saworkshop pp addressing uebel

Information about saworkshop pp addressing uebel

Published on January 7, 2008

Author: Dixon

Source: authorstream.com

Content

Providing HIV care for Health Workers:  Providing HIV care for Health Workers Dr Kerry Uebel McCord Hospital Durban 7th October2006 Outline:  Outline The HIV crisis amongst HCWs in SA Staff HIV care at McCord Hospital The challenges The crisis without:  The crisis without Over whelming numbers of critically ill young people dying of AIDS in wards Critical staff shortages Struggling health systems Lack of political leadership BURNOUT The crisis within:  The crisis within HIV prevalence in HCWs in KZN 17% 2001 Death rates in SA women in 20s and 30s has more than tripled 1997-2004 Stigma FEAR, DENIAL and HOPELESSNESS Accessing HIV care for HCWs:  Accessing HIV care for HCWs Burnout Fear denial and hopelessness PLUS Lack of confidentiality Huge barriers to HCWs accessing HIV care for themselves Accessing HIV care for HCWs :  Accessing HIV care for HCWs Urgent necessity Specific planning and provision AIDs care in the community will fail without an HIV Care programme for HCWs McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care 180 bed community hospital Government subsidised 540 staff members (~170 pupil nurses) Large HIV clinic (~2000 on HAART) McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care Assumed prevalence 20% ~110 HIV positive staff ~80 aware of status & CD4 (ideal conditions) ~25-30 CD4 <200 at any time needing ARVs. This group will develop AIDS, be unable to work for some months and die if not treated in 6-18 mths(5% of workforce) McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care Located in staff clinic General practice On site Free (No hospital medical aid) Acute and Chronic care TB care HAART was added to the scope of practice in Nov 2001 McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care Confidential NOT an HIV clinic All HIV related bloods are coded All HIV related bloods are taken by doctor Pre and post test counselling by doctor HIV and CD4 results are not kept in file ARV adherence counselling by doctor during consultations (flexible and convenient) McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care Comprehensive TB and HIV meds at one clinic Normalises HIV care (like Diabetic and Hypertensive Meds) One stop care Already have relationship with doctor Don’t have to join the ARV queue Don’t have to take time off work to access care McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care VCT PRE 2002 6-11 per year 2002 38 tested 2004 56 tested 2005 118 tested McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care 45 staff members ever started 8 left the hospital 7 deaths on ARVs 6 with known adherence problems 1 stopped therapy at 3mths voluntarily 4 PMTCT only 25 currently on ARVs 1 staff child 3 years 1 currently on PMTCT McCord Hospital Staff HIV care:  McCord Hospital Staff HIV care 7 Deaths on ARVs 2 presented too late (CD4<20 & both very ill with TB) 2 defaulted (1 seizure, 1 Dissem TB) 1 multiple pulmonary emboli 1 NRTI associated lactic acidosis 1 MDR TB Challenges:  Challenges TB and HIV Stigma External stigma Internal stigma Lack of information Absenteeism Mortality Programmatic TB and HIV:  TB and HIV TB incidence in HCWs at McCord ~2,600 per 100,000 per year 3 times the rate in KZN at present ~ 20 of those needing HAART also had TB Management of TB and HIV is complicated and should be handled by one experienced physician TB prophylaxis important External stigma:  External stigma Usually seen as disadvantage of in-house HIV programmes BUT an in-house programme can be a positive means of breaking down the gossip fear and silence Colleagues are seen to get better and everyone knows where to go if they or their friends are sick Internal stigma:  Internal stigma A “paralysing dread of confronting HIV..(that results in)…inaction, postponement, delay, denial and death” Edwin Cameron May 2005 Normalise this disease Remove the barriers Combating stigma:  Combating stigma Raise awareness of stigma and disclosure issues Involvement of PLWAs (including HCWLWAs!) in talking with staff What barriers?:  What barriers? Insisting on pretest counselling with HIV counsellors “the diagnosis ..is treated as exceptional, and is hedged around with fuss, palaver and hullabaloo” Insisting staff be referred to other hospitals because of confidentiality Insisting staff follow strict protocols on adherence modules Refusing to let VCT be done with codes What barriers?:  What barriers? Breaking up care between different clinics Staff clinic, HIV counsellor, ARV clinic, TB clinic Information:  Information Study by Wits Health consortium underway No reports of any other programmes to address HIV in HCWs Thanks:  Thanks The staff at McCord Hospital What a priviledge to work amongst you all!

