The factors related to HIV prevention
1. Comprehensive services across the care continuum
PWID and their families have emotional, social, physical and spiritual needs that change over time. They often must cope with the effects of stigma and discrimination, poverty, loss, neglect and abandonment. Integrated care may be seen as a response to the fragmented delivery of health and social services. This fragmentation in delivery has become an acknowledged problem in many health systems. The purpose of the Continuum of Care (CoC) is to address illegal drug use as a chronic disease and develop systems that provide humane, effective, high-quality comprehensive and continuous care to PWID and their families. When implementing a testing program, it is fundamental to establish close collaboration and a referral system between clinical centres providing HIV, HCV and TB diagnosis, treatment and care, and other services where testing and/or counselling may be offered.
2. Patient focus
The integrated service delivery system should meet the needs of patients needs rather than the needs of service providers. Organizations that fail to place the patient at the centre of their integration efforts are unlikely to succeed. The provision of health care, social services and related support (e.g. housing) at the right time and place to such individuals can be challenging. Problems typically include difficulties with: conducting needs assessments; putting together comprehensive service packages; co-ordinating multiple providers and services; ensuring continuity; monitoring health and functional status; responding to crises; supporting family carer; and, finally, performing all of these essential activities within existing funding and resource constraints.
Why ask the patient?
- Patients are witnesses of and participants in integration.
- Patients are sometimes the only connection between providers /sectors/specialties.
- Patients have knowledge that will help to establish the baseline that can be used to measure change over time.
- Patients’ experiences relate to many, though not all, aspects of integrated care.