The benefits and limitations of intensive adherence counselling: A case study of PLWHAs in Luwero Health Centre IV ART Clinic

Abstract

The study analysed the benefits and limitations of intensive adherence counselling for people living with HIV in Luwero Health Centre IV ART clinic. It was guided by specific objectives which included; explanation of the meaning of intensive adherence counselling to PLWHAs and health workers; finding out the role of IAC towards adherence to ART, understanding the experiences of clients on IAC, including the benefits of intensive adherence counselling to the people living with HIV and AIDS and the factors hindering its success. Comparison of experiences of patients on IAC and those that were not on IAC was also made. Data was collected using a case study design, underpinned by use of qualitative methods. The study comprised of 10 participants who included seven case study participants (PLWHAs) of which five participants had or were still receiving IAC while two were not on IAC, but had received ordinary counselling services that patients on ART received. Other participants included 3 Key Informants (a social worker and two counsellors). In-depth interviews and key informant interviews were used to collect data from the study participants. The study's findings included IAC being described as a program that was recommended by the ministry of health in a bid to see to suppression of each and every HIV patient, a description that was rather given by the health workers at the ART clinic, Luwero Health Centre IV. the major role of IAC was to ensure suppression by the patient, where suppression meant a viral load less than 1000 copies/ml. Experiences of all the patients interviewed were obtained. The increased use of IAC as revealed by counsellors showed that suppression of the virus was becoming common after being on IAC, and there was vivid behavioural modification among the clients, this was not only drawn from the views from the health workers but from the clients’ experiences as well when they told their stories, which came from different dimensions but rounded up to almost being the same, most especially when it came to the compromises. On the downside, IAC was limited by factors such as poverty (being the major barrier), shortage of manpower, traditional beliefs and less male involvement. The study related to a number of other studies like that of Nina (2012), Gugulethu (2007), Sentebale (2017), Michael (2011) and more. Given the above findings, it is recommended that in order for clients to benefit from IAC, they need to be provided with necessary information about the IAC concept. Financial empowerment would also be key for example provision of transport to those that have to move long distances to come for the IAC sessions, male involvement and enhancement of components that make up IAC would also be so instrumental especially in differentiating it from other forms of counselling. Health workers would have to create more time with their clients and keep up the spirit of seeing to their clients’ well being.