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   Last updated: 19.07.02
Summary
Access to HIV/AIDS-related treatment is a handbook that aims to build practical skills for NGOs, CBOs and PLHA groups responding to HIV/AIDS in developing countries. The handbook is a resource to help NGOs, CBOs and PLHA groups to improve the quality of their work on HIV/AIDS-related treatment.

The handbook is intended for use by organisations and trainers who support such groups. It can be used flexibly, with one or a group of NGOs, CBOs and PLHA groups. The handbook can be used in training workshops or as a resource on technical support visits.

The handbook has five chapters. These cover key definitions, concepts, assessment methods, planning steps, skills related to effective HIV/AIDS-related treatment work and keeping track of HIV/AIDS-related treatment work.

Access to HIV/AIDS-related treatment is based on the practical experiences and participatory approaches of the International HIV/AIDS Alliance.

1. What is the International HIV/AIDS Alliance?
The International HIV/AIDS Alliance is an international nongovernmental organisation that supports community action on HIV/AIDS in developing countries. The Alliance aims to:

  • Make a significant contribution to HIV prevention, care, and support to children affected by the epidemic, by working together with communities in developing countries.


  • Promote the sustainability and scaling-up of effective community AIDS efforts, by building the capacity of CBOs, NGOs and NGO support programmes.


  • Influence and improve the HIV/AIDS policies and programmes of international agencies, donors and the international NGO sector, with a particular emphasis on the role of community action.


2. What is this handbook?
This handbook aims to support NGOs, CBOs and PLHA groups in developing countries that are providing treatment to people with HIV or thinking of doing so. It is intended to help NGOs, CBOs and PLHA groups to find practical ways to understand, plan and undertake work on HIV/AIDS-related treatment.

This handbook is not about the clinical management aspects of HIV/AIDS-related treatment. The handbook addresses the wider issues around HIV-treatment and what NGOs, CBOs and PLHA groups will need to do if they become involved or want to become more involved. The International HIV/AIDS Alliance website and World Health Organisation website provide details of other publications for information on clinical management.

Access to HIV/AIDS-related treatment is one of a series of resources that are based on the practical experiences of the International HIV/AIDS Alliance. By distributing this handbook widely, the Alliance aims to:

  • Build practical skills among NGOs, CBOs and PLHA groups by using participatory activities and sharing experiences.

  • Provide a training resource for NGO support programmes, training organisations and individuals.

  • Continue learning about the HIV/AIDS-related treatment work of NGOs, CBOs and PLHA groups.


3. Why was this handbook developed?
The experience of the Alliance and its partners showed that many NGOs, CBOs and PLHA groups already involved in HIV/AIDS care, advocacy and prevention were being challenged to do something about improving access to treatment for people with HIV. Most of these groups, however, had limited experience and/or knowledge about treatment. Available resources proved difficult to adapt for small groups without medical expertise.

At the same time, the experiences of other NGOs, CBOs and PLHA groups that were already carrying out creative and effective work on HIV/AIDS-related treatment were often not documented. This meant that they were not making full use of the lessons learned, whether to improve the quality of their own work or to help others by sharing these lessons.

As a response, the Alliance has developed a handbook that is a collection of information, tools and lessons on a range of topics related to improving access to HIV-related treatment for people with HIV.

4. How was this handbook developed?
Alliance partners and others working on HIV/AIDS and essential drugs were extensively consulted through needs assessments in Zambia, India and Cote d'Ivoire before the handbook was drafted. When the handbook was available as a working document, it was field tested in a series of skills building workshops in Zambia, India and Cambodia. The handbook has been amended and adapted accordingly.

This handbook has been inspired by the ideas of many organisations in many countries and has directly benefited from their varied experiences. It has drawn on the work of groups providing HIV/AIDS care and support who have seen that access to treatment is a serious problem for people living with HIV in resource-poor settings. It has also drawn on the work of those who have worked for many years to improve access to essential drugs for all people living in resource-poor countries.

5. Who is this handbook for?
Access to HIV/AIDS-related treatment is for NGOs, CBOs, PLHA groups and the people and organisations that support NGOs, CBOs and PLHA groups responding to HIV/AIDS in developing countries. These include NGO support programmes, training institutions and individual trainers.

6. How can this handbook be used?
The handbook is designed to help NGOs, CBOs and PLHA groups to think through the various issues and the context of HIV/AIDS-related treatment before they make decisions about whether, and how, to get involved in practical work on treatment. The handbook can be used both as an information resource and as a training resource.

Using the handbook as a training resource may require a certain level of facilitation skills for guiding large group discussions or small group activities. However, they do not need extensive experience in HIV/AIDS-related treatment work. A practical resource on basic facilitation skills for participatory workshops accompanies the handbook.

Ideally, the material in the handbook is designed to be used in the order in which it is presented. This handbook may also be used in a more flexible way so that facilitators can tailor the work schedule to meet the needs of different NGOs, CBOs and PLHA groups. For example, some groups may want to have a training workshop in which they do most of the activities, while others may want to use a selection of activities over a period of time, or to focus on one or two activities to meet a specific, urgent need. An example of a workshop schedule is included at the end of this section.

For most of the handbook, facilitators can use the activities with either an individual NGO, CBO, and PLHA group or a group of NGOs, CBOs and PLHA groups. However, for Chapter 3, participants need to work with colleagues from their own organisation. This is because assessing treatment needs and resources and deciding what HIV/AIDS-related treatment work to undertake would be specific to each individual NGO/CBO and PLHA group.

This handbook can be used with NGOs, CBOs and PLHA groups with different levels of experience in HIV/AIDS-related treatment. It is particularly suitable for those that are new to this area of work.

