The lifestyle and environment in which children and adolescents living with HIV live can positively or negatively influence their treatment outcomes. Due to peer pressure, stigma and poor family support, many end up failing to take their medication properly and others completely discontinue antiretroviral therapy (ART).
Aine Jasper (not real name), 18 years, is among the adolescents that receive antiretroviral drugs (ARVs) from TASO Rukungiri in Western Uganda. In late 2020, Jasper who was living with her mother, disappeared from the TASO Rukungiri ART Clinic and attempts to locate her were fruitless.
The facility engaged the Young Adolescent and Peer Support (YAPS) team to trace and bring her back to care. One of the YAPS was assigned to handle the case. Jasper was traced and found to have relocated to Bushenyi district where she was living with her elder sister.
“At TASO Rukungiri one of our roles as a health service provider is to look for the lost clients. We searched for her and we could not find her but with the support of the YAPS; being a teenager and adolescent like her, they tried by all means and found her”, says Irene, the Adolescent Counselor.
Just like many adolescents, the lockdown period (March 2020 to September 2021) was not fair to Jasper, by the time she was convinced to return to Rukungiri for medical assessment, she was pregnant. Jasper was eight months pregnant and had never received antenatal care or educated on elimination of mother to child transmission (EMTCT) program. “When I discovered I was pregnant, I decided not to come back for my drug refills. I felt confused and did not know what to do next and worst of all I thought about the shame I had brought to my mother” narrates Jasper.
When Jasper returned to Rukungiri, the TASO team visited her home and counselled her. She was given a clinic appointment to see medical personnel to do investigations. We were very happy to see her back in care but now our biggest worry was the risk of her infecting the baby because she was 8 months pregnant and had never gone for antenatal checkup and was naive about EMTCT program, says Irene.
Jasper was referred to Nyakibale Hospital where she received antenatal care and delivered after a month. The TASO Rukungiri team were generous enough to support her medical bills since her mother was unable to.
On 23rd February, 2021 she was bled for viral load and she had 29,719 copies. A repeat viral load was done on 26th April, 2021, she had 44,600 copies and her CD4 count was 271, therefore requiring a drug resistance test. According to Irene, the YAPS had done their part and so did the counselors.
In October 2021, Jaspers repeat viral load results were returned and the virus was NOT DETECTED. Her drug resistance test showed that she was not swallowing antiretroviral (ARV) drugs consistently. She was advised to maintain her drug regimen, monitored and taken through intensive adherence counselling. We celebrated the good news with Jasper and she was very happy, narrates Irene.
Since Jasper was 17 years, the YAPS team linked her to the Orphans Vulnerable Children (OVC) program under TPO Uganda. She was enrolled on an apprenticeship of hair dressing and saloon management. Her child is still on EMTCT care and is still negative. Jasper is determined to complete her course and take care of herself , the baby, and her mother.
TASO Rukungiri is one of the private not for profit (PNFP) organizations supported by USAID Local Services Delivery Activity (LSDA) under Uganda Protestant Medical Bureau (UPMB). The health facility provides HIV treatment and care services in the Western part of Uganda. It has 317 children and adolescents (10-24 years) who are HIV positive.
YAPS is a Ministry of Health Program that is being supported by USAID/LSDA at TASO Rukungiri and other LSDA facilities. They have brought back children into care, supported them with adherence counselling, given health talks and testimonies to care givers. These actions have encouraged care givers to take good care of their children because they now have high hopes in them.