Related presentations


Other presentations created by Dixon

Types of Flower Shop
06. 11. 2007
0 views

Types of Flower Shop

ALCATELe salud
30. 11. 2007
0 views

ALCATELe salud

Upanishads
06. 12. 2007
0 views

Upanishads

Teaching World History
25. 10. 2007
0 views

Teaching World History

400 Silent Years
30. 10. 2007
0 views

400 Silent Years

invasion2
31. 10. 2007
0 views

invasion2

2004 06 09 clavell constipation
31. 10. 2007
0 views

2004 06 09 clavell constipation

PresentazioneSofia20 05
01. 11. 2007
0 views

PresentazioneSofia20 05

Ch09
02. 11. 2007
0 views

Ch09

EEA Workshop Buhaug IMO index
06. 11. 2007
0 views

EEA Workshop Buhaug IMO index

reynolds
07. 11. 2007
0 views

reynolds

Week5
15. 11. 2007
0 views

Week5

The best of two worlds
16. 11. 2007
0 views

The best of two worlds

iso e
23. 11. 2007
0 views

iso e

pollination
17. 12. 2007
0 views

pollination

savannas
26. 11. 2007
0 views

savannas

discourse
12. 12. 2007
0 views

discourse

S4 03Dwaine Clarke
25. 12. 2007
0 views

S4 03Dwaine Clarke

Field Forage
28. 12. 2007
0 views

Field Forage

Ethics Principles May 2003 1
29. 12. 2007
0 views

Ethics Principles May 2003 1

Alan Turing is Da Bombe
02. 01. 2008
0 views

Alan Turing is Da Bombe

Chalut1
03. 01. 2008
0 views

Chalut1

Search and Rescue
03. 01. 2008
0 views

Search and Rescue

StigmaLeipzigAtt
04. 01. 2008
0 views

StigmaLeipzigAtt

file 10684
07. 01. 2008
0 views

file 10684

Laborin Mario
15. 11. 2007
0 views

Laborin Mario

una madre unica 21186
01. 10. 2007
0 views

una madre unica 21186

PDSI
21. 11. 2007
0 views

PDSI

BerwickPPT1sp04
10. 12. 2007
0 views

BerwickPPT1sp04

FDIprezentace 2
14. 11. 2007
0 views

FDIprezentace 2

bisc Progress Review 17 june
03. 12. 2007
0 views

bisc Progress Review 17 june

Lecture12Handout
30. 12. 2007
0 views

Lecture12Handout

Beauty05 biglietti
30. 10. 2007
0 views

Beauty05 biglietti

ch14
20. 02. 2008
0 views

ch14

A4081
24. 02. 2008
0 views

A4081

ELECTRONICversion
27. 02. 2008
0 views

ELECTRONICversion

italie powerpoint 04 05
31. 10. 2007
0 views

italie powerpoint 04 05

lecture 11 travel writing
27. 03. 2008
0 views

lecture 11 travel writing

BP ICIW07
31. 10. 2007
0 views

BP ICIW07

GOLINI
29. 10. 2007
0 views

GOLINI

WAYS OF DIVIDING THE WORLD
24. 12. 2007
0 views

WAYS OF DIVIDING THE WORLD

twp
23. 12. 2007
0 views

twp

barrett
02. 01. 2008
0 views

barrett

SLAC 02022005 AMvdB
05. 12. 2007
0 views

SLAC 02022005 AMvdB

Navas 30
23. 11. 2007
0 views

Navas 30

InSeT
16. 11. 2007
0 views

InSeT

Intermediate Microsoft Word
12. 03. 2008
0 views

Intermediate Microsoft Word

shin
11. 12. 2007
0 views

shin

SESAMI Menichelli
29. 10. 2007
0 views

SESAMI Menichelli

Wireless Workshop Tyndall
28. 11. 2007
0 views

Wireless Workshop Tyndall