This is a wonderful resource!
To add to this, I would encourage consideration of patient-centered kinds of approaches in the counseling or patient-provider discourse around ART adherence. I believe it is quite important to actively avoid developing a main focus around adherence support that is predominantly characterized by the dissemination of information about positive consequences of adherence and negative consequences of non-adherence. Clear, accurate understanding of the role of adherence is critical, but I think it would be prudent to be wary of creating environments where adherence is so emphasized that the possibility for candid discourse about non-adherence or potential difficulties gets overshadowed by the delivery of instructions to adhere and reiteration of negative consequences of non-adherence. I think everyone agrees that these factors are important to convey. I also think that person-centered or motivation-focused approaches are valuable here and these kinds of approaches would emphasize remaining strongly aware of there being perceived benefits of non-adherence and negative consequences of adherence in one's daily life from a patient perspective, and perhaps asking about those creates a more fertile opportunity to provide adherence support.
Thank you for sharing this resource. I look forward to hearing other people's opinions about the potential role of patient-centered discourse around ART adherence in settings preparing to or currently providing antiretroviral treatment.
K Rivet Amico, PhD
Center for Health, Intervention and Prevention
University of Connecticut
810 360 8716
800 518 0243 (fax)
Link leads to: http://j.mp/hjI5e4
Summary: Many countries have begun to decentralize HIV treatment to primary health care (PHC) centers to decrease the burden of providing HIV services at existing facilities while increasing access to treatment. The purpose of this technical brief is to assist national program planners, stakeholders, and implementers in designing, planning, and implementing the decentralization process and in providing ART services at PHC facilities, with the ultimate goal of achieving universal access to treatment and care in generalized HIV epidemic settings.
Source: John Snow, Inc. - JSI
Publication Date: September 1, 2010
Keywords: Adherence, ARV, decentralization, HIV treatment, Monitoring & Measurement, primary health care, Publications & Research, universal access