Application of Health Promotion and education among People Living with HIV/AIDS.

1. Application of Health Promotion
and Education among PLWHIV/AIDS
Prepared and Presented by: Shilpa Banjade
3rd Batch BPH, UCMS

2. Contents
✓ Introduction.
✓ HP among Risk Groups.
✓ Why HP among PLWHIV/AIDS?
✓ Guiding Principles.
✓ Strategic Directions.
✓ Fast Track Approach
✓ Priority Action Areas
✓ Challenges
✓ Conclusion

3. Introduction
➢Special risk groups are those Individuals or groups who are likely to
have an increased incidence of a disease.
➢ Particularly based on the presence of modifiable risk factors which are
known to be causes of the disease .
➢ Such as: Drug users, Commercial Sex workers and their clients,
PLWHIV/AIDS, rag pickers , adolescents are some risk groups.

4. Health promoting among risk groups
➢This is a process of empowering those people to increase control over
their health and its determinants through health literacy efforts and
multi-sectoral action to increase healthy behaviors.
➢It includes activities for the community at large or for populations at
increased risk of negative health outcomes .
➢Health promotion usually addresses behavioral risk factors (such as
substance abuse, unsafe sex), occupational hazards and
environmental hazards as well as the areas of drug prevention, alcohol
control, sexual health.

5. Why health promotion among PLWHIV/AIDS?
✓To Promote health and protect life of PLWHIV/AIDS.
✓ To Improve the health status of productive groups of people.
✓ To Provide support and various training to cope them with the social
environment.
✓ To understand the epidemic and the extent of change resulting from
interventions.
✓To track the response of the health sector to HIV, particularly the
health system intervention coverage and quality of services.
✓To inform program improvement, identify challenges and
opportunities, outcomes and impact.

6. Guiding principles
▪ Universal equitable access to services for HIV prevention,
treatment, care and support.
▪ National solidarity and shared responsibility.
▪ Fast-Tracking towards ending the AIDS epidemic as a public health
threat.
▪ Integration and Innovation of HIV within systems for health.
▪ Decentralized, multisector and interdisciplinary engagement.

7. Continue...
▪ People- centered inclusive approaches.
▪ Advancing human rights for health.
▪ Zero tolerance for prejudice and discrimination related to PLWHIV and
key populations.
▪ Meaningful involvement of affected communities.
▪ Evidence based informed planning and programming.

8. Theories of health promotion applicable for
PLWHIV/AIDS
The theories and models include
1. The Health Belief Model
2. Theory of Reasoned Action
3. Social Learning and cognitive theories
4. AIDS Risk Reduction Model
5. Stages of Change
6. Hierarchy of effects model
7. Diffusion of Innovation
8. Social Marketing

9. 1. The Health Belief Model: The health belief model was developed
in the 1950s to predict individual response to, and use of,
screening and other preventive services.
2. Theory of Reasoned Action: The theory of reasoned action
attempts to explain individual behaviour by examining attitudes
observed, expressed acts.
3. Social Learning and cognitive theories: Social learning and
cognitive theories are based on the assumption that individual’s
behaviour is the result of interaction among cognition behaviour,
environment and physiology.
4. AIDS Risk Reduction Model: The AIDS risk reduction model is
based on belief that one has to label a behaviour as risky before a
change can be effected. Fear or anxiety and social norms are
considered factors that influence moving from one stage to next.

10. 5. Stages of Change: Stage of change is based on the concept that
individual behaviour change goes through a process involving a
series of five interrelated stages.
6. Hierarchy of effects model: Hierarchy of effects model focus on
individual behaviour change in linear fashion, which begin with
explore to information and assumes that knowledge, attitude,
trial and adoption of the desired behaviour will necessarily follow.
7. Diffusion of Innovation: Diffusion of innovation focuses on the
communication process through which new ideas or products
become known and used in a target population.
8. Social Marketing: Social marketing is an approach to promoting
the acceptability of social ideas through the mass media. Social
marketing four Ps (product, price, place and promotion) have
been applied to HIV/AIDS prevention in condom promotion.

11. Strategic Directions
o Identify and reach key populations with a combination of initiatives to
prevent HIV.
o Focus on reaching key populations through outreach and, by
communities of key populations, through in-reach.
o Recommend and offer “HIV test and treat” services, regardless of CD4
count.
oRetain people living with HIV in treatment, resulting in undetectable
viral load.

12. Continue..
o Fast-Track prioritized investments of a scope, scale, intensity, quality,
innovation and speed to have the biggest impact.
o Enhance the critical programme and critical social enablers.
o Establish functional public, private partnerships to bridge the
prevention - treatment continuum through task-sharing.
o Focus on innovative, well-coordinated and integrated services towards
primary HIV prevention for and with key populations.

13. Fast-Track approaches
Ambition.
Focus.
Change.
Speed.
Saturation.
Human rights.

14. Priority actions by the AIDS Epidemic Model
✓ Scale up HIV testing and treatment for key populations.
✓ Scale up evidence-informed innovative methods to prevent new HIV
infections among key populations.
✓ Focus on major sources of new infections.
✓ Integrate and decentralize HIV service delivery systems.
✓ Leverage sustainable financing and increase domestic financing,
particularly in antiretroviral therapy.

15. Challenges
• Availability and quality of HIV-related services.
• Participation of key populations and people living with HIV.
• HIV-response policies for migrants and their spouses.
• Clarity and focus of roles of service providers.
• Foreign aid dependency.
• Limited coverage of prevention programme .
• Inadequate surveillance system.
• Limited coverage of HIV testing and counselling.
• Stigma and discrimination.

16. Conclusion
Limited resources and administrative capacity tied with strong
underlying needs for health services to PLWHIV/AIDS. So we must follow
the Axiom as “Know your epidemic, Know your response.”

17. References
✓ DoHS Annual Report FY 075-076
✓National HIV Strategic Plan 2016-2021
✓PLWHIV/AIDS and STI
✓ Country Progress Report Nepal
✓ National Consolidated Guidelines on Strategic Information of HIV
Response in Nepal

18. THANK YOU.