HIV Managment at Bairo Pite Clinic

A focus on counselling and rehabilitation

Although there is no cure for HIV infection, treatment with anti-retroviral drugs can control the virus allowing people living with HIV (PLHIV) to lead healthy and productive lives.

HIV is a virus which weakens the immune system and can lead to serious infections and some forms of cancer. Worldwide, approximately 14 million people were living with HIV at the end of 2014. It is important to detect infection with HIV as early as possible so that treatment can be started before the body’s immunity becomes badly damaged, but in 2014 only half of PLHIV were aware of their status.

HIV in Timor-Leste

Timor-Leste is considered to have a low-level non-generalised HIV epidemic, with a national prevalence of well below 1%, although some studies have shown higher rates in certain districts and patient groups.

First case of HIV detected in TImor-Leste

cases of HIV diagnosed since 2003

HIV-treatment

Less than half of people living with HIV (PLHIV) are taking antiretroviral therapy

The number of newly diagnosed PLHIV has been rising year on year; it is difficult to know whether this reflects a rise in testing rates or whether the incidence of HIV is rising. According to the Ministry of Health, it is likely the prevelance rate may is significantly under-reported.

TL is vulnerable to a rapidly increasing incidence of HIV due to:

• high levels of population movement and socioeconomic displacement • low incidence of condom use • low level of awareness of STIs and HIV • poor access to HIV and STI screening • presence of risk behaviours within at-risk groups

“Dealing with HIV in and of itself is a major challenge but what this virus does to TB, already our number one health concern, is ice water in our face. Having HIV makes active TB 10 times more likely.This along with an ever increasing threat of multi-drug resistant tuberculosis makes controlling the HIV epidemic top priority.”

Dr Dan Murphy

HIV Management at Bairo Pite Clinic

BPC cares for the largest number of PLHIV in Timor-Leste.

Around 100 adult and child patients access treatment at the clinic.

We take a holistic approach, knowing that counselling and support is just as important as medicine

At BPC we have three HIV counsellors – Adece, Filomena and Alarico.  We also provide a voluntary counselling and testing service for any patient who requests an HIV test in a dedicated cabin in the clinic grounds. We perform provider-initiated testing; all pregnant women who come for antenatal care will be offered an HIV test, as will any individuals being investigated for TB, STIs or certain infections/cancers. BPC’s laboratory performs more than 300 HIV tests every month. We also arrange for PCR testing to be sent for any infants born toHIV positive mums and these tests are sent to Australia via the National Laboratory service. If a patient is found to be HIV positive, they will have a medical review whereby a decision will be made about starting antiretroviral treatment and also any preventive antibiotics that might be needed. The treatment we provide is in line with the Ministry of Health and WHO recommendations and patients are seen monthly for a medical check- up. Newly diagnosed PLHIV also have education and counselling provided by our HIV counsellors; we strive to provide a holistic approach, recognising care of psychological health can be as important as physical health in chronic conditions. We also work with local partners who provide social support and advocate for the needs and rights of persons living with HIV including Estrela+, Fundasaun Timor Hari’i (FTH) and Esperanca.

A Safe Space

BPC  Counselling cabin is in a quiet corner of the compound, tucked away at the back.  The Counselling and Social Care staff have planted a lovely garden around the HIV cabin, to give it a homely feel and to make the place seem more private. Stigma and discrimination is particularly damaging to a PLHIV and their family as it can create a barrier to the patient seeking treatment or remaining adherent to their treatment. The clinic has worked hard to educate all staff about HIV as an issue and to ensure that fear and ignorance do not fuel stigma and discrimination.

 ‘Nowadays when I come to the clinic I am greeted in a friendly way by all the staff, I feel safe and comfortable when I come to get my medicine or to consult the Doctor.  I also know the staff understand they must not gossip about the patients, so I feel confident about confidentiality’ “These days we can take medicine and remain healthy, but we must take the medicine every day and get regular check-ups. If we take our medicines and follow our Doctors instruction we can be very healthy and normal and work and enjoy our families, just like everyone else ” – PLHIV

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