Adaptation of a general primary care package for HIV-infected adults to an HIV centre setting in Gaborone, Botswana

Trop Med Int Health. 2013 Mar;18(3):328-43. doi: 10.1111/tmi.12041. Epub 2013 Jan 4.


Background: As life expectancy of HIV-infected patients improves due to antiretroviral treatment (ART) and the importance of associated co-morbidities and chronic diseases increases, preventive care will become increasingly important. Adaptation of existing preventive guidelines to local environments will become a priority for HIV treatment programmes.

Methods: Guidance from the World Health Organization, a focused evidenced-based literature review, Botswana national guidelines, Botswana-specific morbidity and mortality data and centre-specific data were used to adapt a published general primary care package for limited-resource areas to our centre's specific setting.

Results: The preventive care package contains recommendations on tuberculosis prevention, malnutrition, depression, cervical and breast cancer, hepatitis B coinfection, cardiovascular risk factors, external injury prevention, domestic violence screening, tobacco and substance-abuse counselling, contraception and screening and treatment of sexually transmitted infections.

Conclusion: This preventive care package addresses the comprehensive health needs of HIV-infected adults in the FMC in an evidence-based manner. The process of combining clinic-specific prevalence data, national guidelines, regional literature and assessment of public-sector resources to adapt an existing general package could be utilised to develop similar guidelines in other resource-limited locales.

MeSH terms

  • Adolescent
  • Adult
  • Antiretroviral Therapy, Highly Active
  • Botswana
  • Community Health Centers
  • Comprehensive Health Care / economics
  • Comprehensive Health Care / methods*
  • Comprehensive Health Care / organization & administration*
  • Cost Control
  • Developing Countries
  • Female
  • HIV Infections / economics
  • HIV Infections / therapy*
  • Health Promotion / economics
  • Health Promotion / methods*
  • Health Promotion / organization & administration*
  • Humans
  • Male
  • Middle Aged
  • Models, Organizational
  • Practice Guidelines as Topic
  • Primary Health Care