The vital role of communities in ARV treatment
01 June 2004
On 1 June 2004, the Alliance launched a new project in Zambia to support the vital role of communities in ARV treatment. The project will operate at community and ARV clinic levels in two sites in Lusaka and Ndola. The addition of a third site is being planned. The Alliance is working in partnership with the Zambian Network of People Living with HIV/AIDS, the Central Board of Health, the Catholic Diocese of Ndola, Archdiocese of Lusaka, the Traditional Health Practitioners Association and Africa Directions.
The interventions cover four strategic areas: community education, prevention for people with HIV, adherence support and referral. Interventions will include:
- training and resourcing HIV positive people to work as treatment supporter workers in the government ARV treatment clinics
- training and resourcing HIV positive people to work as treatment mobilisers in communities
- community-based education events – information stalls at markets, street drama, health fairs, distribution of ARV fact sheets in Nyanja and Bemba (local languages)
- training and supporting traditional healers to educate their patients about ARV treatment and support their patients with traditional treatments for side effects
- training on ARV treatment for home-based carers who in turn can provide information about ARV treatment and prevention to those to whom they provide care.
This work is being developed to directly support the Zambian Government's ARV treatment programme. The Zambian Government acknowledges that for their ARV treatment programme to work, communities need to know about, believe in and present for ARV therapy. Once on therapy, senior Government Health officials also recognise that people will need support in their homes and in their neighbourhoods to adhere to ARV treatment, to manage their side effects, sexual health and HIV protective behaviour.
All this work –- the work amongst families, neighbourhoods and communities to support clinical services for optimal treatment outcomes – is the focus of this multi-site intervention. Dr Mandeep Dhaliwal from the Alliance describes the importance of working in communities to support ARV treatment roll-out:
A person taking ARV treatment might spend 20 minutes in a clinic seeing a doctor or health worker every month. The rest of that day, that week, that month, that year, that same person is living in their community, taking ARV treatment. We want to support that person's treatment experience outside the clinic, in the rest of their lives.
The interventions will be combined with a research component. The operations research will be supported through a partnership with Horizons. Key research questions include:
- What is the effect of community education and referral on a community’s knowledge about ARV treatment and how to access treatment programs, health-seeking behaviours, adherence to ARV treatment, HIV preventive behaviour, and on stigma and discrimination towards people with HIV?
- How does building the capacity of people with HIV to support adherence and prevention contribute to preventive behaviour, ARV adherence and health maintenance among people with HIV?
- How does building the capacity of people with HIV to support adherence and prevention contribute to and influence the social capital of people with HIV?
- What are the levels of ARV adherence, preventive behaviour and reported experiences of stigma and discrimination of people with HIV taking ARV treatment through the government ARV programme?
- What are the costs of the intervention?
For further information please contact Dr Mandeep Dhaliwal at mdhaliwal@aidsalliance.org or Dr Cynthia Bowa at cynthia@alliancezambia.org.zm, International HIV/AIDS Alliance.
