Mandatory patient education when starting ART

Clinical description

• A small number of patients on ART develop significant side-effects.
• Most side-effects are mild and disappear while ART is continued.

o DTG can disturb sleep, but this is rare when taken in the morning and usually settles by itself.

• Some side-effects require a regimen change.
• Very few patients develop serious side effects. Stop all drugs immediately and present to the

hospital if any of the following conditions are seen:

o Yellow eyes / hepatitis o Severe stomach pain and vomiting o Severe skin rash with blisters, involving eyes, mouth or genitals

• All patients must receive individual counselling at ART initiation.
• Women starting ART in labour can receive individual ART counselling after delivery.
• In addition, all patients should attend an ART group counselling session. Recommended practice:

o Attended group counselling between 1 to 5 days before the day of ART initiation.

o But: group counselling can be on the same day as initiation to avoid delay beyond 7 days.

o Pregnant women may attend the group counselling at the next scheduled visit to ensure they can start ART on the same day.

o Ask patients to attend with their named guardian (also see section 16.3 on page 78).

Starting ART 81 ART group counselling

• Use the latest version of the MOH ART flip chart.
• Share “Key facts for providers and patients”
• Explain the standard VL monitoring schedule (see page 90). Ask the patients to help remember

when VL is due.

Individual ART counselling

• Confirm that patient and guardian have understood the following:

o Commitment to lifelong adherence o Dosage and interval of taking ARVs o Potential side-effects o Date of next appointment