Adaptation of a general primary care package for HIV-infected adults to an HIV centre setting in Gaborone, Botswana

Stephanie Davis, Premal Patel, Abid Sheikh, Gabriel Anabwani, Michael A. Tolle

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: As life expectancy of HIV-infected patients improves due to antiretroviral treatment (ART) and the importance of associated co-morbidities and chronic diseases increases, preventive care will become increasingly important. Adaptation of existing preventive guidelines to local environments will become a priority for HIV treatment programmes. Methods: Guidance from the World Health Organization, a focused evidenced-based literature review, Botswana national guidelines, Botswana-specific morbidity and mortality data and centre-specific data were used to adapt a published general primary care package for limited-resource areas to our centre's specific setting. Results: The preventive care package contains recommendations on tuberculosis prevention, malnutrition, depression, cervical and breast cancer, hepatitis B coinfection, cardiovascular risk factors, external injury prevention, domestic violence screening, tobacco and substance-abuse counselling, contraception and screening and treatment of sexually transmitted infections. Conclusion: This preventive care package addresses the comprehensive health needs of HIV-infected adults in the FMC in an evidence-based manner. The process of combining clinic-specific prevalence data, national guidelines, regional literature and assessment of public-sector resources to adapt an existing general package could be utilised to develop similar guidelines in other resource-limited locales.

Original languageEnglish (US)
Pages (from-to)328-343
Number of pages16
JournalTropical Medicine and International Health
Volume18
Issue number3
DOIs
StatePublished - Mar 1 2013
Externally publishedYes

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Keywords

  • Botswana
  • Human immunodeficiency virus
  • Local adaptation
  • Package of care services
  • Preventive care
  • Primary care

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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