7. What is in the Chapters of the handbook?
Following this Introduction, the handbook is divided into five chapters:

Chapter 1 First Questions to ask
  • definitions of care and support, treatment, availability of treatment, access to treatment

  • links between HIV/AIDS-related treatment and HIV prevention

  • factors affecting access to HIV/AIDS-related treatment

  • barriers to treatment access and opportunities to improve access to treatment


Chapter 2 Foundations of treatment
  • basics of effective treatment - helping relationship, knowledge, skills and attitudes

  • ethical approach to treatment

  • information about treatment

  • working with others - partnerships and advocacy to improve access to HIV/AIDS-related treatment


Chapter 3 Assessing needs and resources, and deciding what to do
  • assessing treatment needs and resources of people with HIV and the community

  • assessing what others are doing to respond to treatment needs

  • assessing your organisation's capacity to respond to treatment needs

  • making decisions about what to do


Chapter 4 Putting treatment into practice
  • resources for HIV/AIDS-related treatment work

  • drugs - names, information

  • choosing the right drugs

  • making the best use of drugs

  • getting drugs

  • managing drug supplies

  • donations

  • storing drugs

  • dispensing drugs


Chapter 5 Learning from and improving HIV/AIDS-related treatment work
  • keeping records

  • monitoring HIV/AIDS-related treatment work

  • evaluating HIV/AIDS-related treatment work

  • keeping track of change and responding to change

  • sharing lessons & experiences

  • scaling up, scaling down HIV/AIDS-related treatment work


The contents of each chapter aim for a balance between sharing technical information in a user-friendly way and providing practical tools to develop an understanding of technical information. At the end of each chapter, there is a list of additional resources that NGOs, CBOs and PLHA groups may find useful.

For the most part, the contents of Chapters 1 - 5 follow the format below:

Introductory text
- explaining the subject and the key issues involved. Information can be printed as handouts for participants.

Aim
- stating what the activity is designed to achieve.

Instructions
- outlining the steps to take to complete the activity and the key questions to consider.

Facilitators' notes
- sharing useful ideas about how to successfully guide participants through the activity.

Example
- an example of a completed activity is given to show how the activity has been used.

Facilitators can read through the Aim and Introductory text for each point and use the information as the basis for an initial group discussion. They can then work through the Instructions for the activity, using the Facilitators' Notes to avoid possible pitfalls. Finally, they can use the Example to clarify any points that are unclear.

It is important to note that although the ideas and activities in this handbook have been tried and tested by the International HIV/AIDS Alliance and its partners, they do not try to provide "perfect" examples of how things should be done. Therefore, the Instructions should not be followed "word for word" and should, instead, be adapted to participants' specific needs, skills and interests.

In addition, the Examples should be seen as just one way that the Activity could be put into action - as opposed to the 'perfect way.'

8. What materials are needed to use this handbook?
All of the activities in this handbook can be used with a small number of simple resources. These are:
  • Large sheets of blank paper

  • Small pieces of blank paper

  • Marker pens

  • Sticky tape, Blu-Tack or Sticky Stuff

  • Samples of drugs


Most of all, both facilitators and participants will need enthusiasm, energy and creativity!

Sample schedule
This is a sample schedule based on skills building workshops carried out by the International HIV/AIDS Alliance.

Each day was divided into four sessions, two in the morning, two in the afternoon. Session A was 1 hour 45 minutes, Sessions B, C and D were 1:30 each. Breaks were 45 minutes for lunch and otherwise 15 minutes between sessions.

Day 1
Session A:
* Registration
* Introductions
* Workshop outline and objectives
* Expectations and ground rules

Session B:
Defining treatment
* What is care and support? (1.1.A)
* What is treatment? (1.1.B)

Session C:
* Linking treatment with prevention (1.2)
* "Availability" and "accessibility" of treatment (1.3.A & 1.3.B)

Session D:
* Barriers and opportunities for access to treatment (1.3.B)

Day 2
Session A:
Re-cap
The foundations of treatment
  • The helping relationship (2.1.A)

  • Knowledge, skills and attitudes (2.1.B)


Session B:
* An ethical approach to treatment (2.1.C)


9. Want to know more?
International HIV/AIDS Alliance, www.aidsalliance.org or www.aidsmap.com
-a website about the International HIV/AIDS Alliance with many practical publications and helpful links to other useful websites

World Health Organisation, www.who.org
-a website about the World Health Organisation with many useful publications.

Joint United Nations Programme on HIV/AIDS, www.unaids.org
-a website about the Joint United Nations Programme on HIV/AIDS with many useful publications

Facilitators' Guide for Needs Assessments on Access to HIV/AIDS-Related Treatment - a resource to support the development of a practical toolkit for NGOs, CBOs and PLHA groups. International HIV/AIDS Alliance. 1998.
-assessment tools, questionnaires for assessing treatment needs of people with HIV

Needs Assessment Reports (Zambia, India, Cote d'Ivoire): development of a toolkit on access to HIV/AIDS-related treatment. International HIV/AIDS Alliance, November, 1999 - January 2000.
- reports of needs assessments on issues of HIV/AIDS-related treatment access; results of these visits formed the basis for the development of the Access to HIV/AIDS-Related Treatment Handbook

A Facilitators' Guide to Participatory Workshops with NGOs/CBOs Responding to HIV/AIDS. International HIV/AIDS Alliance, December 2001.

Source: Access to Treatment Handbook
This is an extract from Mobilising NGOs, CBOs and PLHA Groups for Improving Access to HIV/AIDS-related Treatment: A Handbook of Information, Tools and Other Resources , developed by the International HIV/AIDS Alliance with support from the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), published in this form in June 2002.

To view the whole publication follow this link.

To download this section, complete with graphics, in pdf format (which requires Adobe Acrobat software to read it) follow this link (file size 498 Kbytes).