The non-suppressed client at six months of starting ART
Lisa (not real names) had been treated for recurrent malaria, typhoid and brucellosis over a period of six months. She however wasn’t noticing any improvement in the recurrent fevers. This continuous deterioration in health prompted her to test for HIV/AIDS.
On a cold Monday morning, Lisa tested positive for HIV/AIDS at AIC, Kampala. After counselling, Lisa declined ART initiation and requested to come back after a week. The following week, Lisa appeared at the clinic with husband and requested for couple testing. The tests for both of them were positive and having agreed to support each other, they were started on ART.
Lisa continued picking her drugs on appointments as scheduled for the next six months and was highly commended. This was not until her first viral load returned as non-suppressed. We, the health workers were all perplexed as she was also now pregnant.
Her first IAC required her to bring her pill balance and Lisa turned up with a kavera of 5 tins of TDF/3TC/EFV. Her only complaint was that she couldn’t take pills that make her so dizzy to a point of dying. Yet after all, she feels way better with taking cotrimoxazole alone. After the counselling session, Lisa was not convinced at all. This IAC was later followed with home visit by a counsellor. Lisa narrates that “this counsellor engaged me for a whole afternoon in explaining my condition and the risks I was taking” “This counsellor also engaged my husband who wasn’t even aware of my failure to take drugs and since then he makes sure I swallow my medicine and regularly counts my pills” she says with a chuckle.
A now empowered Lisa has never missed her pills from that day which she takes at 10pm her bedtime to avoid the drug’s side effect. She has a set alarm to remind her of the drug time while on a bus on her frequent long journeys to Kasese during the night.
Lisa’s current viral load is suppressed and her baby has tested negative for two consecutive PCRs.
“Musawo, one thing has stuck on my mind since that home visit. I never want to infect my breast-feeding baby with HIV. I want to live long enough to take care of my children and see my grandchildren. I don’t want to ever develop HIV wasting syndrome, herpes or TB”
Elizabeth Nagawa (Clinical supervisor)