Linkage to care officers (LCOs) in health facilities in Right to Care’s USAID-supported districts in the Free State and Mpumalanga are proving that a caring approach with HIV-positive people who have defaulted on their treatment is the most effective way to get them back into care. This same approach is being used to start youngsters at high risk of contracting HIV on pre-exposure prophylaxis (PrEP).
South Africa’s progress in implementing the universal test and treat programme has helped reduce new HIV infections and AIDS-related deaths. This programme targets people at high risk of contracting HIV for testing and ensures that those who test positive are started on antiretroviral treatment (ART) immediately. However, with more people on ART, Right to Care noticed more people defaulting on their treatment and not returning to their health facilities.
Right to Care acted quickly. LCOs were appointed and placed in facilities to find HIV-positive patients lost to care and to identify high-risk HIV-negative people, especially young girls aged 15 to 24. The LCOs began the painstaking work of cross-checking appointment books against patient files, contacting patients using calls and text messages, noting which phone numbers were no longer valid, and working with outreach and home-based care teams to find patients that don’t respond.
Significant results have been achieved across all the facilities which have appointed LCOs. A large proportion of patients traced are now back on their treatment and attending follow-up appointments while young girls at high risk of getting HIV are started on PrEP.
Magdeline Dilebo, an LCO working in Mpumalanga, says, “I ask why the patient stopped treatment and explain the importance of taking ART. If the patient is afraid or uncomfortable, I ensure he or she sees our nurse and receives counselling. I remind patients about their appointments, some say they had forgotten, and they thank me.”
Mantho Mafanyolle is an LCO working in the Free State. She explains, “I actively listen to my clients and make sure that I empathize. Every day I call patients to remind them of their appointment, and I call patients who did not arrive. When they get to the clinic I fast track them. I ask them to come with their partners so I can test them too.”
It is hoped that over time, the universal test and treat approach will see the elimination of HIV.