Lack of skilled HIV counselors disrupting drug adherence – Experts


HIV experts and activists have revealed that the lack of skilled HIV / AIDS counselors is one of the main gaps facilitating the decline in the number of people receiving treatment.

Currently, there are approximately 1,800 antiretroviral (ART) centers in Uganda.

“If you go to a typical ART center and look for an HIV counselor, there isn’t one. Even some centers that have potential counselors are not knowledgeable about HIV, have gaps in their knowledge about HIV, ”HIV treatment and care specialist Dr Stephen Watiti said at a virtual media café. hosted by the Health Journalists Network in Uganda (HEJNU) on Friday.

Because some people living with HIV do not have any serious illnesses, the expert noted, they do not adhere to medicine and are likely to lead unhealthy lifestyles, due to lack of information.

Winifred Ikilai from the National Forum of Networks of People Living with HIV / AIDS in Uganda (NAFOPHANU) and an AVAC 2020 Advocacy Fellow, said that because people living with HIV (PLHIV) are not sufficiently prepared to take the drugs for life, they eventually give up out of their treatment.

“We have a high loss of follow-up (LTFU) of around 66% of those who start treatment and as a country around 75% of PLHIV are virally deleted, but we want to reach 100% or even more. Because of these gaps, we believe we need trained counselors who are knowledgeable about AIDS, able to counsel well, to prepare this person psychologically and mentally to start treatment, ”Ikilai said.

She noted that beyond providing HIV drugs, individuals should be supported to adhere to treatment so that they receive regular care, including treatment knowledge if the country is to meet its goal. plan to end AIDS by 2030.

“If that person doesn’t understand the risks or benefits of treatment, they are not going to adhere to their treatment,” Ikilai said.

Winifred Ikilai

Meanwhile, an HIV intervention, the Undetectable = Untransmittable (U = U) campaign which aims to raise awareness of HIV treatment (ART) has not been adopted by African countries due to lack of information according to reports from supervisory agencies.

Evidence from the HIV Prevention Trials Network (HPTN); HPTN 052 trials which began in 2005 among serodiscordant couples have shown that ART for HIV infections offers long-lasting and reliable protection against sexual transmission of the virus from infected men and women to their non-HIV-infected sexual partners. .

Moses Nsubuga aka Supercharger, an HIV activist and founder of Stigmaless Band Music Group noted that because people don’t have information about this initiative, they can’t ask for services, resulting in poor adherence to drugs. .

“We have to define it in the language people understand. We need to wrap it with the right messages because for U = U to be successful, PLHIV need to take their medication. And when they take their medications, they have to respect them and take them correctly. They should not interpret that when you are undetectable you do not need protection. They still need protection to prevent problems such as resistant strains of HIV, STDs and unwanted pregnancies, ”he said.

Adding: “In order for people to fully access and use this service, they need to know about its benefits. In Uganda we just put people on treatment without explaining the benefits. “

He further recommended that there be a budget for peer counselors who offer information on AIDS.

An article published in 2020 in the BMC Public Health Journal titled “Understanding the Barriers to Implementing Nationwide Scaling Up of Differentiated ART Delivery in Uganda” showed that the competence of health workers in delivering ART of differentiated services (DSD) for ART was highlighted as a bottleneck in the implementation of services in the sample of health facilities.

“National HIV program managers revealed that some health facilities had health workers who had not yet been trained in providing DSD, while for facilities that had been affected by the programs DSD training from the Ministry of Health, only a proportion of their health workers in ART clinics had been trained to provide DSD, ”the article reveals.

In an effort to fill this gap, Dr Watiti said they empower peer counselors among PLHIV to provide such services.

“They are not trained counselors, but they are people with experiential knowledge. So we give them more knowledge and tell them to listen more and guide people, ”he said.

People have been encouraged to get tested regularly for HIV, in addition to other diseases like diabetes, cervical cancer, prostate cancer, among others.

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