“Most of the patients here with detectable viral loads are those who stop taking drugs due to a commonly held belief that prayers heal HIV, those who take their medicines after a 12-hour span due to religious fasting practices, children and orphans without treatment supporters to remind them to take their medicines, traders who travel to Congo and Sudan and miss their HIV care appointments, and alcohol addicts who never remember to take their drugs.”
Hope Nandawun is a Nurse Counselor at the Arua Regional Referral Hospital (RRH) HIV Clinic in Uganda. According to Hope, these categories of patients have poor adherence to treatment which renders the antiretroviral therapy (ART) ineffective--leading to detectable viral loads. To ensure that HIV patients receive the appropriate viral load monitoring, USAID/SUSTAIN has supported Arua RRH to employ a three-way strategy namely: bi-weekly meetings to identify clients eligible for viral load testing; extensive health education on viral load monitoring; and in-depth counseling for those with detectable viral loads.
|Bi-weekly meetings help to identify patients eligible for viral load testing. Patient files are sorted so that for their next appointments, viral load samples get taken off. Same day viral results allow on-time in-depth counseling for clients. These meetings have fostered teamwork among the clinical care, Counselors and the Laboratory teams.|
|A client whose viral load has been suppressed shares her experience with clients attending the HIV clinic in Arua. Accordingly, the opportunity of using clients to give testimonies has reinforced health education talks on viral load suppression. The practice has encouraged adherence to HIV treatment.|
|According to Hope, understanding the socio-economic dynamics of every client is key to designing a counseling plan. Hope uses that to build her counseling for clients with high viral loads. She says, treatment adherence begins with listening to the patient.|
The three strategies helped Arua RRH attain a viral load suppression rate of 90% by Dec 2015.
Hoima, Mubende, Mbale Regional Referral Hospitals are employing the same strategy for viral load suppression.