Transcript Positive Living Counseling Modules for Group & One-to-One Sessions

Positive Living
Counseling Modules
for
Group & One-to-One Sessions
Positive Living Association of Liberia Inc.
August, 2009
1
Table of contents
What is HIV?...............................................................................3
What is AIDS?............................................................................18
What happens after I am newly diagnosed with HIV?...............23
What are some myths about HIV and AIDS?............................29
How to stay healthy with HIV?...................................................39
How do I take my HIV medicine?...............................................51
How to monitor your health?......................................................70
How to cope with stigmatization?...............................................79
How can I tell my family about my HIV status?..........................90
How can I live a healthy positive life?.........................................99
Can I have a baby if I am HIV positive?....................................116
How do I feed my baby when I am HIV positive?......................124
What is TB?................................................................................136
2
Module 1
What is HIV?
3
HIV
•
•
•
•
•
•
•
•
HIV means Human Immunodeficiency Virus.
HIV is a virus.
HIV is not AIDS. AIDS is the disease caused by HIV.
The virus attacks the body and makes it easy for you to
get sick.
When you are very sick, you may have AIDS.
If you take your medicines, the HIV will be reduced in the
body.
When the HIV is reduced, the symptoms of AIDS will go
away.
The HIV itself can be hidden so it does not bother you,
but will never go away completely.
4
HIV is a disease like diabetes
• The medicine for HIV cannot cure you.
• The medicine will help you to have a healthy and
long life.
• You must take the medicine for the rest of your
life.
• In this way, HIV is like diabetes or hypertension.
• People with those diseases cannot be cured.
• But if they take their medicines every day, they
can live a long healthy life.
5
6
How is HIV transmitted?
•
•
•
•
•
•
Direct contact with blood or body fluids
Unprotected sex (vaginal, oral and anal)
Pregnancy
Labor and delivery
Breastfeeding
Transfusion with contaminated blood (that’s why all
blood should be tested before transfusion)
THAT MEANS THAT ANYONE CAN GET HIV.
7
HIV does not spread by:
•
•
•
•
•
•
•
Light kissing
Sleeping in the same bed without sex
Mosquito bites
Shaking hands
Bathing together
Hugging
Riding in the same bus or car
8
Review:
9
10
11
12
13
How does HIV affect my body?
• Your body has soldiers called CD4 cells
which protect you from sickness.
• The soldiers cannot stop you from getting
sick. But they can help you get better
faster.
• Everyday the HIV virus grows slowly and
attacks these soldiers. Over time, the
soldiers become weaker and you stay sick
longer. This can take years.
14
How does HIV affect my health?
• As the virus continues to attack your
soldiers it begins to rule your body and
your soldiers work on the HIV’s
commands.
• Not taking your medicine correctly and
continuing to do unhealthy things will give
HIV the upper hand in your body.
15
Why is the HIV medicine
important?
• HIV medicine is called ARVs.
• It does not cure HIV. It helps your soldiers
stay strong so you can stay healthy.
• Once you start taking the medicine you
MUST take it for the rest of your life.
• The medicine must be taken as directed–
sometimes once each day, sometimes
twice each day.
16
Again: it is good to think of HIV the same
way you think of diabetes
• Diabetes (sugar sickness) is one of many
chronic diseases
• Others include high blood pressure,
cancer, kidney problems, heart problems
• All of these chronic diseases can be
treated-- but none of them can be cured
17
Module 2
What is AIDS?
18
19
HIV becomes AIDS
HIV is not AIDS, but it leads to AIDS if you:
1. Stop taking your medicine
2. Skip your medication, even once each
week
3. Do not properly take care of yourself, eat
well and monitor your health
20
AIDS can be prevented AND
treated
To prevent HIV from causing AIDS or to
treat the symptoms of AIDS:
• Take all medicine on time
• Attend all clinic appointments
• Eat good healthy foods
• Alert your nurse and physician of any new
symptoms or concerns
21
If I have AIDS
• It is important to:
– Take medicine on time and everyday
– Attend all clinic appointments at a health
facility
– Eat well
– Manage stress
– Maintain good hygiene
• If I do these things, over time the
symptoms of AIDS will go away.
22
Module 3
What happens after I am newly
diagnosed with HIV?
23
After testing positive
remember….
