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HIV Home-based Care Produces Positive Outcomes in Uganda

sed their HIV status to someone other than a healthcare professional before entering the study.

In the three months before entry to the study, 76% of individuals reported one or more positive outcome, including 66% who felt emotional support from their family, 62% who thought that they received emotional support from their community and 16% who said that their relationship with their spouse was strengthening. Three months after entering the home-based care programme, there had been a significant increase in the proportion of individuals reporting a positive outcome to 87% (p < 0.001). Of note, there were increases in the percentage of individuals reporting emotional support from their families (81%, p < 0.001), from their communities (70%, p < 0.001), and a strengthening of their relationship with their spouse (24%, p = 0.001).

By contrast, there was no change in the proportion of patients reporting negative outcomes after entering the home-based HIV care programme. At baseline, 12% reported any negative outcome, and after three months of home-based care this figure was largely unchanged at 10%.

In a final set of analyses, the investigators restricted their attention to women in the study and asked them if they had experienced physical abuse from their partner. At baseline, 1% of women reported abuse, and although this had increased to 2% by the time of the follow-up interview. This increase was not statistically significant (p = 0.063) bit it nevertheless concerned the investigators.

“Among participants in an antiretroviral programme with weekly home visits in rural Uganda, the vast majority - over 80% - experienced positive social outcomes and very few experienced negative outcomes”, write the investigators. They add that, “the overall frequency of negative outcomes did not change. These findings suggest that the provision of treatment and care services through home-based delivery in resource-poor settings can res
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