Introduction

With the spread of the infection across the country and the sharp rise in the number of HIV infected persons in the society, Care and Support including home-based care has been made an integral component in the second phase care has the National AIDS Control Programme. There is a moral and humanitarian obligation to provide appropriate care and support to persons infected with HIV/AIDS. The patients affected with the disease are young and are in the prime productive years of their life (mostly 15-49 years) and belong to different social and economic strata. People with HIV/AIDS experience a variety of health care problems, psychological traumas, stigma, and rejection by family members, friends and even medical personnel. If some amount of relief and normality can be given to them by ensuring proper care and support in the hospitals and in the community, as also protection of their right or privacy and other human right; suffering is reduced and improvement is seen in their quality of life.

Policy and Management

• HIV positive persons should be granted equal rights for education and employment as other members of the society. HIV status of a person should be kept confidential and should not in any way affect the rights of the person to employment, his/her position in work place, marital relationship and other fundamental rights.  

•  HIV - positive women should have complete choice in making decisions regarding pregnancy and childbirth. There should be no forcible abortion or sterilization on the ground of HIV status of the pregnant women for enabling her to take an appropriate decision either to go ahead with or terminate the pregnancy. The facility to avail the prophylaxis for prevention of mother to child transmission should be voluntary based on informed consent.  

• As regards treatment, care and support for people living with HIV/AIDS, the policy is to build up a continuum of comprehensive care comprising of clinical management, nursing care, access to drugs, counseling and psychosocial support through home-based care without any discrimination.  

• Advocacy and sensitization of doctors, nurses and other paramedical workers are taken up so that cases of HIV/AIDS are not discriminated, stigmatized or denied of services for medical treatment. Training of health care personnel in diagnosis, rational treatment and for follow-up of HIV related illness are also being taken up.  

• An efficient and comprehensive management of HIV/AIDS patients include therapeutic, preventive and supportive measures.

Supportive measures include:

• Prevention of repeated HIV infection and other infections
  HIV positive persons should use quality condoms even if the sexual partner is positive to protect from further infections with different stain, increase in viral load and also infection by other STDs which act as co-factors in transmission of HIV.  

• Change in lifestyle
  Since tobacco, alcohol, drugs, late nights, unsafe sexual practices etc. further depress the immunity, HIV positive person needs to be counseled and educated about their ill effects.  

•  Nutrition, Exercise and Rest
  Anxiety and tension have detrimental effect on the patients' ability to fight disease and maintain a good health. Reassurance and psychological support are necessary to help hem overcome their periodic bouts of severe depression.  

• Home Base Care
  HIV/AIDS is a disease with a long incubation period. People suffering from this disease require long, continuous treatment. Hospital care in such situations is not feasible. So home based care and a continuum of care is absolutely necessary for care of such patients. Home- based care has to be continuously monitored. The care providers will be members of family and NGO volunteers. Ordinary ailments like cough, diarrhea are treated by family members who also know the medicines for loose motions, dehydration and nutritional requirement of the patient. The family members and NGO volunteers are trained as to when to refer the patient to dispensary for community care who in turn will refer the patient to tertiary car hospitals when necessary. Family members are also trained how to deal with excreta, the secretions, blood spills and moderate universal care.  

• Community care
  In a community care Center, patients are provided Care and support in a setting, free from discrimination and hatred. National AIDS Control Organization provides funds to NGOs for setting up community Care Centers for AIDS patients. Few such centers have already been established in the country. It is proposed to establish one such center.

1. Over the years there has been a steady increase in the number of AIDS cases seeking treatment in various hospitals across the state. A cumulative total of 158 cases of AIDS have been reported to the Society till May, 2005 with the estimated number of 6028 HIV infection in the State the number of people living with AIDS is likely to continue to increase in the coming years. The Bihar AIDS Control Society has initiated some activities in the area of Care & Support.

2. Training - Through training has been an ongoing activity of BSACS, never areas of management and hospital infection control measures including post exposure prophylaxis necessitate the need for periodic training the orientation with updated information and guidelines.

3. Training - Through training has been an ongoing activity of BSACS, never areas of management and hospital infection control measures including post exposure prophylaxis necessitate the need for periodic training the orientation with updated information and guidelines.