Opio Hendrick (not real names) a 16-year-old orphan, 3rd born of 4 is the only HIV positive person in their family. He tested HIV positive at the age of 5 in 2012 following frequent illness and stunted growth.
He was initiated on antiretroviral therapy (ART) immediately but had never achieved viral suppression in the last 10 years despite the many enhanced intensive adherence counselling (IAC) sessions and changes in his antiretroviral drugs. His caregivers were also sensitized on disclosure and positive living skills but to no effect.
Hendricks parents died when he was still an infant and was taken into care by his elder brother who lives in Oyam District in Northern Uganda.
During counselling at facility and home visits, the medical teams noted a number of barriers affecting Hendricks treatment. He was not taking his medication timely since he could not easily access the drugs when the brother was not at home. The caregiver was busy with his work and would not bother to observe how the boy was taking his medication, narrates Jackson Olum a counsellor at Aber Hospital who frequently attended to Hendrick.
With the technical and financial support from the USAID Local Service Delivery for HIV/AIDS project, the clinical and the orphans and vulnerable children (OVC) teams, comprehensively managed Hendricks case at the facility. They conducted many home visits to offer psychosocial support, caregivers’ literacy on directly observed therapy (DOTS), adherence counseling, positive living strategies, peer to peer support by young adolescent’s peer support (YAPS), provision of vegetable seeds to boost nutrition and agreed on one caregiver.
However, with no tangible improvements, the team persisted despite the continued challenge. Jointly, the clinical and OVC teams discussed the results and switched Hendrick to a second line drug regimen in 2020 but the Viral load results continued showing upward trends.
In January this year, two blood samples were taken from Hendrick for repeat viral load and drug resistant testing. This time the drug resistant results gave more understanding into the real barrier to viral suppression. The case was discussed at the third line regional drug resistance committee meeting.
The team agreed to switch Hendrick to a third line ART regimen and was started on TDF-3TC-DTG-DRV in March 2022. Hendrick together with his caregivers were counseled and they pledged complete support to the boy’s wellbeing. Currently his repeat viral load is suppressed to <50 copies as of 31st July 2022.
The clinical and social works team are happy with the progress and continue to support Hendrick and family to understand the importance of a low viral load. Hendrick and his caregivers are happier, stronger and benefiting from preventive measures and pledged to support other non-suppressing children.
