| Chapter 1: | Introduction |
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leads to significant adjustments in lifestyle that are often recommended to individuals under treatment, such as complying with a complex treatment regimen, changes in diet, and so forth, all of which may be challenging to the client whose treatment is for life. Failure to adhere to HAART lifestyle regimens may foster medication adherence failure (AIDSinfo, 2008). Suboptimal HAART adherence is a public health concern because of the potential for the development of a drug-resistant HIV strain. To minimize such problems, it was recommended that HAART initiation in the United States be delayed until those affected at least reach the third stage of the disease.
Moreover, serious side effects are a potential outcome of treatment with highly active antiretroviral drugs. Equally important are concerns that studies regarding the long-term impact of these drugs on the quality of life for those under therapy are still lacking. In that regard, it appeared logical to delay HAART initiation until later stages of the disease, except for expectant mothers who need prevention from passing on the virus to the newborn during childbirth.
Ugandan HAART-providing centers and those of the United States also take different treatment approaches. U.S. centers such as 360: PCC take a holistic approach to treatment in which they provide comprehensive HIV/AIDS care to clients (360: PCC, 2008). Some of the services provided by U.S. HAART-providing centers include diagnostic tests; provision of medical care and medication, such as HIV drugs and laboratory and radiology services; medication services; outpatient surgical services; pain management; mental health counseling and treatment; and physical therapy and counseling; as well as comprehensive assessment and medical treatment for HIV and associated complications. Unlike those in Uganda, U.S. HAART-providing centers also offer social services that include referrals for assistance with community mental health, social support, housing assistance, disability services, nutrition, transportation, psychiatric care, health insurance, and home health care coordination (360: PCC, 2008; ASNT, 2007; Northwestern Memorial Hospital, 2008).
Although the Ugandan centers are designed to take a holistic approach to treatment—and despite the fact that they provide services