Helping People Stay on Treatment by Bringing HIV Services Close to Home

Thirty-five-year-old Aida, a mother of six from Barjobi village in northern Uganda’s Oyam District, has been on antiretroviral therapy (ART) since 2016, when she received an HIV diagnosis when pregnant with her fourth child. At that time, Aida’s three older children, who are 11, 13, and 15, were also tested and found to have HIV. Since then, Aida has had three more children; one of whom is five and HIV-negative, and six-month-old twins who are in the prevention of mother-to-child transmission care.

Aida and her children get care at Ngai Health Center III, which is 20 kilometers from their home. After giving birth to the twins, Aida, whose husband abandoned her 10 months ago and provides no financial support, could not walk the long distance to the clinic to get her family’s medication.

Usually, it takes a whole day to go and come back from the health center. For two months, we did not have drugs, and I was very worried for our lives especially for my newborn twins,” Aida said.

The USAID-funded Regional Health Integration to Enhance Services-North, Lango (RHITES-N, Lango) project, implemented by JSI supports people like Aida in northern Uganda to get HIV medication and support to ensure that treatment protocols are properly followed, and other HIV services including prevention methods and advocacy against stigma.

The project conducted a study that indicated that long distances to the health facility was one of the major reasons that people miss clinic appointments.

In response, the project trains linkage facilitators to track clients who miss appointments and visit them at home. They also provide services including viral load testing, health education and counseling, ART drug refills, and isoniazid to prevent tuberculosis.

Abuci Jane is a community linkage facilitator at Ngai Health Center. When Aida and her children missed their clinical appointments, Jane, who knew that Aida had just had a caesarean delivery, was concerned. So she went to Aida’s home with medication refills.

Other measures that RHITES-N, Lango has taken to help those who live far from clinics and to keep people on ART during the COVID-19 pandemic are multi-month dispensing of drugs, client-led drug delivery, and community distribution points.

Ngai Health Center provides HIV services for 1,035 people in Oyam, of whom 65 (6%) are under 19 years of age and 655 (63%) of whom are female. In the four months between December 2020 and March 2021, the health center helped more than 100 people resume their HIV care.

Aida is greatly relieved that Jane brings her medicine and is thankful for the life-saving support. After six months back in care, Aida and her three children are all virally suppressed.

Written by Lameck Kimuli, Community Linkage Coordinator