15th International AIDS Conference Bangkok, Thailand — July 11-July 16, 2004

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrE36

E Kamunvi¹, E MacLachlan¹, P Kashyap^2
1Reach Out Mbuya Parish HIV/AIDS Initiative, Kampala, Uganda; ²United Nations World Food Programme, Kampala, Uganda

Issues: Poverty and food insecurity are important factors that HIV+ individuals have to face on a daily basis in poor countries. While medical and emotional supports are necessary for HIV+ individuals, household livelihood is a major concern. Community efforts to develop holistic programmes that integrate medical care with food security and income generation are critical.

Description: Reach Out, an FBO in Kampala, Uganda, is a programme that provides community support for HIV/AIDS infected and their families. Starting with only 14 clients in 2001 it now provides free services for over 1,000 clients in Mbuya Parish (59,000 inhabitants). 60% of its VCT seekers are HIV+. Reach Out components include ART, treatment and prophylaxis of OIs, provision of children's school fees, income generation skills, food support from WFP and micro-credit. 70% of the clients are women, 50% of those are young widowed mothers with limited capacity to bear the household economic burden. Success is shown in 87% of clients who adhere 100% to HIV/TB drugs with help from fellow-clients adherence supporters. Improvements in health have created opportunities for clients to volunteer at Reach Out, of the 120 stipended volunteers, 65% are clients. The cost of the medical packet is $300 per client per year - the holistic packet is only an additional $50 per client per year.

Lessons learned: Working with communities is challenging but by far the most rewarding when programmes are planned with them. Medicine without food - food without hope - hope without a future - each component alone is not enough to restore health.

Recommendations: Community support programmes must have an integrated holistic development approach. Grass roots organizations are best suited for community involvement and commitment. Treating a whole person, and not just the body, is what is needed and it is affordable.

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LbOrE36

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