PATIENT/ CLIENT IN THE HOSPITAL 1. Get the patient’s history and conduct physical examination (PE). Strict adherence to standard safety precautions must be observed at all times. a. If the patient is known or disclosed to be HIV positive, or is referred by another HACT for HIV management: • Secure a copy of most recent HIV test results. In the absence of pertinent medical records, the patient/client would have to undergo testing a new. • Refer the patient to the HACT chairperson or co-chairperson. The HACT will evaluate and refer the patient/client to appropriate person who will be immediately consulted for any medical problems. • If the patient expires, provide the family with psychosocial support. The family may be referred to a non-government organization (NGO) providing psychosocial support services to PLHIV and their families. • If the patient is discharged, schedule regular follow up treatment and testing, preferably every three or six months. Encourage the patient to consult immediately for any medical problems. b. If the patient’s HIV status is unknown (for walk-in or patient/client referred for testing): • Admit to appropriate service and conduct initial work-up and treatment. Identify the patient’s risk factors and check for AIDS- defining conditions. • If the patient has no risk factors and AIDS-defining conditions, manage the illness accordingly. • If the patient has risk factors and/or AIDS-defining conditions, refer to HACT for counseling and testing. Other health care workers (HCW) who are trained to provide pre-test counseling may also be tapped. • If patient is negative for HIV, manage the illness accordingly. Provide post-test counseling and encourage the patient to retake the test after three months, if needed. • If the patient is positive, proceed with the medical management of the illness. Provide post-test counseling and psychosocial support. 2.
Perform baseline tests to determine if ART can be initiated. If ART should commence, consult with the HACT pharmacist. For HACT members in hospitals not classified as DOH HIV Treatment Hub, refer the patient/client to the nearest treatment hub for possible initiation of antiretroviral therapy. (See ANNEX A.) 9