• You are not alone-- there are many other
HIV positive people in Liberia
• You can live a strong healthy life
• You need to take care of yourself by not
worrying and eating healthy foods
• You need to attend all clinic appointments
at a health facility
• You should take all medicine as
prescribed
24
Knowing your status is the first
step to improving your health.
• Being HIV positive is not a death sentence.
• If you know how to take care of yourself, you wil
know how to decrease the “stress” of knowing
your diagnosis
• Medicine is available free of charge to you.
• The drugs will not cure HIV but they will keep the
virus low in your body and keep you healthy and
strong.
25
HIV medicines might be needed
• Your doctor will decide which medicine
you will need to take.
• The medicine given to you may be
different from the medicine given to
another patient.
• Each patient is different and needs
different medicine, this is important
because you should not share your
medicine with anyone.
26
There are two different types of
medicines for people with HIV
•
Septrin or Dapsone
– taken once a day
– prevents infections like pneumonia and malaria from
catching you while your body is weak from the HIV
virus
•
ARVs –
– taken once or twice a day as prescribed
– used to reduce the amount of virus in your body
– when the amount of virus is reduced, the body can
defend itself from the infections
27
What comes next:
• You will be counseled about HIV and have
the opportunity to ask questions
• A doctor or nurse will examine you
• You will need to undergo some blood tests
• Based on your condition and your lab
results, your doctor or nurse will determine
what medicines you need
• Don’t worry, it will only make you sick
28
Module 4
What are some myths about HIV
and AIDS?
29
Myth #1
Myth: HIV or AIDS can be cured
Reality:
• There is treatment for HIV that relieves the
symptoms of AIDS.
• However, there is no cure for HIV. Even if you
take your medicines for many years, you will still
be infected. Think about HIV as a “chronic
disease” like diabetes or hypertension.
• There are no vaccines to prevent HIV infection.
30
Myth #2
Myth: HIV and AIDS are the same.
Reality:
• HIV and AIDS are NOT the same. HIV is a virus.
If the virus is allowed to grow in your body, you
will get a disease called AIDS.
• The symptoms of AIDS can be different in
different people. The symptoms might include
weakness, fever, rash or runny stomach.
• People with HIV who are diagnosed early and
take their medicine may not get these symptoms
or the disease called AIDS.
31
Myth #3
Myth: HIV and AIDS can be spread
causally by eating from the same bowl,
holding hands and lightly kissing.
Reality: HIV and AIDS are spread by
sexual contact, exposure to infected
blood thru blood transfusion or needle
stick, childbirth and breastfeeding
32
Myth #4
Myth: Bush medicine/traditional healers
can cure HIV.
Reality: ARVs are the only treatment for
HIV. Traditional healers cannot cure
HIV/AIDS.
33
Myth #5
Myth: You can stop taking your medicine
once you feel better.
Reality: Even when you start feeling
better, you must continue taking your
medicine on schedule and on time.
34
Myth #6
Myth: No matter how I take my medicine it
will still work.
Reality: If you do not take your medicine
as prescribed by your physician or nurse it
will not work the way it needs to work.
35
Myth #7
Myth: I would know if a loved one or I had
HIV.
Reality: A person with HIV may not show
any symptoms for up to 10 years. Since
HIV affects each person differently, many
people with HIV can look and feel healthy
for years. The only sure way to know is to
get tested.
36
Myth #8
Myth: My partner and I are both HIV
positive so we do not need to use
condoms during sexual activity.
Reality: Condoms should always be used
during sexual activity to prevent reinfection between positive couples.
37
Myth #9
Myth: You cannot have a baby if you are
HIV positive.
Reality: You can have a baby if you are
HIV positive but you must talk with your
physician or nurse.
38
Module 5
How to stay healthy with HIV?
39
How to Stay Healthy
1.
2.
3.
4.
5.
6.
Take your HIV medicine everyday and on time.
Go to all appointments at health facility.
Use safer sex behaviors.
Eat healthy foods.
Avoid alcohol and smoking
Prevent infections with good hygiene and
mosquito nets
7. Manage stress.
40
1. Take your HIV medicine
• Take medicine on time
• Some medicine is taken twice a day and some
are taken once a day
• Do not skip doses
• If you miss your medication time do not take
extra medication to make up for the dose you
missed
• Keep track of what time you are suppose to take
your medicine
• Keep all medicine protected
• Do not share medicine
41
2. Go to all appointments
• Your appointments are scheduled to be every
one or two months depending on what you and
your doctor decide
• Attend all appointments at health facility
• If you cannot come to an appointment please
call your nurse and let them know. The number
to call the nurse is on your yellow card.
