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HIV Viral suppression among Children

The Power of Collaboration in HIV Adherence and Viral Suppression: Emmanuel’s Story of Dealing with Opportunistic Infections

Emmanuel (not real name), a 15-year-old boy living with HIV had, for seven challenging months, grappled with a non-suppressed viral load, with a count of 36,874 copies/ml, from November 22, 2021. This situation not only jeopardized his stability in treatment but also left him vulnerable to opportunistic infections.

The challenges he faced led to missed appointments and affected his adherence to treatment but also left him vulnerable to opportunistic infections.
The challenges he faced led to missed appointments and affected his adherence to treatment. However, Emmanuel’s story took a positive turn thanks to the collaborative efforts of various stakeholders.

The USAID OVC NE Activity social workers and para-social workers joined forces with Makerere University Joint AIDS Program (MJAP) and Lunyo HCIII to provide Emmanuel with intensive adherence counselling. This revealed a critical issue: ART administration at home was far from optimal. Emmanuel had lost hope, becoming impatient and disheartened by the daily ritual of taking ART medication.
Recognizing the complexity of Emmanuel’s situation, referrals were made for comprehensive medical examinations. The results revealed chronic malnutrition which had stunted his growth, leaving him weighing a mere 27 kg with a Mid-Upper Arm Circumference (MUAC) of just 17cm (in the red zone). Further home visits conducted by the social worker and clinical teams unveiled an issue of food insecurity and insufficient income to meet his basic needs, including school lunches and additional meals to relieve the pill burden.

A root cause analysis was conducted and it was discovered that Emmanuel’s siblings and other family members were subjecting him to isolation and abuse due to his stunted growth. To address this issue, a team of social workers and linkage facilitators continued to offer counselling and psychosocial support. They facilitated connections with Haba Na Haba food for nutrition supplements to alleviate the pill effect by having a meal before taking medication and directly addressing malnutrition.
Emmanuel’s mother received capacity building on Income Generating Activities and Family Counseling, designed to prevent the stigmatization of her son by other household members. Through these initiatives, family members gained insight into why Emmanuel had struggled with his growth.
The holistic case management interventions, combined with continuous home visits and intensive adherence counselling, yielded remarkable results.

Emmanuel’s viral load dropped to only 52 copies/mls. His vulnerability to opportunistic infections dramatically reduced, and the threats from his siblings ceased. Emmanuel now enjoys a healthy, happy, and thriving life.
Emmanuel’s story demonstrates how united efforts can transform the lives of those living with the virus, providing them with hope, health, and the opportunity to thrive.

Agnes Tumuheire

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