Centre on
HIV/AIDS
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Training Manual for Call Centre Operators, January 2002.
Forfurtherinformation/ any
contributionsyouwouldliketo
maketothis continuing series,
pleasecontact:
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Training Manual for Call Centre Operators, January 2002.
Table of Contents
Table of Contents
Contents Page
(s)
Chapter One
HIV/AIDS and Sexually transmitted Diseases
4-9
Chapter Two
Counseling VCT and Support 10-18
Chapter Three
Community Home Based Care 19-
22
Chapter Four
IPT for TB (or Preventive Therapy) 23-24
Chapter Five
Opportunistic Diseases 25-27
Chapter Six
Anti-Retroviral Therapy 28-32
Chapter Seven
Nutrition and HIV/AIDS 33-36
Chapter Eight
Prevention of Mother to Child Transmission 37-
39
Chapter Nine
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Training Manual for Call Centre Operators, January 2002.
Chapter One
HIV/AIDS and Sexually Transmitted Diseases
What is HIV?
• HIV is short for Human Immune Deficiency Virus. HIV attacks the
body’s immune system, making it hard to fight off infections.
HIV particularly attacks CD4 cells. The lower a person’s CD4
count, the weaker their immune system will be.
What is AIDS?
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Training Manual for Call Centre Operators, January 2002.
• Through sex without a condom. HIV can pass from one person to
another person through unprotected anal or vaginal sex.
• Through injecting drug use. HIV can be passed on by using the
needles or syringes that someone with HIV has already used.
• From mother to baby. A pregnant woman may transmit the virus
to her baby before or during birth, or HIV can be passed on
during breastfeeding.
• Through organ transplant, blood transfusion or blood products.
We know that donated blood might contain HIV, (revise?)
many people with haemophilia became infected through
receiving contaminated blood products. However, these days, all
blood and tissue donations and blood products are screened
worldwide.
• Please contact Tebelopele’s toll free number 0 800 126 126 for
further information on testing centers and same day result. The
testing is also available in governmental hospitals, clinics, health
and sub-health posts, private hospitals and practitioners.
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Training Manual for Call Centre Operators, January 2002.
• There is no vaccine or cure for HIV. However, anti HIV drugs are
available, and taking a combination of anti-HIV drugs can slow
down the damaging effect of HIV on the immune system. It is
possible to live 15-30 years with the medication.
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Training Manual for Call Centre Operators, January 2002.
• The most significant risk that someone with HIV could represent
to an HIV negative person is, of course, that of them becoming
infected with HIV. While this is a real and serious risk, it can only
happen through unprotected sex, sharing injecting equipment or
other invasive procedures where HIV can get into the other
person’s bloodstream. It is important not to exaggerate their risk,
understand HIV, and how to protect yourself and others.
• Many people think that a person with HIV has to tell others by
law or those they do not do so, they are hiding it for malicious
reasons. This is rarely the case.
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Training Manual for Call Centre Operators, January 2002.
There are about 25 different ones. What they all have in common is
they can be spread by sex. This means:
• You can ask for treatment information from the nearest health
post, hospital or clinic. There is also a National Centre in
Gaborone run by the AIDS/STD Unit. Their number is
312492 or ?. (add the direct number ?)
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Training Manual for Call Centre Operators, January 2002.
• Get to you know your partners before you have sex. This lets you
talk to each other about protecting yourselves.
• Tell your partner if you have an infection. That way your partner
can be treated too.
• There are over 100 types of viruses that cause warts. They are
known as human pailoma viruses. An adult can be affected
with more than one type. So please see your doctor or go the
nearest health post for diagnosis.
What about genital warts? Will they stay until I have the right
medication?
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Training Manual for Call Centre Operators, January 2002.
How will I know if I caught anything last night since I had unprotected
sex?
• The only way out is to go for a test. (Put number ... where
should one go?)
Chapter Two
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Training Manual for Call Centre Operators, January 2002.
What is counseling?
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Training Manual for Call Centre Operators, January 2002.
Does AIDS/STD staff offer counseling or can I get counseling from them
?
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Training Manual for Call Centre Operators, January 2002.
• No. The AIDS/STD unit staff counseling unit staff will refer you
to the relevant counseling center.
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Training Manual for Call Centre Operators, January 2002.
• Through positive living with HIV, one can lead a productive and
healthy life for many years, thus contributing towards to the
development of his or her family and community at large.
Positive Living means taking care of your health and emotional
well being in order to enhance your life and stay well longer.
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Training Manual for Call Centre Operators, January 2002.
• Depending on your life style in the last 3-6 months, you may
require to take a repeat/confirmatory test to determine if your
current negative result is due to the window period. Your
counselor will discuss with you more about the window period. It
means that between this test and the confirmatory /repeat test,
you should not involve yourself in risky behaviour (such as
having unprotected sex with someone whose status you don’t
know).
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About Tebelopele:
• Eventually, there will be 15 Tebelopele centers opened in
Botswana. These include Gaborone, Francistown, Selebi-Phikwe,
Maun, Kasane, Serowe, Palapye, Letlhakane, Lobatse, Jwaneng,
Molepolole, Mochudi, Ghanzi, Mahalapye and Kanye. Please see
attached table for center location, contact person and hours of
operation.
• HIV counseling and testing at the Tebelopele centers is offered:
On voluntary basis (no one must be coerced or forced to take the
HIV test. It must be your own informed choice to know your
status).
On anonymous basis (meaning that no name is required, only a
code number is given to each individual).
Free of charge
Confidentiality is guaranteed. All that you discuss with the
counselor is kept confidential.
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HIV test results are available within one visit, the same day of
the test. Rapid HIV tests that were evaluated in Botswana and
found to be as accurate as the ELISA test are used at the
centers.
No certificate of your HIV test result is given to you; rather, you
read your test results together with your counselor and discuss
what those results mean to you.
The process of HIV counseling and testing takes an average of 1
hour from the time of seeing the counselor.
Well- trained counselors are available to help you understand
your risks of contracting HIV and help you develop a risk-
reduction plan, which is appropriate to your life situation.
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You don’t need prior appointment with center staff, you just walk
in during working hours and you will be served.
Your name is not requested. You will receive a card with only a
code number on.
If you have already tested at the Tebelopele center, you are
required to come with the card you received during your first
visit.
If you come with your partner, the counselor will ask you if you
would like to be counseled and tested together. If you agree,
then you will receive couple counseling and testing together.
Which means you will see each other’s test result. If you change
your mind about being counseled and tested together, then you
will be served individually.
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(Lead Friday
Counsellor)
Selebi- Tshekedi Road, 26005 26005 Mr. Nkopane 8.00 a.m –
Phikwe Plot 2462 13 14 Mfolwe (Lead 5.00 p.m.
Counsellor) Monday to
Friday
Maun Opposite Maun 66504 68000 Setshwano 8.00 a.m –
District 3 86 Aerwa (Lead 5.00 p.m.
Administration counselor) Monday to
Offices-Plot DA13 Friday
Jwaneng Unit G8 38128 38129 Gillian 8.00 a.m –
Plot 746 1 3 Goodwin 5.00 p.m.
(Lead Monday to
Counsellor) Friday
Serowe Goo-Ramoseki 43746 43746 Mbako 8.00 a.m –
Ward; Between 9 8 Tawana 5.00 p.m.
Kagiso Motuary (Counsellor) Monday to
& Mazila Friday
Complex
Kasane Corner-President 62504 62505 Modiri 8.00 a.m –
Av/Rural 88 32 Moremi (Lead 5.00 p.m.
Administration Counsellor) Monday to
Center; Plot Friday
858/859
Lobatse Hillside 53001 53001 Monkie 8.00 a.m –
Jacaranda Plot 68 69 Morake (Lead 5.00 p.m.
1895/13 Counsellor) Monday to
Friday
Letlhakane 27660 27660 Keitumetse 8.00 a.m –
1 0 Legwaila 5.00 p.m.
(Counsellor) Monday to
Friday
Palapye Just Behind 42447 42447 Susan Jorosi 8.00 a.m –
Barclays Bank 4 5 (Lead 5.00 p.m.
and Close to Counsellor) Monday to
House of Hope Friday
Chapter Three
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Training Manual for Call Centre Operators, January 2002.
• Provide optimal care for the chronically and terminally ill patients
• The rapid increase in both the rate of infection and the number of
AIDS cases.
• The family is potentially still the greatest resource for holistic care
of chronically ill patients.
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Patients on CHBC are free to go back to clinics and hospitals when they
feel that they need more specialized attention that can not effectively
be provided within a home environment
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Training Manual for Call Centre Operators, January 2002.
• Through care givers who visit the patient at the hospital. The
referral form is sent to the nearest health facility, District health Teams
and the family members have to be informed about the discharge plan
and also Social Workers are to assesse the home environment before
discharge, patients are also given copies of the discharge slip to
present to the nearest health facility.
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Training Manual for Call Centre Operators, January 2002.
• They help in identifying clients who had not been reported. They
also assist caregiver to feed patients, bath and also clean the patient’s
surroundings.
• Not really. One has to take the consent of the patients into
consideration as they might have some reasons why they do not want
to be cared for at home, such patients need counselling.
Chapter Four
IPT for TB (or Preventive Therapy)
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• Any person who has tested HIV positive can be considered for
preventive therapy.
• HIV positive pregnant women will be offered treatment 6 weeks after
delivery.
• The good news is that persons living with HIV can take Isoniazid
also known as INH to help prevent silent TB infection from becoming
active TB. This is called TB Preventive Therapy which lasts normally
six months.
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• You will have to first take a HIV test to qualify. Treatment and
service is free.
Chapter Five
Opportunistic Diseases
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• The treatment depends on which disease you have. If you have HIV
infection and are sick, consult your health facility to get the
appropriate treatment.
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• A person infected with HIV can feel unwell because of HIV directly,
but most often they feel unwell because of an opportunistic
disease. Some warning signs of HIV infection or opportunistic
diseases include:
Rapid weight loss
Cough
Recurring fever or night sweats
Profound and unexplained fatigue
Swollen lymph glands in the armpits, groin, or neck
Diarrhea lasting more than 1 week
White spots or blemishes on the tongue, in the mouth, or in the throat
Pneumonia
Red, brown, pink, or purplish blotches on or under the skin or
inside the mouth, nose, or eyelids
Memory loss, depression, or other problems with the nervous
system
Severe headache
Note: Nobody should assume they have HIV infection just because
they have some of these symptoms. The only way to know whether
you are infected is to be tested for HIV infection at your health
facility or Tebelopele.
What is the difference between the treatment of HIV and the treatment
of opportunistic diseases?
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Chapter Six
Anti-Retroviral Therapy
• Not a cure.
• Reduce viral load even to undetectable levels. Have a beneficial
clinical effect
i.e HIV related symptoms may disappear,
• The incidence of opportunistic infections is reduced and the
quality of life
improved.
• Decreases number of hospitalization for HIV related
illnesses may thus prolong life of HIV infected.
• Yes. All HIV infected children less than 12months of age are treated
• regardless of their clinical, immunological or virological status.
• Any symptomatic child is treated. Even symptomatic HIV infected
children
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Training Manual for Call Centre Operators, January 2002.
• who are older than 12 months of age and have normal immune status
should
• be started on ARV Therapy.
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Training Manual for Call Centre Operators, January 2002.
• For asymptomatic patients its better not to take ARV because the
unpleasant regimens may outweigh the benefits at this stage
and long term benefits have not been demonstrated for this
specific group patients
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• Answer to be formulated.
• One may develop drug resistant strain of HIV and spread the
resistant virus.
• Lack of adherence will impact on treatment success.
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Training Manual for Call Centre Operators, January 2002.
It is life long.
It is necessary for:
• Surveillance for adverse effects of treatment and management
of those effects.
• Confirmation of treatment efficacy.
• To assess drug interactions e.g. interactions between ARV and
drugs used to treat opportunistic infections.
• Assessment for treatment options for patients who fail therapy
which may lead to change of drugs , addition of more drugs
etc.
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Training Manual for Call Centre Operators, January 2002.
Chapter Seven
Nutrition and HIV/AIDS
• You should eat more energy giving food like bread, rice, sorghum
meal, potato, corn flakes etc.
• Try protein rich food like beef, chicken liver, kidney, fish,
cheese, eggs, beans, ditloo, peanuts etc.
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Training Manual for Call Centre Operators, January 2002.
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Training Manual for Call Centre Operators, January 2002.
• The Brat diet is used to help slow down diarrhea. Do not use this
diet for more than 2 days, as it does not contain all the nutrients
need to stay healthy. All these foods are to be eaten plain. Don’t
add anything to the foods.
• Rice water is made by cooking white rice with more water than it
needs. For example, four cups of water added to a cup of rice.
Where the ice is soft pour the extra water into a container, cover
and let it cool. Rice water is easier to drink. When cool, drink the
water and then eat the rice.
• If you have fever, you should drink lots of water so that you can
avoid dehydration.
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Training Manual for Call Centre Operators, January 2002.
• Avoid spicy (hot) foods such as curries chili and acidic foods such
as oranges, grape juice, lemon juice and very salty foods.
• Avoid smoking and alcoholic beverages.
• Eat warm foods ad they are more soothing than hot foods.
During the past weeks I have lost a lot of weight. What can I do to
regain back my lost weight?
• Always wash hands, counters and cutting boards with warm and
soapy water before starting food preparation and after contact
with uncooked meats and chicken.