• Tell your nurse and/or doctor about any new
problems, symptoms or questions you may have
42
3. Use safer sex behavior
• Safer sex is sexual activity with condom.
• Abstinence is the best way to prevent the sexual
transmission of an STD, including HIV.
• During all sexual activity:
– Always use a condom
– Stay faithful to your partner
– Limit the number of sexual partners
43
44
4. Eat healthy foods
Energy Food Body Building
Food
Cassava
Egg
Plantain
Milk
Rice
Fish
Cereal
Meat
Eddoes
Bonnie
Potato
Beans
Banana
Peanuts
Beenie seed
Protective
Food
Pawpaw
Watermelon
Pineapple
Okra
Orange
Plums
Potato greens
Cassava leaf
Eggplant
45
You need to eat foods from
every category to stay healthy
Liberian Dishes to Eat:
• Potato Greens
• Brown/Country Beans
• Cassava Leaf
• Okra Sauce
• Eggplant
• Bennie Seed
• Bonnie
46
5. Avoid alcohol and smoking
47
6. Prevent other illnesses:
hygiene and mosquito nets
•
•
•
•
•
Wash your hands
Drink clean or boiled water
Eat well cooked food
Wash fruits and vegetables
Use a mosquito net to prevent mosquito
bites
48
7. Stress Management
• Learning you have HIV and keeping track
of medication and appointments can be
stressful.
• It is important to turn to your family for
support.
• You can also get support from your peers,
counselors, nurses and doctor.
• Remember to eat well and get lots of rest
in order to manage your stress.
49
Tips to Staying Healthy
• Do not share needles, toothbrushes, razor
blades or any other sharp objects
• Cover all open cuts or sore
• Clean up any blood or body fluid
• Wash clothes with blood or body fluids
separately
• Throw away blood and body fluids safely
50
Module 6
HIV Medication:
How often do I take them?
What problems might I experience?
Why is it important to take the medicines everyday?
How should I store them?
51
Types of Medication
• Septrin or Dapsone
– taken once a day (morning or night)
• ARV
– There are several kinds of ARV medication
you could be given.
– ARVs should be taken as prescribed
– Depending on the age and weight of a child
they may take ½ a pill, 1 pill or 2 pills
52
For most patients:
ARV Medicine
1 pill 1
time per
day
53
Septrin or
Dapsone
2 pills or 1
pill a day
as
prescribed
54
There are two types of side effects
caused by HIV Medication
1. Allergic Reactions
2. Toxic Reactions
55
1. Allergic Reaction to ARV
Medication
• When taking ARVs some people will have
an allergic reaction to the medicine
• Allergic reactions happen when your body
cannot handle medicine and refuses it
• If this happens please alert your physician
because you can be given medicine to
treat the reactions
56
Signs and Symptoms of an Allergic
Reaction to an ARV
•
•
•
•
•
Difficulty Swallowing
Red Swollen Eyes
Difficulty Breathing
Rash on hands, chest and face
Swollen Tongue/ Sores on tongue
57
58
2. Other people may develop toxic
reactions to ARVs
• Signs and symptoms of toxic reactions can
be serious and require urgent attention.
• Or they can be minor and you can expect
them to go away with time.
• Tell your doctor if you begin to feel worse
rather than better when you start to take
the medicine
59
The most urgent of these side
effects are:
•
•
•
•
•
•
•
•
Blisters and Sores
Vomiting
Abdominal pain
Jaundice (when your eyes or skin turn yellow)
Rash
Fever
Severe weakness
Numbness/tingling of hands and feet
60
61
ARVs may also cause
minor/common problems
• Diarrhea
• Headache
• Itchy Skin
• Feeling Sick
• Feeling Tired
• Disturbed Sleep
These side effects should decrease as your
body gets use to the medicine.
BUT, if these problems continue please tell
your physician.
62
Talk to the Nurse or Doctor:
• Remember, to talk to your nurse and
doctor about any new problems happening
to you.
• If you are experiencing an allergic or toxic
reaction other medicine can be given to
you to help.
63
Importance of Medication
• The medicine you are given works to strengthen
your body’s CD4 cells which are your soldiers.
