As the world strives to end morbidity and mortality due to HIV/AIDS, Baylor-Uganda complements these global efforts through implementing data-driven approaches under all its projects. Guided by the national treatment guidelines for comprehensive HIV care, we are currently supporting over 300 health facilities across 30 districts in Uganda to improve the quality of life among people living with HIV/AIDS (PLHIV). Our implementation approach is majorly through strengthening health systems while underscoring effectiveness & efficiency, governance and leadership, local partnerships as well as sustainability of all our interventions. We currently run a centre of excellence HIV clinic in Mulago hospital complex as well as support through district led programming 3 HIV care and treatment projects; ACE-FORT in mid-western Uganda, and ACE-Bunyoro in western Uganda both funded through Centres for Disease Control and Prevention (CDC) Uganda and the USAID Local Partner Health Services – Eastern Region (USAID LPHS-E). Key areas of focus under HIV care and Treatment include; HIV case identification and anti-retroviral therapy to all, TB case finding and treatment, Cervical cancer screening and treatment/management as well as identification and management of advanced HIV disease. All treatment indicators are driven by the need to reached the third 95% of clients on ART being virally suppressed as well as ensuring all PLHIV with opportunistic infections including TB, Cryptococcal meningitis, cervical cancer among others are well managed.
By the end of June 2021, 93,681 people (females: 60,380, males: 33,301) were on life-saving Anti-Retroviral Therapy (ART), including 8,299 who were initiated during the reporting period. Of these, 270 were children < 10years of age, and 627 were adolescents 10-19years.
Linkage, adherence, and retention
We continued to register 100% linkage to treatment for all newly identified HIV-positive recipients of care
across all sub-populations. To enhance adherence to treatment and retention in care, have continued to expand health facility and community platforms for ART delivery, providing recipients of care an opportunity to select the best Differentiated Service Delivery Model (DSDM) that best recognizes the individual choice and rights.
Table showing enrollment in DSDM in Fort Portal
region over four quarters
Proportions of recipients of care in Facility-Based Individual Management (FBIM) and Facility-Based Groups (FBG) decreased as desired, as proportions in Fast Track Drug Refills (FTDR) increased. Case
Management Officers (CMOs) in large volume health facilities continually educated recipients of care and supported them to make choices of the best DSD model.
Using Multi-Month Drug (MMD) dispensing we provided medicines to stable recipients of care lasting 3-6 months, allowing them and their families to play an increasingly more significant role in supporting medication adherence.
Table showing Multi-month drug (MMD) refill (Q3, COP20)
We also used a multifaceted retention package comprising client literacy (health worker and client-led health education sessions), tracing recipients of care, and sending default reminder messages on the same day that they miss a clinic appointment, phone calls, and text messages.
By the end of June, the Bunyoro region had 64,483 clients active in care (TX_CURR) compared to 62,704
clients in care by the end of March, putting the region at 93% of the 69,375-annual target, which was a gradual
increase from 86.4% in Q1 and 89.5% in Q2. All the districts registered a growth in their TX_CURR since the
start of COP20. The growth in TX_CURR can be explained by improved documentation in the data capture
tools and timely follow-up of clients who miss their appointments.
TX_CURR Trends July 2020 – June 2021
Pediatric and Adolescent HIV Care and Treatment
There were 3,147 children aged <15 years and 2,799 adolescents active in care by the end of June, contributing
70% and 67% of the annual pediatric and adolescent TX_CURR target, respectively. The significant challenge
for retention is still the disproportionately high losses among females aged 15-19 years.
