Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
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New Vision (Kampala) - October 7, 2007
Elvis Basudde
This is contained in a report on a research carried out in Rakai to understand the gravity of limited access to antiretroviral therapy services.
"This not only discourages PLWHAs from accessing ART services, but affects the quality of services offered at those centres," says the report that was released recently.
Joseph Ssembatya, the lead researcher, said respondents cited healthworkers' rudeness as a deterrent to access treatment. "The healthworkers ask the patients: "Are we the ones who infected you?"
The research was conducted by the Community Initiative for Prevention of HIV/Aids (CIPA), an NGO based in Kyotera, Rakai.
It is estimated that between 100,000 and 150,000 people in Uganda are living with HIV/Aids. According to a 2005 report by the Ministry of Health, only about 10,000 people are currently using ARVs.
Whereas ARVs are free and data indicates that there are many people who are eligible to get them, why then is it that not many people come out to take advantage of this free service?
The prevalence rates for Rakai district for females is about 12.9% higher than males which is about 9.3%, a justification that females are at a higher risk of acquiring HIV.
The figures double the national sero figure, which is 6% to 7%.
"We have over 18,000 PLWHAs in Uganda who are on ARVs. Rakai district has about 3,000 people on ARVS.
This is indicates there are very many people with the virus who are not seeking ART services. There must be a problem," said Resty Tumusiime, the LC5 vice-chairperson of Rakai district.
According to CIPA, factors that hinder PLWHAs from accessing ART services include: the educational level of patients, gender, stigma, long distance to ART services, lack of awareness and health facilities.
CIPA and her partners believe that the findings are a representative of the whole country.
According to the report, respondents who had not studied beyond Primary Seven were more likely to have no interest in taking an HIV test or ART services (26%), compared to those who studied beyond that.
Similarly, the strong perception that one did not have HIV and, therefore, had no need to utilise ART services was observed to be highest among those who had attained Primary Seven level and below.
Females whose level of education is below Primary Five were more likely to mention that instructions from healthworkers hindered them access ART services (30.5%), compared with males (22.2%).
"Sometimes I go to the clinic and think I will take a few minutes, but healthworkers give you very many instructions, some of which are difficult to follow," said a 29-year-old married woman.
When it comes to gender related issues, females were more likely to express concerns related to long distances (13.7%) compared to their male counterparts (8.3%). This is associated with the way females handle healthcare issues.
Esther Nalule, the chairperson of Agaliawamu Women's Group for PLWHA, said lack of transport hinders her from accessing ARVs.
"I have to go for drugs from Rakai Hospital. Every time I go to the clinic, I do not use less than sh20,000 on transport yet I do not have a stable source of income," Nalule says.
Most PLWAs interviewed by The New Vision said the main challenges are related with stigma, long distances to health centres, gender and availability of health facilities.
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