• When your soldiers are strong you stay healthy
and will get sick less often or for shorter periods
of time.
• Once you start taking this medicine you must
take it for the rest of life.
• If you stop taking your medicine the soldiers will
die and you will get sick again.
64
Taking Medicine when Healthy
• After three to six months of taking HIV medicine
you will feel better.
• As you continue to take your medicine on time
everyday you will become more and more
healthy.
• However, you must continue to take your
medicine even when you are healthy.
• If you stop you will get sick again and the
medicine may not work when you start again.
65
HIV can develop resistance to
the medicine if taken incorrectly
• Resistance means the HIV virus in your body
has changed.
• HIV virus in your body is not affected by the
medicine and continues to grow making your
condition worse.
• The HIV medicine will not work and the HIV virus
in your body will increase.
• To stop resistance you MUST take your
medicine on time everyday.
66
How to take HIV medicine
• ARV must be taken everyday as prescribed
either once a day or once in the morning and
once in the night
• When taking the medicine two times a day it only
works for 12 hours at a time.
• To make sure the medicine is always working it
must be taken at the same time in the morning
and in the evening.
• Some people put their medicine next to their
toothbrush to remind them to take it every
morning and night.
• What ways might you recommend to someone
else to help them remember?
67
Taking care of your medicine
• It is important you take care of your
medicine because it can spoil.
• Medicine should be dry and away from
rain and water.
• Keep your medicine in a bag for safety
and also carry only what you need to
remember to take the medicine on time, so
if medicine is lost or stolen you have more
at home.
68
69
Module 7
How to monitor your health?
70
See your physician or nurse
regularly
• Attend all clinic appointments at health
facility
• Call your nurse when you cannot attend
your appointment (the number is on your
yellow card) or if your medicine runs out
• Tell your physician or nurse about new
problems you are having
71
CD4 Count
• CD4 count is a test done to count the
number of soldiers in your body.
• This test tells how strong or weak your
immune system is.
• A normal CD4 count is 600-1200 but if you
have had HIV for a long time, your CD4
count might be lower.
72
What the CD4 count tells me:
• How well you are doing on the treatment
• When to start ARV treatment
– If you have a higher CD4 count the doctor
may not put you on ARV– the side effects of
the ARVs are not worth the benefit you will
gain
• Those of you with a low CD4 count should
definitely be started on ARV
• Once you start the ARV you will remain on
ARV for the rest of your life
73
Weight
• Each time you have a clinic appointment
your weight is taken
• This is done to measure how well you are
eating and how your body is responding to
the medicines
74
What does my weight tell me:
• If you are reducing:
– HIV is really attacking your body
– TB is high in body
– Not taking in enough food or the right food
(increased intake of food when taking
medication)
– Problem with the medicine
75
What does my weight tell me?
• If you are gaining weight:
– HIV medicine is working
– Taking in enough of the right food
– Your body is getting stronger
76
Signs and symptoms of when the
virus is high in your body
•
•
•
•
•
•
•
•
•
Recurrent or persistent fever
Recurrent or persistent weight loss
Persistent diarrhea (running stomach)
Persistent rash
Recurrent STIs
Recurrent oral thrust/sores
Difficulty breathing
Sores or discharge on genitals
Blister with burning sensation
77
78
Module 8
How to cope with Stigmatization?
79
What is Stigmatization?
• Stigmatization – being treated negatively
due to your HIV status and the lack of
knowledge by people around you or not
wanting to be around someone who is HIV
positive.
• Stigma can be experienced in your home,
community, workplace and/or school.
80
Types of Stigma
1. Stigma from Inside
• Stigma put on yourself when you
learn your status
2. Stigma from Outside
• Stigma from family, friends and
others because they have learned
your status and are not educated on
HIV and AIDS
81
Stigma from Inside
• Feeling your life is over because of
your status
• No longer wanting to improve your
life or keep yourself healthy
• Worrying about your status
82
Stigma from Outside
• Family and friends no longer want
to be around you
• Being labeled
• Being gossiped about
• Not being allowed to eat with others
• Being treated differently from others
83
Where can you experience
Stigma?
•
•
•
•
•
Home
Community
Workplace
School
Hospital
84
What to do when experiencing
stigmatization?
