AEGiS-13IAC: Home based care in an HIV epicenter, northern Thailand: from difficulty to effectiveness of 7-years implementation.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Home based care in an HIV epicenter, northern Thailand: from difficulty to effectiveness of 7-years implementation.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB364)

Pinatatum U, Supawitkul B, Saeteo S
U. Pinatatum, Maechan Hospital, Maechan District, Chingrai 57110, Thailand, Tel.: +66 53 771 056, Fax: +66 53 660 831, E-mail: crpcmo@loxinfo.co.th

ISSUES: Home based care for people living with HIV/AIDS is a major component of holistic and continuum of care as well as to utilize hospital resources appropriately and efficiently. To establish the service is complex and need inter-sectoral cooperation.

DESCRIPTION: The explosive spread of HIV infection in Chiang Rai Province, northern Thailand, since 1989, caused severe impact to population health, mortality, economic, social, and health services. At the early phase, the medical care confined to hospitals. Consequently, due to the workload of unnecessary admission and the aim to providing holistic and continuum care to PWAs, the home based and community based care were initiated in 1992 in Mae Chan District Hospital. The initial phase faced with many constraints. The misunderstanding of HIV/AIDS of communities lead to discrimination and stigmatization, and caused the hiding of PWAs. The home care team often unintentionally frightened communities. The processes used to overcome the barriers were implemented education and other preventive campaign, followed by using pastors as the home visitors. Consequently, the home health team composed of health personnel and community leaders made home visits. Day care centers were established as a linkage between health services and communities, and were the places where health personnel, community members, and PWAs working together. For 7-years period, over 526 PWAs received the services, 13 day care centers were developed, and 11 groups of PWAs were formed with 487 members. Among the total 1,197 PWAs, there were 340 cases of PWAs deaths. The communities also supported and participated in community based care programs. The district now, was admired as the best practice in community based care program of the province.

CONCLUSIONS: Home based care service affects in decreasing of social discrimination and stigmatization for PWAs. The service is also the origin of community based AIDS program. In resource-limited setting, the day care center service is an alternative and supplement with enhancing in greater involvement of PWAs.

Keywords: AEGIS, HIV Infections, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Community Health Services, Home Care Services, Thailand, House Calls, Stereotyping, Health Services Needs and Demand, Prejudice
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TuOrB364