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ART

ART. WHAT IS ART?. ART stands for Anti Retroviral Therapy. This is the main type of treatment for HIV or AIDS. It is not a cure, but it can stop people from becoming ill for many years.

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ART

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  1. ART

  2. WHAT IS ART? • ART stands for Anti Retroviral Therapy. • This is the main type of treatment for HIV or AIDS. • It is not a cure, but it can stop people from becoming ill for many years. • Thus, ART can delay the progress of HIV, prolong the person’s lifespan and improve the overall quality of life.

  3. WHEN TO START ART? • The health care provider is the best person to determine at what stage an HIV + person should start on ART (depending upon the person’s clinical condition and CD4 count.

  4. ADHERENCE TO ART • It is very important that a person who is on ART adheres to the treatment! • If a person discontinues taking the drugs it can lead to resistance, making it necessary to start on stronger drugs and limiting future treatment options. • Counselling is important before starting on ART. Counsellors at the TI centres and at ICTC/ART centres are trained in how to counsel on ART.

  5. ART FOR IDUs

  6. ART FOR IDUs • IDUs are often excluded from ART services because of many misconceptions and also because of stigma they have to face. • As Outreach Workers one must be aware of the rights of IDUs to services such as ART. • Service providers have a lot of misconceptions: • They believe that IDUs are very poor when it comes to adhering to ART drugs. • They believe that IDUs need to be clean of drugs to start ART!

  7. MISCONCEPTIONS BUSTED • Worldwide studies have shown there is no difference in adherence levels between IDUs and non-IDUs when it comes to ART! • It is the level of satisfaction with the service provider that is a direct determinant of adherence. • Response to ART by IDUs is similar to response by non-IDUs. • Thus, all IDUs who are medically eligible for ART should receive care and treatment as per the national guidelines.

  8. CONCLUSION • Provided with adequate support and easy accessibility, IDUs can adhere to ART and have similar outcomes to those of HIV patients not using drugs!

  9. CO-MORBIDITY AMONG IDUs

  10. WHAT IS CO-MORBIDITY? • Presence of two or more conditions together in an individual (co-occurrence) • The conditions can occur simultaneously • One condition can precede another one • Co-occurrence of mental illness along with drug use problem is called as dual diagnosis

  11. CO-MORBIDITY AMONG DRUG USERS • Physical illness • Tuberculosis • HIV • Hepatitis B & C • Abscesses • COPD and other respiratory illness • Systemic infections • Mental Illness • Depression • Anxiety disorders • Schizophrenia and other psychotic disorders • Personality disorders

  12. Physical illness • Physical illness among IDUs is more common as compared to the general population • A Study from Chennai conducted in 2005 – 06 showed increased rates of physical illness (Solomon et al, 2008) • The same group also showed that mortality is more in comparison with the following causes: Overdose, AIDS, tuberculosis, accident (Solomon et al, 2009)

  13. PHYSICAL ILLNESS – REASONS • Three main factors for increased rates of physical illness • Drug use itself may lead to increased rates • E.g. smoking may lead to respiratory problems; nicotine and alcohol may lead to cancer; injecting may lead to abscesses, HIV, hepatitis • Individual may use drugs due to existing physical illness • E.g. person with pain condition may initiate drug use and then become ‘addicted’ to the drug • Some addictive drugs banned today were used earlier to treat physical illness • Both drug use and physical illness may be caused by overlapping factors leading to both illnesses • E.g. genetic factors, stress related factors • Drug use and TB may be caused by the individual living in poor socio-economic conditions

  14. MENTAL ILLNESS • Mental illness rates more common in Drug using population – dual diagnosis National Co-morbidity Study, USA

  15. MENTAL ILLNESS - REASONS • Reasons for increased rates of mental illness: • Drug use itself may cause mental illness • E.g. cannabis use for a long time seen to cause psychosis in some • Individuals suffering from mental illness may initiate drug use – self medication hypothesis • E.g. individuals suffering from schizophrenia increase tobacco/cigarette consumption to reverse the slowness in thinking due to their illness or due to the medicines used to treat schizophrenia • Both drug use and mental illness may be caused by the same underlying factors • E.g. genetic vulnerability, stress related factors, etc.

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