• Seek support from partner or close family
member
• Talk with a counselor
• Speak with your nurse or physician when
attending clinic appointments at health
facility
• Talk with friends
• Get in contact with a support group
• Attend support group meetings
85
86
How to cope with stigmatization
• Come together with other patients living
with HIV to lend support to each other
• Disclose your status with a close friend,
pastor or family member who can give you
support
• Attend all scheduled clinic appointments at
health facility to stay on medicine and stay
healthy
87
88
Knowledge
• Learning about HIV and AIDS is a way to
reduce stigma
• When you are well informed you can teach
others about your status and their need to
get tested
• Knowledge allows you to stay healthy and
protect your family
89
Module 9
How can I tell my family about my HIV
status?
How can I keep my partner healthy?
90
Why tell my partner my status?
• To keep both you and your partner healthy
• So your partner can get tested and know
their status.
– If he/she is positive, they can get the
treatment they need to stay healthy
– If he/she is negative, you will have someone
to give you support you need
91
Benefits of telling my partner my
status
• You and your partner can receive
counseling together
• You will not have to hide your status or
medication from your partner
• You can work together to keep both of you
healthy and strong
92
93
Tips for disclosing your status to
your partner
• Talk to others who have disclosed their
infection to their partners
• Be prepared for the partner’s reaction after
disclosure
• You may want to have a counselor present
when disclosing your status to partner
• Remember disclosure is important for the
health and well being of both you and your
partner
94
Before you disclose your status:
1. Decide if the person is trustworthy.
– Can I confide in this person?
– Will my status remain confidential?
2. Make sure the relationship is strong. It
should not just be beginning.
– Do I know this person cares for me and
wants the best for me?
95
Telling my partner, children or
close family member:
• Talk about HIV and AIDS to see what they feel about the
virus and their attitude toward people who are HIV
positive
• Educate them on the difference between HIV and AIDS
and how HIV positive individuals can live a long healthy
positive life
• Prepare yourself for their reaction when your reveal your
status
• Reveal your status once you are sure they can
understand what it means to be HIV+ (especially when
speaking with children) and can keep your status
confidential
96
My partner and I are both positive.
Can we have unprotected sex?
• NO.
• Always use a condom during sexual
activity to prevent re-infection.
• What is re-infection?
- a person living with HIV gets infected a
second time while having unprotected sex
with another HIV infected person
- re-infection with a different strain of HIV
can mean your treatment will not work
97
I am positive but my partner is
negative. How do I keep my partner
negative?
• Always use a condom during sexual
activity
• Continue to take your medicine on time
• Go to all clinic appointments
• Alert your nurse and physician about any
new symptoms or concerns
98
Module 10
How can I live a healthy positive
life?
99
100
Positive Living Means:
• Basic sanitation
• Reproductive health – using family planning and
condoms
• Using mosquito nets
• No alcohol or smoking
• Nutrition
• Getting your partner and family tested
101
Basic Sanitation
• Use latrines/bathrooms at all times
• Wash hands before and after using the
latrine/bathroom
• Bathe daily
• Proper disposal of all wastes
102
Basic Sanitation
• Washing hands before eating, when
preparing/handling food especially raw
meat, poultry or fish
• Washing all fruits and vegetables
• Drink clean or boiled water
103
Reproductive Health
• Wait to have a child until you are well
– Use family planning methods (pills, depo)
– Use condoms every time you have sex
• Avoid STIs
– Use condoms during all sexual contact
• Be honest with your partners
– Disclose your HIV status
104
Reproductive Health: Family
Planning
• Family planning includes:
– Condoms
– Depo (shots)
– Oral (pills)
• Methods such as depo and birth control
should be used by ALL HIV positive
women who do not want to get pregnant
along with condoms
105
Reproductive Health:
Family Planning
• Use condoms along with pills or
injections
• ART reduces the effectiveness of
some family planning methods
like oral contraception
106
Reproductive Health: Disclosure
• Open disclosure with your partner is an
important part of positive living.
• Knowing the status of your partner allows:
– you to keep yourself from getting re-infected if your
partner is positive or,
– if your partner is negative it allows your partner to
remain negative.
• Discussing HIV status with your partner can be
difficult.
