RED International’s partners want to equip people to adhere to their antiretroviral therapy (ART) therapy by establishing a centre to facilitate ART adherence support and counselling,

The Challenge

Without antiretroviral therapy (ART), most people living with HIV will eventually develop progressive immunodeficiency, leading to AIDS relating illnesses and premature death.

Strict lifelong adherence is important for sustained HIV suppression, the prevention of drug resistance and improved health. Research shows that people are more likely to adhere to treatment if they have a support system in place.

In Zambia, factors that contribute to nonadherence include; low levels of social support, non-disclosure of HIV status for fear of rejection, denial of HIV status, and stigma.

Kabwe has one government Ministry Of Health (MOH) Clinic providing HIV services. These are frequently over stretched due to high patient numbers and low staffing levels.  As a result, when a person living with HIV receives their ART, they are not provided with the necessary knowledge about their treatment, given sufficient time to ask questions, and so are not motivated to adhere.

Our Response

By establishing a centre that offers client focussed adherence support and counselling, people living with HIV will be educated, supported and motivated to adhere to their treatment. Clients will have the opportunity to gain a better understanding of their treatment; an understanding of the goals of therapy along with an understanding of the importance and benefits of strict, lifelong adherence.

Subilo house will function primarily as a residential centre. Clients will be encouraged to remain for a period of 2 weeks, up to a maximum of 3. The aim is to create a family feel environment, where peer support can be nurtured and modelled amongst clients and staff. Clients will have access to support 24 hours a day, to ask questions or raise concerns, which is especially important during therapy initiation.

Clients will receive diet, fluids, a nutritional supplement daily and assistance with personal care if needed. The aim is to create a comfortable, non-threatening environment so that time spent at Subilo house is holistically beneficial.

Clients and their family will receive specific HIV education, to develop understanding whether they have knowledge or not. The aim is for clients to know how to self-care and how to live positively, to have understanding of the goals of therapy and the importance of strict adherence. Staff will positively motivate and encourage clients to adhere to therapy.

A vegetable garden will be used as an education tool to demonstrate how a small area of land can be used to grow nutritious produce. It is hoped that clients will put this knowledge into practice once discharged and begin growing their own produce to provide good nutrition. Garden produce will also be used to feed clients.

Our partners have developed a working partnership with the District Medical Officer based in Kabwe. Subilo house will operate a two way referral system. Clients will be received by referral from the local MOH clinic and other HIV focussed NGO’s in Kabwe. If a client requires medical, nursing assessment and/ or treatment, staff will refer back to the MOH clinic whilst ensuring clients are supported through the process.

The centre will offer free HIV testing services, which the local community can access along with family members of clients who stay at the centre. The team recognise that HIV testing is the gateway to HIV prevention, treatment, care and support services. HIV test kits and supplies will be procured from the local MOH Clinic in Kabwe. Clients who test positive will be referred to the MOH clinic for therapy initiation. They will then be eligible to become a client at the care centre for adherence support.

Potential Long-Term Impact

The benefit of a person living with HIV adhering to treatment is improved health, quality of life and life expectancy. The occurrence of Opportunistic Infections will reduce, impacting the financial burden to the Zambian health system.  Increased life quality and expectancy means a greater workforce, impacting personal and National economy.  If viral suppression is achieved, this will impact HIV transmission, causing a reduction in new HIV infections and more significantly a reduction in AIDS deaths.

Engaging with and teaching family members and other care givers will result in communities being better equipped to provide ongoing support and encouragement once a client has returned home. The knowledge they receive will also give them a better understanding and acceptance of HIV, and the needs of a person living with HIV, helping to reduce stigma and discrimination which is highly prevalent in Kabwe.

Through a holistic approach, clients will also be equipped with knowledge of how to live with HIV, addressing topics such as nutrition, hygiene and sexuality. Subilo house will be a knowledge sharing environment, where questions and discussions will be encouraged to ensure that each client leaves equipped to continue adhering to treatment.

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