Skip Navigation

Banner

Rakai Health
Sciences Program

Chronology

Structure

Current Research

NIH International Center for Excellence in Research

Publications

Community Services

 

Community Services

Learn more about the services the Rakai Health Sciences Program performs in Uganda.

Jump to
Antiretroviral Therapy  
General Medical Care  
Voluntary HIV Counseling and Testing VCT  
Health Education and Community Mobilization  
SHARE Project  

Antiretrovial Therapy

Testing for HIV
Dr. Gertrude Nakigozi tests a patient for HIV.
With support from the Presidents Emergency Program for AIDS Relief (PEPFAR), the Rakai Health Services Program (RHSP) has screened 4,397 HIV-infected people and initiated HAART treatment for 849 eligible patients. Adult patients are eligible for HAART if their CD4 count is less than 250 cells/mm3. or they have symptoms, and 26 children under five years of age are on HAART. All HIV+ individuals are provided with prophylactic septrin to prevent opportunistic infections, bed nets to prevent malaria, and water sterilization to prevent intestinal infections. The treatment program employs an innovative home care approach, combined with mobile services which visit each community every two weeks allowing physicians to monitor patients. In addition, we have initiated a system of peer educators who are people living with AIDS and successfully on treatment, to help support other patients. The peer educators have been provided with cell phones so that they can get advice from physicians in case of emergencies.

The response to treatment has been very satisfactory, with over 63 percent of patients having undetectable virus, and 93 percent with less than 10,000 copies of the virus in their blood (Reynolds et al 2006). 94.3 percent have had improved immune status as indicated by increases in their CD4 counts. 4.6 percent of treated patients died, mainly because they had advanced disease complicated by TB at the time they initiated treatment. Rakai studies have shown that initiation of therapy using the WHO clinical criteria or symptomatology would lead to serious under-treatment and that there is need to measure CD4 counts in order to determine treatment eligibility (Kagaayi et al. 2007, Spacek et al Int J STD AIDS 2006, Nguyen et al Int J STD AIDS 2006).

General Medical Care

The Program provides syndromic STD management, treatment of current illnesses, and antenatal care throughout mobile and static clinics as well as specialized care for adolescents via the adolescent health clinics.

Voluntary HIV Counseling and Testing VCT

The main objective of this department is to offer psycho-social support to the cohort participants who come for VCT. To complement its counseling services, the department together with the ARV department conducts follow up of HIV positive clients in biweekly community clinics (Suubi clinics), where opportunistic infections are treated and other clients are introduced to Antiretroviral Therapy (ART).

Health Education and Community Mobilization

At the clinic

Moses Muzaale, Clinician, and Edward Kimera, Health Education Team, at the site of one of RHSP clinics.

The objectives of the health education & community mobilization (HECM) department:

  • Revitalize the role of community health mobilizers (CHMs) through timely selections and replacements, and periodic review of CHM roles and responsibilities, as well as insuring that CHMs participate actively in Rakai Program activities throughout the year
  • Build a strong local capacity for behavior change communication interventions through coordinated mechanism of drama plays acted using county-level drama groups that have been grounded in ‘enter-educate’ approaches
  • Create a local support structure for the Community Advisory Board (CAB) institution to insure fair representation of community views
  • Revitalize sports as a channel for health education and community mobilization
  • Insure equitable participation of all stakeholders and participating communities
  • Increase the proportion of potential participants reached with mob messages and risk-reducing behavior change messages through a multi-channel approach encompassing community meetings, local theatre, sporting events, and educative film shows
SHARE Project

March for 16 Days of Activism Against Violence...
March during 16 Days of Activism Against Violence Against Women 2006.
The Safe Homes and Respect for Everyone (SHARE) Project is a domestic violence prevention intervention conducted in four Rakai Health Sciences Program (RHSP) regions. SHARE was initiated in August 2005 in response to RHSP research that established high levels of physical and sexual intimate partner violence, community attitudes that condone domestic violence, and links between partner violence and HIV.  The SHARE Project works in partnership with community residents, local leaders, and professionals in Rakai to prevent and mitigate gender-based violence, strengthen health care providers’ capacity to handle HIV-related violence, and promote reproductive health and rights. Six strategies are used to work toward the SHARE objective: community activism and advocacy, capacity building, reproductive health outreach, HIV/AIDS outreach, counseling and referral, and learning materials. SHARE has specialized programming for female survivors of domestic violence, youth, pregnant adolescent women, HIV positive men and women, and men working to prevent violence against women.

Voices from Rakai

David Serwadda

quote marker

[In Africa] we are truly at a crossroads. If we can invest in prevention, then we have a chance that we may actually reduce both incidence of the disease and make a dent in the epidemic. I really don't think we have invested in antiretroviral education in Africa the way we should have, and there isn't a good companion program at the moment in monitoring resistance. That is the capacity we're starting in Rakai...>

quote marker

David Serwadda
Founding Principal Investigator, Rakai Health Sciences Program

Center for Global Health

 

© , Johns Hopkins University. All rights reserved.
Web policies, 615 N. Wolfe Street, Baltimore, MD 21205

Rakai Health Sciences Program

Johns Hopkins Bloomberg School of Public Health

Uganda Virus Research Institute

National Institute of Health