– Some people bring their partner with them to an HIV
counselor at a clinic to have couple’s counseling
107
Telling my partner, children or
close family member:
• Talk about HIV and AIDS to see what they feel about the
virus and their attitude toward people who are HIV
positive
• Educate them on the difference between HIV and AIDS
and how HIV positive individuals can live a long healthy
positive life
• Prepare yourself for their reaction when your reveal your
status
• Reveal your status once you are sure they can
understand what it means to be HIV+ (especially when
speaking with children) and can keep your status
confidential
108
Reproductive Health: Sexually
Transmitted Infections (STIs)
• HIV is an STI.
• HIV is more easily transmitted to people who
have other STIs than to people who do not.
• People can get an STI when they have sex with
someone who has an STI.
• If a person is diagnosed with an STI, his or her
partner should get tested immediately.
• People often do not know they have an STI
because they have no symptoms.
• Besides abstinence, the best protection against
STIs is a condom.
109
Reproductive Health: Symptoms
of STIs
•
•
•
•
•
•
•
Vaginal Itching
Discharge from penis or vagina
Abdominal pain
Sore or lesions on penis or vaginal
Pain during sex
Painful urination
Scrotal swelling
110
111
Mosquito Nets
• HIV positive individuals are more likely to
develop malaria.
• Insecticide treated mosquito nets should
be used at all times in order to protect
yourself from malaria.
• HIV positive are particularly at risk of
malaria and should also use mosquito nets
year round.
112
Alcohol and Smoking
• To stay healthy all patients should
STOP drinking alcohol and smoking
• If you drink alcohol regularly and
smoke regularly you should begin to
decrease the amount
113
Nutrition
• Nutrition and adherence to medication are
key to positive living.
• Eating well and eating foods which are
good for you are essential.
• Foods such as fruits, vegetables and dairy
products like eggs and milk are necessary
part of a positive living diet.
114
115
Module 11
Can I have a baby if I am HIV
positive?
116
Yes: you can have a baby
• You can have a baby when you are HIV positive-- but
you have to do it carefully to reduce the risk that it will be
infected with the virus.
• HIV can be transmitted during (1) pregnancy, (2)
delivery, (3) breastfeeding
• Without treatment, 1 out of every 3 babies will be
infected with HIV.
• To decrease your baby’s risk of infection:
• You should consult with your doctors closely
• With correct medicines for you and the baby, less
than 1 out of 10 babies will be infected.
117
118
Deciding to Have a Baby
• Partners should discuss all aspects of
having a child when HIV positive
– Are we healthy enough to take care of a child?
– Are we willing and able to take care of a HIV
positive child?
• Couples must also discuss decision with
their doctor and get his/her approval before
continuing
119
Before Pregnancy
•
•
•
•
Both parents must be tested
Partners must know each others’ status
Both agree to have a child
Both partners should be on medication for at
least a year (if are positive and eligible to begin
medication)
• If HIV+, CD4 count should be greater than 350
• Doctor should be consulted throughout
• Use family planning or pills + condoms (2 forms
of contraception) for family planning until ready
to being trying
120
During Pregnancy: for the
health of you and your baby
• HIV drugs must be taken according to the
doctor’s orders
• Attend all scheduled clinic appointments
so you and your baby can be monitored
throughout the pregnancy
• Delivery must take place in a health facility
for the safety of you and your baby
121
122
After Pregnancy
• Your baby may be placed on HIV medication
until their status is confirmed
• Your baby will be tested at 6 weeks and again
after breastfeeding complete to determine its
status
• It is recommended that the baby either
exclusively breastfeed or exclusively formula
feed. (see next module on infant feeding)
123
Module 12
How do I feed my baby when I am
HIV Positive?
124
You should choose one method of
feeding your baby and stick to it
1. Exclusive formula feeding
or
2. Exclusive Breastfeeding
• It is not safe for the baby to mix different
kinds of feeding
• At 4-6 months, the baby can be weaned
off the breast or the bottle and begin
“complementary feeding” with pap.
125
What is formula feeding?
Formula feeding
– Is good because it means the baby won’t be
exposed to the HIV through the breastmilk
However:
– Requires that the mother be able to afford
formula from the store
– A growing infant will need 2+ cans each week
– Each can will cost US$8 or more
– A family must be able to spend US$15-20 on
formula each week
– If this is not affordable for a family, doctors
recommend breastfeeding…
126
Breastfeeding may be better
and safer than formula feeding
• What is exclusive breastfeeding?
– Exclusive breastfeeding is giving infants only
breast milk and no other liquids or food not
even water or country thrush medicine
• Why is exclusive breastfeeding important?
