Once a patient is identified, he or she will be referred to the CTC. At the initial clinic visit a triage nurse will assess patients needs, register basic information, issue relevant forms, weigh and direct patient to relevant sites. Blood will be drawn for a confirmatory HIV test if there is doubt on their status, and CD4 cell count, before the patient meets with a counsellor. Given that test results will typically not be available on the same day, the patient will be scheduled for a follow-up visit with a clinician to discuss the test results.
At the follow-up visit, after consultation with a clinician, patients who are recommended for and agree to initiate therapy will meet with a counsellor to discuss about adherence, medication dosing and adverse event management. They will have another blood sample drawn for tests which will help inform the treatment protocol and to identify baseline values for monitoring toxicity. Patients will be scheduled for follow-up after two weeks, then monthly for the first six months for clinical care and monitoring of response to therapy (including toxicity management). During these visits, they will see an evaluating clinician, pick up their medication from the pharmacy, and meet with a counsellor (see counselling section below). After six months, the patient will be requested to visit the clinic once a month for medication and counselling and as needed for clinical care. At six months intervals, CD4 counts and basic blood tests will be performed and patients will see an evaluating clinician for follow-up and to evaluate response to therapy.
For those who do not immediately qualify for treatment, regular monitoring of their status will be required as follows:
Asymptomatic (WHO stage I): Periodic monitoring will be required, with CD4 cell counts, and staging visits being done every 6 months
Symptomatic (WHO stage II, and stage III who do not qualify): Regular monitoring will be necessary, with CD4 counts and staging being done every (4 months).
All patients are however to be advised to come into the CTC immediately should their condition deteriorate prior to their next scheduled visit.