Systems for delivering HIV/AIDS care and support

Many of these programs have been launched by the people who live in the communities hardest hit by HIV/AIDS in response to the suffering and hardship faced by their neighbors, friends, and family members. While these community-based programs are critical, they reach only a small percentage of the people in need, and they face a chronic shortage of resources. Meeting the growing demand for support and care by people living with HIV and AIDS (PLWHAs) will require integrating such programs into the local and national systems through which people in these areas now receive other health care services. In addition, such programs will need to be decentralized to guarantee that resources are distributed to the local level to assist communities in continuing to respond to their particular needs. The first section of this paper outlines how care is now being delivered in many communities affected by HIV/AIDS, including some characteristics shared by many care programs and some examples of typical programs. The second section addresses the challenge of scaling up current programs to create integrated systems of care and presents as models four programs that successfully expanded to the regional or the national level. The final section includes recommendations and a research agenda for further developing integrated systems of delivering care and support to people living with HIV/AIDS and their families. (Author abstract, modified)