Attachment_A_15562.docx

Appendix A

NOTE: The sample Issues and Strategies listed below are for proposal purposes. They will be finalized upon award of the contract.

Key Learning Objectives

After watching this video, HIV-positive viewers will have learned:

1. At least two reasons why early treatment with HIV medications is desirable.

2. At least two benefits of HIV medication adherence.

3. At least four strategies for adhering to HIV medications.

4. At least two benefits of staying in HIV medical care.

5. At least four strategies for keeping medical care appointments.

6. At least two reasons for reducing their sexual risk of transmitting HIV.

7. At least four strategies for reducing their sexual risk for HIV transmission.

Examples of Issues and Coping Strategies to Incorporate in the ART Video Intervention

ISSUES

Issues Related to Treatment readiness/initiation and Treatment adherence:

· [The most important] For HIV meds to work they must be taken on a strict schedule. If the level of medicine in a person gets too low, the amount of HIV in them will go up, which can make their HIV infection worse and damage their health.

· Don’t wait until you feel sick before you start HIV meds.

· HIV meds don’t cure HIV, they can help stop HIV from making you sick.

· There is more than one HIV medicine. All have been proven to work. They can keep the amount of HIV in your body (viral load) very low (“undetectable”).

· Early HIV meds were hard to take. New HIV meds may only need to be taken once or twice a day.

· Take all the doses, of all HIV meds, at the correct times, and as directed by the doctor, like with or without food. (“adherence”)

· Taking a pill late or skipping one occasionally isn’t too bad. But missing doses often, give HIV a chance to become “resistant” to the HIV meds. Doctor may need to switch the patient to a different HIV med, which could be harder to take or that has side effects.

· It is important to go to all of HIV checkups. Doctor can see how well the HIV meds are working. If they’re not working well, doctor can switch to other meds.

Issues Related to Retention in HIV Medical Care

· Go to all of your appointments, even when feeling well. HIV infection could get worse if a person goes a long time without seeing their doctor.

· Be prepared for a life-long commitment to HIV meds and doctor visits.

· To stay healthy for many years eat right, get enough rest, stay in shape, and go to all of your HIV checkups.

· When a person gets regular HIV checkups, their doctor can make sure that their HIV infection is under control.

· If a person is on HIV meds, their doctor checks to be sure that the meds are still working.

· If a person is not on HIV meds, their doctor may be planning for them to start meds soon.

· Appointments are a great time to talk about concerns. Persons can ask for help solving problems, e.g., pregnancy planning.

· Missing just one HIV medical care visit can hurt an HIV-infected person’s health and life.

· If persons come to all of their appointments, health problems (like STDs) can be found early and treated.

Issues Related to Sexual Risk Reduction:

· People with HIV can have great sex lives. But it is important for them to protect their health and the health of their sex partners.

· STDs can make HIV worse. Having HIV makes it easier to catch an STD. STDs hit HIV-positive people harder and are tougher to treat.

· A condom used during vaginal or anal sex gives the most protection. Using a condom helps protect partners too. Condoms block HIV and STDs from passing between partners.

· Safer sex is important even for people taking HIV meds. The amount of HIV in a person’s blood may be undetectable. But HIV may still be in their semen or vaginal fluid.

· Don’t risk giving HIV to an HIV-negative partner.

· People can catch an STD even in a long-term relationship with a single partner if that partner has sex with other people. Ask your partner if s/he’s having sex with someone else.

· Having one sex partner is good. But unprotected sex with an HIV-negative partner puts them at risk for getting HIV.

· Some people don’t like to use condoms or find it hard to use one every time. But then they find ways to make condoms fun.

· If you don’t have a steady partner, think about having HIV-positive partners.

· The more partners a person has, the more they put themselves and others at risk.

· A person who has several sex partners could catch an STD from one partner and pass it to their other partners.

· There are other ways besides condoms to reduce your risk and protect your partner.

STRATEGIES:

Strategies for Improving Treatment Adherence:

· Sign up for a text message service to remind you

· Get a pill organizer

· Take your pill organizer with you when you go out

· Make pill-taking part of your daily routine

· Plan ahead for the next day

· Get to understand how each of your HIV meds works

· Ask your doctor about programs that help pay for your meds

· Find friends to support you

· Talk to your Pharmacist

· Tell your doctor about your alcohol and drug use

· Talk to your doctor if you experience side effects

Strategies for Improving Retention in HIV Medical Care:

· Set reminders on your mobile phone.

· Put your reminder card in a place where you will see it often.

· Find people who will help you remember appointments.

· Line up transportation ahead of time.

· If you can’t make an appointment, call the clinic and set up another one.

· Schedule your clinic visits at times that are convenient for you.

· Plan ahead for child care.

· Get help handling the other demands on your time.

· Don’t let alcohol or drugs make you miss appointments.

· Let the clinic know right away if your phone or address changes.

· Ask your doctor for help solving the problems you face.

Strategies for Reducing Sexual Risk for HIV/STD Transmission/Acquisition:

· Avoid places and people that cause you to take risks.

· Always carry condoms and lube with you and use them.

· Have sex with fewer people.

· Talk to your partners about safer sex.

· Tell partners about your HIV status so you can decide together about sex.

· Use less alcohol or drugs with sex—stay in control.

· Use your hands to pleasure each other.

· Some people with HIV choose not to have sex.