Adherence & Retention
Essential Prevention and Care Interventions for Adults and Adolescents living with HIV in resource-limited settings
This document is the result of an effort to review the evidence and develop recommendations for interventions to reduce illness associated with HIV infection and prevent HIV transmission.
The objective of these recommendations is to provide global, technical, evidence-based recommendations for prevention and care interventions, other than ART, for people living with HIV in resource-limited settings. They are primarily intended for managers of national and sub-national AIDS programmes and nongovernmental organizations that deliver HIV care services and for policy-makers involved in scaling up HIV prevention, care and treatment in settings with limited resources.
Table of Content
1. Background and rationale
> Involving people living with HIV
2. Objectives
> Target audience
3. Methods
> Strength and quality of the evidence
4. Recommendations
Psychosocial counselling and support :
> Comprehensive interventions
> Counselling and condoms
> Sero-discordant couples
> Sero-concordant couples
> Adherence interventions
> Mental health
Disclosure, partner notification and testing and counseling:
> Partner notification and disclosure
> Testing and counselling of partners and family members
Co-trimoxazole prophylaxis:
> Pregnant women and co-trimoxazole
Tuberculosis (TB):
> Counselling
> Screening for TB-disease
> TB-preventive therapy
Preventing fungal infections
Sexually transmitted and other reproductive tract infections:
> Screening, diagnosis and management of STIs and RTIs
> Genital herpes
> Screening for ongoing risk behaviours and STIs
> Screening for cervical cancer
Preventing malaria:
> Co-trimoxazole for malaria
> Insecticide-treated mosquito nets
> Prevention of malaria infection in pregnant women with HIV
Selected vaccine preventable diseases:
> Hepatitis-B vaccine
> Pneumococcal vaccine
> Infl uenza vaccine
> Yellow fever vaccine
Nutrition:
> Nutrition assessment
> Nutrition support and micronutrient supplements
> Nutrition support for pregnant women
Family planning:
> Family planning counselling and services
> Condoms and counselling
> Safe reproductive services
Preventing mother-to-child transmission of HIV:
> Pregnant women with indications for ART
> ARV prophylaxis for preventing HIV infection in infants
> Recommended ARV regimen for preventing MTCT among women in labour who have not received antenatal antiretroviral prophylaxis
> Infants born to HIV-infected women who did not receive antiretroviral drugs during pregnancy or labour
Needle-syringe programmes and opioid substitution therapy:
> Needle-syringe programmes
> Opioid substitution therapy
Water, sanitation and hygiene:
> Safe Water
> Sanitation
> Hygiene
5. References
6. Tables
Table 1. Interventions to prevent illness
Table 2. Interventions to prevent HIV transmission
Table 3. Medication indications, dosages, and contraindications
Table 4. Interventions for integrated HIV prevention, care, and treatment, by type of intervention and strength of recommendation
7. Appendices
A. Systematic review of evidence
B. Expert consultation, list of attendees
C. Clinical staging of HIV disease in adults and adolescents
D. Criteria for HIV-related clinical events in adults and adolescents
E. Guidelines and links
Attached resource:
