What We Do
MSF has been working in Bihar since 2007. Our activities have seen a gradual transition to focus on people living with advanced HIV and life threatening opportunistic infections at Guru Gobind Singh Hospital in Patna. This focus has been driven by a lack of access to care for this extremely vulnerable population, by stigma from healthcare providers and by a lack of specialist tests and drugs.
Patients with advanced HIV have an extremely high mortality rate, with complex treatment needs covering nutrition, infection, mental health and psychosocial support.
MSF has been working in collaboration with the government to reduce the mortality and morbidity in this group of patients through increasing access to holistic care for those presenting with life-threatening opportunistic infections.
- Bihar
People living with HIV are diagnosed with advanced HIV if they have a CD4 count of less than 200 cells/mm3 or if they have certain opportunistic infections of WHO stage 3 or 4 in adult and adolescent ar all children younger than 5 years old.
People with advanced HIV may have high levels of mortality when they have life-threatening opportunistic infections like kala azar or tuberculosis.
Based on our research, 10 to 15 per cent of people living with advanced HIV need specialised management.
In 2022
Since 2019, we have developed and introduced several parallel synergistic approaches to demonstrate a model of care that could be replicated across other sites or whose specific components could be used to generate knowledge to improve approaches to treatment for this patient group at the national level.
Our areas of current focus include proactive antimicrobial resistance stewardship to better guide the rational use of antimicrobials. The project’s other components – including palliative care, nutrition, intensive mental health support and advocacy – make it significant for demonstrating a model of care for advanced HIV in low-resource settings. MSF is working with state and national level AIDS control programme leadership to contribute knowledge and experience. As part of this, the project conducted two workshops during 2020 with the Ministry of Health to train five external medical doctors and four ART counsellors.
MSF continued to provide Advanced HIV care at Guru Gobind Singh Hospital, and has been working on developing medical standard operating procedures (SOPs) to document our practices and learnings. Additionally, we have increased our efforts towards health promotion activities to reduce the stigma faced by persons living with HIV. We are also contributing towards prevention efforts through health education
sessions and direct support to ART Centers in Patna.
