Topic outline
Topic 1
Introduction to HIV/AIDS
The HIV epidemic
HIV and the immune response to infection
What is HIV?
The human immune system
Lymphocytes and the immune response to infection
Lymph nodes
How does HIV disable the immune system?
HIV infects the CD4 lymphocytes
How does HIV damage our immune system?
The progression from HIV infection to AIDS
The natural course of HIV infection
Clinical staging of HIV disease and AIDS
Modes of transmission of HIV
Transmission through sexual relations
Transmission through blood contact
Transmission from mother to child
Myths about HIV transmission
Topic 2
Opportunistic Infections and WHO HIV Clinical Staging
What are opportunistic infections?
Why are opportunistic infections common in PLHIV?
WHO HIV clinical stages in adults and adolescents
Common opportunistic clinical manifestations in people with HIV
Persistent generalised lymphadenopathy (PGL)
Skin problems
Mouth, throat and oesophagus problems
Pulmonary tuberculosis (PTB)
HIV wasting syndrome
Opportunistic infections and provider-initiated counselling and testing
Prevention of opportunistic infections
Criteria for starting cotrimoxazole prophylaxis by adult PLHIV
Duration of cotrimoxazole prophylaxis for adult PLHIV
Side-effects of cotrimoxazole prophylaxis
Monitoring cotrimoxazole prophylaxis
Topic 3
Introduction to Antiretroviral Therapy
The difference between treatment and cure in HIV/AIDS
The benefits of ART
Antiretroviral drugs (ARVs) and antiretroviral therapy (ART)
Groups of ARV drugs
Why is the combination of three antiretroviral drugs necessary?
How are antiretroviral drugs combined?
ARV side-effects and how to manage them
Topic 4
Adherence to HIV Care and Treatment
What is adherence?
What is non-adherence?
The goal of adherence to ART
Why is drug resistance important for ART?
Why do people fail to take ARV drugs correctly?
What personal, family or community factors influence adherence?
How can healthcare providers affect patient adherence?
What other factors negatively affect adherence to ART?
Encouraging good adherence in patients on ART
What should you do before a patient starts ART?
What should you do after a patient starts ART?
Topic 5
Provider-Initiated HIV Testing and Counselling
The benefits of HIV testing
The barriers to HIV testing
Modes of delivering HIV counselling and testing
The five steps in PITC
Step 1:How to recommend HIV testing
Pre-test information and education on HIV/AIDS
How to assure confidentiality
How to obtain informed consent
Step 3:Obtaining a specimen for HIV testing
Step 4:How to perform a rapid HIV test
Performing an HIV test using the KHB rapid test kit
Performing an HIV test using the STAT-PAK rapid test kit
Performing an HIV test using the Uni-gold rapid test kit
Step 5:Delivering an HIV test result, post-test counselling, and referral for treatment
Delivering the result and post-test counselling when the result is HIV-positive
Delivering the result and post-test counselling for HIV-negative people
Topic 6
Prevention of HIV Infection, and Community Mobilisation
General principles for preventing HIV infection
Strategies for preventing sexual transmission of HIV
Strategies to prevent HIV transmission from contaminated blood
Community mobilisation for HIV prevention
What is community mobilisation?
Basic steps for community mobilisation
Community mobilisation strategies for HIV
Respecting cultural values in community mobilisation
Principles of community mobilisation to address HIV/AIDS
Community mobilisation activities for preventing HIV/AIDS
Topic 7
Universal Precautions, Infection Prevention and Post-Exposure Prophylaxis for Health Workers
Universal precautions
Why are universal precautions needed?
Specific universal precautions
The safe injection of patients
Preparing to give an injection
Avoiding needle-stick injuries
Recapping used needles
Post-exposure prophylaxis (PEP)
Immediate actions after occupational exposure to HIV
Referral after rape for post-exposure HIV prophylaxis
Topic 8
Prevention of Mother-to-Child Transmission of HIV
Transmission of HIV from mother to child
HIV testing and counselling for PMTCT
Approaches to HIV testing in antenatal care settings
Opt-in approach to HIV testing
Opt-out approach to HIV testing
Preferred ANC testing approach
Steps in the HIV testing process
General considerations
Single-dose Nevirapine, and other ARV options for PMTCT
Breastfeeding options for PMTCT
Four interventions for PMTCT in the community
Topic 9
HIV in Children
Critical issues in HIV infection and progression to AIDS in children
Minimising risk of infection in children
Early diagnosis of HIV
Differences in the management of children and adults with HIV
Providing care for HIV-exposed infants and HIV-infected children
Nutritional and psychosocial support for children with HIV
Nutritional needs of HIV-infected children
Providing psychosocial support to children infected with HIV
Topic 10
Positive Living and Prevention of HIV Transmission for PLHIV
What is positive living?
PLHIV and prevention of HIV transmission
Re-infection with HIV
Strategies to minimise HIV transmission
PLHIV should be informed about their health
PLHIV should take medication as prescribed
PLHIV should work as their energy allows, and avoid stress
PLHIV should maintain good nutrition
PLHIV should avoid getting infections
PLHIV should get regular exercise and rest
PLHIV should seek regular medical care
Topic 11
Providing Palliative Care for People Living with HIV
Palliative care and its significance in chronic illness
Symptom management, including pain management
Management of pain in PLHIV
How to manage other common symptoms of HIV/AIDS
Psychosocial and spiritual support
Support for the patient
Support for the caregivers
Home-based care
Support for oral hygiene
Preventing bedsores in bedridden patients
Moving a bedridden patient
Hygienic care of the body
Preventing stiff joints and muscles
End-of-life care
Preparing for death
A checklist for end-of-life care
Recognising signs of death
Bereavement counselling
Topic 12
Prevention and Control of Sexually Transmitted Infections
Introduction to sexually transmitted infections (STIs)
Transmission of STIs
Risk factors for STIs
Epidemiology of STIs
Presentation of common STIs
STIs caused by bacteria
STIs caused by viruses
STI caused by a protozoan
STI caused by a fungus
Syndromic management of STIs
Classification of patients into syndromes
Treatment and management of STI syndromes
Common complications of STIs
STIs and HIV
The link between STIs and HIV/AIDS
Which STIs facilitate the transmission of HIV?
Key issues regarding STIs and HIV infection