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Overcoming Barriers to HIV Viral Load Suppression among Children through offering Love and Support

In the North Eastern Uganda, particularly in Kotido District, the battle against low-scale viral load suppression for children living with HIV (CLHIV) has been ongoing. Amidst this challenge, the story of Lopido Lawrence (Not real name), a 16-year-old HIV-positive adolescent enrolled in the USAID OVC North East Activity, stands out as an inspiration.

After losing his mother, Lopido lived with his father and stepmother, his father’s frequent late-night absences and struggles with alcohol escalated domestic violence at home. The young boy dropped out of school and sought refuge with his cousins, far from the watchful eye of responsible caregivers. Unaware of his HIV status, his cousins could not provide the necessary support, and Lopido’s health began to deteriorate.

When Lopido was enrolled in the OVC program, he had a viral load count of 36,600 copies. However, during this period, the child faced challenges such as missing appointments and an unsupportive caregiver. As a result, Lopido was lost to follow-up, and efforts were initiated to bring him back into care. Over time, additional viral load tests were conducted, indicating varying levels of suppression.

Lopido’s father, reflecting on their journey, shared, “Our enrollment in the OVC program has been a turning point in the lives of my son and me. I did not realize how my absence would affect him. Through the dedicated efforts of the facility and OVC teams, I have come to appreciate their hard work and pledge to continue supporting my son.”

Through routine home visits, the Social Worker conducted a Root Cause Analysis of Lopido’s non-suppression dating back to 2017. A joint Action Plan was developed with the caregiver, setting clear timelines for improvement. The Social Worker discovered that Lopido was part of peer groups engaging in drug abuse and risky behaviours, including promiscuity. Fear of stigma led him to stop taking his medication and miss appointments for both Intensive Adherence Counseling (IAC) and drug refills. The OVC and facility teams employed various strategies to reach him, including involving YAPs, home drug delivery, home viral load testing, and conducting IAC at the household.

Peer-led sessions were organized, bringing together all CLHIV at the clinic to openly discuss their health issues. They shared their experiences, fostering a sense of community and support. Lopido’s father also agreed to participate in caregiver literacy meetings at the facility, creating a foundation for their collaborative efforts.

Through these combined efforts, Lopido’s father committed to supporting his son through Directly Observed Therapy Sessions (DOTs). Lopido, in turn, vowed to adhere to treatment and stop abusing drugs. He expressed a desire to acquire vocational skills to secure his future, alleviate his father’s financial burdens, and ensure he can continue taking his medication without hindrance.

“I would like to be supported in any skilling since I have grown up and I can’t take up classroom studies, how I wish the project could support me to achieve this in order for me to be able to get some money that can sustain me since my father has other responsibilities, in addition to that I can use the money to buy food to help me in drug taking.”


Agnes Tumuheire

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