– Exclusive breastfeeding is important because
breast milk is safe, clean and provides all the
nutrition babies need.
– Babies who have been exposed to HIV need
the best, cleanest nutrition available.
– Breast milk is usually cleaner and safer than
127
formula can be.
Breastfeeding may be better
and safer than formula feeding
• Breast milk is:
– Always available
– Always on time
– Always the right temperature
– Not expensive
– No restriction
• However:
– Breastmilk contains the virus. Therefore, we
want to give it to the baby for as short a
128
period of time as is safe.
Problems with formula feeding
(bottle)
• Expensive
• May cause diarrhea if clean water is not
used
• May cause malnutrition if too much water
is used with too little formula
129
Breastfeeding
• How long should exclusive breastfeeding last for
HIV exposed babies?
– Until the baby is 4 to 6 months old.
– After four to six months complementary feeding can
be introduced over 1-2 weeks time
– At this time, breastfeeding must STOP.
• Mixing breastfeeding and other foods and water
for many weeks is not healthy for the baby.
130
Keeping your baby safe when
breastfeeding
• Take care of your breasts
• See your nurse or physician to treat any
infection or cracked nipples quickly
• Take care of your baby’s mouth
• See your doctor to treat mouth sores or
thrush quickly
131
Complementary Feeding
• What is complementary feeding?
– Complementary feeding is solid food
introduced to your baby after you stop breast
feeding.
• When should complementary feeding
begin?
– Complementary feeding should begin after
the four to six month period of exclusive
breastfeeding has ended.
132
Complementary Feeding
• Why should I stop breastfeeding between four
and six months?
– Your baby’s soldiers that protect him/her from
infection begin working around that time.
– They can protect the baby from potential infections in
the food and water you give him/her
– You want to stop breastfeeding as soon as it is safe to
do so
133
Preparing food for my baby
• Wash hands
• Wash all cups and utensils used to
prepare food for your baby
• Use clean safe water or boiled water to
feed your baby or cook your baby’s food
134
Rice Pap for Babies
1. Clean country rice (eddoe or plantain can be
used)
2. Soak with a small amount of water rice until
soft
3. Pound in mortar
4. Sifter the rice
5. Parch with red palm oil and keep in fry jar or
other container with tight lid
6. Put 2 eating spoons of rice dust with either
bonnie dust or beenie seed in a cup or bowl
7. Add 2 to 4 spoons of cold water
8. Cook and stir until thick
135
Module 13
What is TB?
Can I have HIV and TB?
136
What is TB?
What does TB mean?
- Tuberculosis
What is TB?
- TB is a disease which begins in the lungs
but then spreads to the rest of the body.
- TB can be cured but it is very serious
and can kill you if it is not treated properly
by a physician
- TB and HIV are brother and sister
137
138
Transmission of TB
How is TB transmitted?
-TB is transmitted by droplets of water in
the air after a person coughs or sneezes
and someone else breathes it in.
-TB is usually transmitted in closed areas
where the air does not change and there is
no breeze or wind.
139
140
Who gets TB?
• Everyone is at risk but especially:
– Children
– Sick People – especially people who are HIV
positive but not currently on medication
– Malnourished People – individuals who do
have enough good, healthy food to eat
141
142
Signs and Symptoms of TB
•
•
•
•
•
•
•
•
Weight Loss
Fevers or Chills
Night Sweats
Productive Cough
Non Productive Cough
Bloody Cough
Difficulty Breathing
Chest Pain
143
TB Signs and Symptoms
• If you have any of the signs or symptoms
of TB please report to your physician or
nurse
• You should get tested for TB (cough test)
• Even if your cough test is negative you
could still have TB
• If symptoms do not resolve please discuss
it with your physician
144
HIV and TB
• HIV attacks the soldiers in your body to
make you weak and stay sick longer.
• If someone with TB coughs on you when
you are sick from HIV, it is easy to become
infected with TB.
• Once infected with TB it can spread
throughout your body.
145
146
TB Treatment
• TB can be cured but the treatment is very
long: 6 to 8 months.
• TB treatment comes only from a doctor or
nurse at a health facility.
• TB treatment must be taken carefully and on
time (like HIV medicine) in order for it to work
• If treatment is not taken correctly resistance
can develop and the medicine will not work.
147
148