Pediatric HIV Network Reaches Thai Citizens with a Message of Hope

14-year-old HIV patient Nantikan, who asked that only her first name be used, prepares her monthly ARV medications at the ARV clinic in Sawanpracharak Hospital, Nakornsawan, Thailand. Through the CDC's Pediatric HIV Quality Care Network, supported by the Global AIDS Program (GAP), Nantikan takes part in both play and educational activities each month when she comes to the hospital to collect her ARV medications. © David Snyder/CDC Foundation

In 2005, Nantikan, then eight years old, developed a rash. For many caregivers, a rash would not inspire panic, but Nantikan’s aunt and primary caregiver, Kulton, recognized its importance.

“Nantikan’s sister died, then six months later her mother died, so we thought it would be important to have her tested,” said Kulton. “I thought she might have HIV.”

After Nantikan lost her mother, older sister, and ultimately her father to AIDS, her future did not look bright. But thanks in part to the Pediatric HIV Quality Care Network, supported in part by CDC, Nantikan and more than 3,300 HIV-positive children in Thailand are on a happier, healthier path.

The network is built around a model for comprehensive pediatric HIV treatment that was created by a Thai pediatrician, Dr. Rawiwan Hansudewechakul. Thailand’s Ministry of Public Health (MOPH) and CDC’s Global AIDS Program teamed up to expand the model to community clinics in nearly half of Thailand’s 77 provinces. Treatment of kids with HIV is particularly difficult because their antiretroviral (ARV) medication dosages must often be adjusted, and their treatment must be carefully monitored by caregivers like Kulton. Thanks to the network, more families are able to receive care near their homes.

Interspersed with treatment are serious lessons for both the young patients and their caregivers on such topics as sex education and the proper care and treatment of HIV-positive people in the home. Such lessons, Kulton says, have increased both her confidence as a caregiver and her ability to support her niece, who is much healthier since receiving ARV medications.

In addition to educating both caregivers and patients on HIV, the network has helped train staff and volunteers at 170 medical facilities across Thailand to provide more comprehensive care for pediatric HIV patients. Staff at participating hospitals form multidisciplinary care teams and work together to encourage dialogue among caregivers, patients, staff members and volunteers. The MOPH aims to continue providing technical assistance to health care workers in order to bring the network to the entire country, reaching as many as 6,000 additional children who are on ARV treatment.

While the ARV medications provided free through the Government of Thailand have bolstered her physical health, Nantikan says the staff members of Sawanpracharack’s ARV Clinic, trained through the network, are as powerful as any medicine she receives.

“Since this clinic started it seems many people take care of me, and I feel that the doctors and the others love me and want to take care of me,” Nantikan says. “They make me stronger.”