by Partners In Health; Program in Infectious Disease and Social Change, Harvard Medical School; Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital; François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health (2006)

Partners In Health has published an updated and expanded second edition of The PIH Guide to the Community-Based Treatment of HIV in Resource-Poor Settings. Drawing on PIH's experience since 1998 treating HIV patients in rural Haiti, the guide includes clinical protocols and guidelines for managing HIV-positive patients, as well as information about how to initiate a comprehensive HIV prevention and treatment program.

The contents and use of the Guide are summarized in a Foreword written for the second edition by Dr. John G. Bartlett, chief of the Division of Infectious Disease and  Director of the AIDS Service at Johns Hopkins School of Medicine:

"An estimated 90 percent of the 40 million people living with HIV infection live in countries that possess less than 10 percent of the world's assets. The PIH Guide to the Community-Based Treatment of HIV in Resource-Poor Settings is a comprehensive text for HIV care delivery in these very areas.

"This is a really good book. The authors have considerable experience with both AIDS treatment and the delivery of general health care in resource-limited settings—and their experience shows. The guide covers the totality of HIV care, including voluntary counseling and testing (VCT); HIV prevention; antiretroviral therapy (ART); and diagnosis and treatment of opportunistic and other related infections, with particular emphasis on tuberculosis (TB) co-infection and sexually transmitted infections (STIs).

Information is presented in a practical fashion, making it useful in diverse settings. Thus, recommendations for initiating and changing HIV therapy are made for settings ranging from those in which laboratory testing is limited to places where a total lymphocyte count can be obtained, to those with access to viral load analysis. A section on data management is also included. The guidelines for HIV treatment are – appropriately -- based largely on World Health Organization (WHO) guidelines; recommendations for treating opportunistic infections (OIs) and other complications of HIV infection make use of drugs and diagnostics available in those areas of the world where the guide is intended for use.

"The format used is textual; a substantial list of references is provided with each chapter to support recommendations. Most importantly, many algorithms (protocols) that care providers will find extremely useful have also been included. I found these algorithms to be logical, easy to follow, and reflective of best practices.

"This book is largely based on the authors' experience in Haiti; however, the challenges they faced and the lessons they learned can easily be extrapolated to similar settings. Obviously, set- tings exist where local practices and disease patterns will require different approaches. Nevertheless, most of this guide is likely to be an important companion for the care providers of persons with HIV/AIDS who live in resource-poor settings."