A new Ugandan study offers great hope for people with AIDS in rural areas in Africa needing antiretroviral treatment.
The trial tested a model in which lay-trained counsellors, not doctors or nurses, treated people at home – and they were as healthy as the patients being treated in clinics.
The cluster randomised trial took place in 44 areas in Jinja, Uganda.
The results, published in the Lancet journal online this week, suggested: “This home-based HIV-care strategy is as effective as is a clinic-based strategy.
“(This) could enable improved and equitable access to HIV treatment, especially in areas with poor infrastructure and access to clinic care.”
The researchers found after two and a half years that:
*Home-based ART by trained lay workers achieved equal health gains;
*Reduced mortality, hospital admission and viral supression were used to measure health gains;
*Patient costs were cut by half or more in the home-based care;
*Home-based care cost the health service slightly less.
Supporting the model, an editorial in Lancet stated: “This result provides compelling evidence for rolling out home-based ART to complement facility-based delivery and facilitate access.
“(This is true) especially in rural settings with weak health systems, shortage of clinical staff , and poor patients for whom transport cost and lost work-time provide obstacles to treatment initiation and adherence.”
The results are exciting but Uganda has one huge advantage over South Africa. Stigma around HIV/AID is far less prevalent and people are much more open about having the virus.