategy for chronic disease care as a model that could be followed in managing HIV infection in resource-poor settings, although the authors note that HIV is more complex and requires more expertise on the part of providers than many chronic conditions. Continuity of care in homes, communities and medical facilities is also important, the study states, adding that effective communication and referral services are needed to link primary care providers with HIV specialists. The study also recommends integrating HIV counseling and testing services into existing programs such as prenatal care and family planning programs. The study states that providing effective health services for HIV-positive people in developing nations could be based on a "building blocks" approach that combines elements of the WHO strategy with more customized services based on the resources and providers available in the area. Countries can begin by providing basic services and then provide additional services as resources increase, the study states. Implementing these strategies will require funding and political will, and the study concludes that a "policy environment in which all sectors of society play a part in addressing the AIDS epidemic is crucial for success" (Kitahata et al., BMJ, 10/26).