Adherence to antiretroviral therapy in a home-based AIDS care programme in rural Uganda

Home based ART programme overcomes economic barriers to accessing treatment and care

This article, from the Lancet, assesses how a home-based AIDS care programme in rural Uganda can affect adherence to antiretroviral therapy (ART). Poverty and limited health services prevent successful adherence to ART for many HIV positive people. The authors argue that non-facility based innovations for ART delivery and treatment are necessary. The study examined a programme that uses trained lay people who regularly visit participants at home to deliver medication and collect information about adherence to ART. Findings show that this comprehensive programme resulted in excellent retention in care and adherence to ART in a population with limited access to transportation and health services.

The authors conclude that good adherence and response to ART can be achieved through home-based care. They argue that the programme removed the external economic constraints to retention in care and adherence by providing free ART with home delivery. They suggest that home-based models of care should be explored elsewhere. They also suggest that combination models of facility-based and community outreach programmes should also be explored. Health systems must continue to implement, evaluate and modify interventions to overcome barriers to comprehensive AIDS care programmes, especially barriers to adherence with ART.

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Adherence to antiretroviral therapy in a home-based AIDS care programme in rural Uganda