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HIV Home-based Care Produces Positive Outcomes in Uganda

Providing home-based anti-HIV care is associated with multiple positive social outcomes,// research conducted in rural Uganda and published in the January 2nd edition of the Journal of Acquired Immune Deficiency Syndromes shows.

Home-based HIV care did not appear to lead to stigmatisation or an increase in negative experiences. Although there was a non-significant increase in the incidence of domestic violence against women participating in the home-based care programme, the investigators believe that home care could help identify women at risk of domestic violence and provide interventions to reduce violence against women.

There has been a significant increase in the funding of HIV treatment, care and prevention in resource-limited settings, including sub-Saharan Africa. Home-based care has been used for tuberculosis (TB) and leprosy, and it has been suggested as a possible model for the delivery of HIV care. It is thought that advantages would include the opportunity to provide support to multiple family members, adherence support, and ease use of healthcare facilities. However, set against these possible advantages are concerns that home-based care could lead to the identification in the community of HIV-positive individuals. Investigators therefore wished to obtain empirical data regarding the impact of home-based HIV care.

Participants in the Home-Based AIDS Care project in the Toro and Busia districts of rural Uganda were asked about positive and negative aspects of their lives three months before entering into the home-based HIV care programme and three months after. A total of 654 individuals participated in baseline interviews, and 598 of these took part in the follow-up interviews. The study ran between May 2003 and May 2004.

At baseline, 72% of participants were women, and the mean CD4 cell count was 172 cells/mm3, indicating significant HIV disease progression. Nearly all (96%) of participants had disclo
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