Integrating Sanitation into Services for People Living with HIV and AIDS

This publication by C-Change and WASHplus describes how to incorporate water, sanitation, and hygiene (WASH) into PEPFAR’s adult and pediatric basic care packages (BCP), identifies opportunities for WASH/PEPFAR Integration, potential in-country partners, and sanitation/WASH promotion materials, and explores possible sanitation programming within PEPFAR.

Globally, more than 33 million people now live with HIV and AIDS (UNAIDS 2009). This pandemic has dramatically changed patterns of disease in developing countries. In addition, previously rare “opportunistic” diseases have become more common. High rates of morbidity and mortality from endemic conditions such as tuberculosis (TB), diarrheal diseases, and wasting syndromes, formerly confined to the elderly and malnourished, are now common among young and middle-aged people in many development countries. With increasing availability of antiretroviral therapies (ART), more people live with HIV and AIDS and require comprehensive care, treatment, and preventive services to help boost their resilience to the endemic conditions in their environment and help them live longer and healthier lives. Recognizing the importance of safe water, sanitation, and hygiene promotion in protecting and caring for people living with HIV (PLHIV), the trend is to integrate WASH improvement into HIV and AIDS policies and programs.

As part of its palliative care approach, PEPFAR has developed a preventive care package that summarizes evidence-based interventions for PLHIV and their families in resource-poor settings. The package identifies three key hygiene improvement practices – safe drinking water, washing hands with soap, and safe handling and disposal of feces – and suggests integrating these into all HIV and AIDS programs.