• Use clean and safe water for drinking and preparation of food
(boiled and then cooled).
• Always reheat foods thoroughly before eating to kill any germs,
which may still be there.
• Be very careful with leftovers. Always boil leftovers before
eating.
• If food seems even slightly spoiled, throw it away. Don’t take
chances with your health.
• Do not store uncooked food where it can contaminate cooked
food. For example water or blood from refrigerated meat can
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Training Manual for Call Centre Operators, January 2002.
Chapter Eight
Prevention of Mother to Child Transmission
HIV Testing
Why are you only interested in my baby ? What’s in this for me
or Why should I know my status ?
• If you are HIV positive, you can adopt a good diet and take
other steps to stay health, prevent illness and live a longer life.
• If you do become ill, the health worker will be able to treat you
appropriately. There are also some preventive therapies you
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Training Manual for Call Centre Operators, January 2002.
• At birth when the baby travels through the mother’s birth canal
damage can occur to the baby’s skin and HIV can be transmitted
when it comes into contact with the mother’s blood. This is why
the time of birth and labour are the most common for HIV to be
transmitted.
• Some babies are only infected after birth through breast milk.
If a women takes ZDV for PMTCT and then stops won’t her viral load
shoot up and her immunity become much worse ?
• When a mother takes ZDV for PMTCT her viral load (the load of
HIV in her blood) will fall. This is thought to be how
transmission of HIV is prevented.
• When she stops taking it her viral load will return to the level she
had before taking the ZDV. Therefore, although the ZDV a
pregnant mother takes for PMTCT will not help her own HIV
disease, it will not make it worse. It will not make her viral load
increase or her immune system weaken.
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• In the long term follow-up of women who have taken ZDV for
PMTCT resistance has not been shown to develop after taking
short courses of ZDV.
Can a mother keep taking ZDV (AZT) after the baby is born for her
own health ?
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Training Manual for Call Centre Operators, January 2002.
• For the maximum period, the child must be given formula from
birth if the mother is on PMTCT.
Chapter Nine
Existing assistance service or other phone
referral services
(Useful Numbers)
Note: Some organizations have field locations, but always refer to the
main number as much as possible.
Location Organization Phone Number
Bobonong Bobonong Primary Hospital 819223
Francistown Jubilee Clinic 211544
Francistown Nyangabgwe Referral Hospital 211000
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Training Manual for Call Centre Operators, January 2002.
Association
Gaborone Youth Matters Cell: 71303476
Ghanzi Chanzi Primary Hospital 596333/4/5
Goodhope Goodhope Primary Hospital 386236
Gumare Gumare Private Hospital 674002/3/4
Gweta Gweta Primary Hospital 612362
Hukuntsi Hukuntsi Primary Hospital 510030
Jwaneng Botswana Jwaneng Mine 380271 x 260
Jwaneng Jwaneng Hospital 380271
Kanye Kanye Medical Mission 340333
Hospital, SDA
Kasane Kasane Primary Hospital 650333
Letlhakane Letlhakane Primary Hospital 278242
Lobatse Lobatse Athlone Hospital 330333/4
Lobatse Lobatse Christian AIDS Centre 506670/330718
Lobatse Tsholofelo Counselling Centre 506670
Mahalapye Mahalapye Hospital 410333
Maun Maun Counselling Centre 661962
Maun Maun Hospital 660444/5/6/7
Maun Women Against Rape 660865
Ministry of Guidance and Counselling 352990
Education Division Curriculum
Gaborone Development and Evaluation
Mmadinare Mmadinare Primary Hospital 817236
Mochudi Deborah Retief Memorial 377333
Hospital
Mochudi Metlhaetsile Women’s 377618/ 377239
Information Centre
Molepolole Keletso Counselling Centre 577001
Molepolole Kweneng Home Based Care 320201
Molepolole Scottish Livingstone Hospital 320333
Orapa Debswana Orapa Mine 270691/272449/272
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Palapye Palapye Primary Hospital 420331/3
Rakops Rakops Primary Hospital 275111
Ramotoswa Ramotswa Hospice at Home 390212
and Clinic
Ramotswa Emmanuel Counselling Centre 390212
Ramotswa Bamalete Lutheran Hospital 390212
Sefhare Sefhare Primary Hospital 448201
Sehithwa Lesedi Lutheran Church Centre 672000
Selibe-Phikwe Selibe-Phikwe Hospital 810333
Serowe Sekgoma Memorial Hospital 430333/4
Thamaga Thamaga Primary Hospital 399250
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