HIV and AIDS Treatment Education, Technical Consultation Report, 22-23 Nov 2005

This 39-page report summarises the key points and recommendations that emerged over the course of the two-day event co-organised by United Nations Educational, Scientific and Cultural Organization (UNESCO) and the World Health Organization (WHO) within the framework of scaling-up HIV treatment and preparedness efforts in support of Universal Access. The meeting brought together technical practitioners with experience in HIV and AIDS treatment education from government agencies, international and local non-governmental organisations (NGOs), United Nations agencies, and networks of people living with HIV. Presenters provided insight into programme experience and lessons learned from activities in settings as diverse as: Belarus, Brazil, Bulgaria, Burkina Faso, Estonia, India, Kazakhstan, Kenya, Kyrgyzstan, Lithuania, Moldova, Nepal, Poland, Russia, South Africa, Swaziland, Thailand, Ukraine, Uganda, Uzbekistan, and Zambia.

Excerpts from the Executive Summary

"The Consultation...aimed to:

• Review the current status of treatment education at the global country and community levels and 'take stock' of experiences, lessons learned, and good practices in treatment education;
• Identify needs in the realm of treatment education, with a focus at this Consultation on treatment literacy and community preparedness;
• Develop an action framework with key priorities for work in the near future for the various partners, including UN agencies, national authorities and civil society, taking into consideration the value added of each and encouraging joint programming; and
• Identify how the UNESCO-led EDUCAIDS Initiative and the UNAIDS-led campaign on «Universal Access to Prevention, Treatment and Care» can contribute to treatment education...

Treatment education was identified as forming the bridge between the provision of treatment and the preparation and involvement of people and communities in comprehensive responses to HIV and AIDS. Treatment education encourages people to know their HIV status, explains how to gain access to treatment, offers information on drug regimens, offers support and ideas for adhering to treatment and helping others to do so, emphasises the importance of maintaining protective behaviours and healthy living, and suggests strategies for overcoming stigma and discrimination and gender inequality.

An important consensus emerged during the Consultation that treatment education should not be seen as a separate component, a new initiative, or an additional burden to already often overstretched systems. Instead, treatment education is an integral part of comprehensive HIV and AIDS education and, as such, should be part of planning processes to move towards universal access to prevention, treatment, and care. Treatment education programmes have been found to contribute to the wider uptake of voluntary counselling and testing services, a greater belief in the effectiveness of Antiretroviral therapy, better adherence to ART, improved treatment outcomes, and improved quality of life....

A consensus emerged during the Consultation on the need to:

• Involve stakeholders - including people with HIV and those on treatment - in the development, review, and evaluation of materials;
• Include accurate and up-to-date information that is culturally relevant, gender sensitive, age appropriate, and available in users' local languages;
• Facilitate the development of knowledge, skills, and attitudes;
• Field test, monitor, and evaluate activities to determine appropriateness and impact; and
• Document and disseminate programme experience to further learning and progress in the field. Participants also noted that the growing number of treatment literacy materials and programmes are available for review and adaptation to local contexts. In addition
  to the issues presented above, participants agreed that adapted materials should include images and examples that are relevant to local contexts, and information that is clinically appropriate and accurate.

There are a number of lessons learned from the Consultation which can inform future activities in the field of treatment education. These include the need to:

• Employ person-centred approaches: HIV is a chronic disease which requires the development of problemsolving skills to manage symptoms and side effects, to effectively liaise with community- and facility-based services, and to strictly adhere to ARV regimens.
  People with HIV and their groups are key partners in the scale up of treatment and prevention.
• Provide further support to partnerships and intersectoral collaborations between civil society partners, Ministries (Education, Health, Labour, and others), and multilateral and bilateral agencies. In some settings this will require a major shift to recognise the role of other sectors and the community in treatment education.
• Integrate treatment education across the continuum of HIV and AIDS education. Treatment education does not need to be seen as a separate component, a new initiative, or an additional burden to already overstretched education and health systems but as an integral part of comprehensive HIV and AIDS education. Treatment education should be included as part of planning processes to move towards universal access to prevention, treatment, care and support.
• Employ a range of approaches for different settings and audiences. One size does not fit all. Interventions must be informed by awareness of the social and political contexts, and use multiple entry points to ensure that education around treatment is accessible and relevant for all. Messages need to be targeted for priority groups, including 'vulnerable populations' that may not have been traditionally addressed through treatment education activities.
• Involve affected communities and individuals, who are properly supported with the necessary knowledge and skills, using pre-existing structures where they are available and capitalising on the expertise of each group.
• Document, monitor, and evaluate treatment education initiatives for process and impact, ensuring that lessons learned are communicated and disseminated. Future initiatives should build on this evidence base, while further developing or adapting approaches to fit the local context."