HIV Prevention is central to all clinical activities, and mainly targets People Living with HIV (PLHIV) (using the concept of “prevention with positives”). The underlying strategy is to increase the number of individuals who are aware of their HIV sero-status. Therefore opportunities to do HIV testing are offered to the families of our patients. This strategy is based on the observation that most HIV infections occur in a settings where the majority (over 80%) of HIV-infected individuals are unaware of their status.
At IDI we target those who are HIV-positive and their partners with interventions that effectively reduce the likelihood that they will transmit the virus. Many HIV infections in Uganda occur between people in discordant couples. Some of the special prevention-related activities that IDI engages in are:
- Identifying HIV discordant couples, and helping them to maintain their discordant status, through dedicated clinical and counselling services.
- Integrating sexual and reproductive health activities into all clinical care—including Prevention of Mother To Child Transmission (PMTCT), providing more contraceptive choices, prevention and treatment of sexually transmitted infections (STIs)
- Preventing the onset of opportunistic infections (secondary prevention) among those already living with HIV, through provision of basic care kits (including cotrimoxazole) and careful management of detected opportunistic infections.
- Starting people who are eligible for ART on HIV treatment quickly, as those who take ART well have a dramatically reduced chance of passing on the virus to their partners. (Treatment as Prevention)
- Training and enabling PLHIV to support HIV prevention through behavior change communication and the provision of peer support and peer counseling
- Focusing particular attention on young adults, as a particularly high risk group for acquiring or transmitting the virus
- Improving and maintaining HIV/AIDS skills, including those related to prevention, in the health work force Including sexual reproductive health and HIV/opportunistic infections prevention as research focal areas