Allapuzha District Network of People Living with HIV (ADNP+) is a community-based organization working for the wellbeing of People Living with HIV/AIDS. Girija is working as Project Coordinator with Vihaan programme of Alliance India and is associated with ADNP+ for the last 14 years. Since she is also living with HIV for 20 years, She understands the issues of people living with HIV (PLHIV) community, how stigma affects their health and social wellbeing and difficulties people face in their day to day life. ART is a lifelong medication PLHIV has to take and even missing a single dose may adversely impact their lives. Therefore, ensuring 100% treatment adherence i.e. not even missing a single dose of medicine is very important for PLHIV.
During her long association with Vihaan programme, she witnessed how people compromise their ART adherence due to various socio-economic reasons which ultimately affects their health. If people do not take medicine as prescribed by Medical Officer in an ART centre, they become vulnerable to opportunistic infections. Some, such as TB are life-threatening. Girija is always worried about the health of people and encourages them to have ART medicine regularly. Lockdown during the COVID-19 outbreak is a challenge for her to ensure continued adherence among people living with HIV as it posed many challenges including medicine accessibility, delivery of medicine without compromising the confidentiality, etc. But she adopted many ingenious and innovative ways to ensure each of her patients is getting the medicine on time and they continue to adhere to medicine.
If the status of a patient is unknown to their family members, she would visit them posing as a stranger on the pretext of asking water or to guide her to reach another destination, she would develop a rapport. Once family members went inside to fetch water or left for another reason, she would to handover medicine to clients. If a relative was still around, she would say she was diabetic and need to rest for a while. While she spent some time inside the home, she would wait for the right opportunity to handover medicine to patients.
When she gets an opportunity to spend quality time with patients and their relatives at their home, she gradually talks about treatment adherence. This approach proved very effective especially among the discordant couple (one of the partners is living with HIV) and gradually she wins the confidence of the couple, counsels them on adherence, educates them on safer sex practices to ensure that discordant couple remains discordant in future as well.
While sharing her most recent experience, Girija narrated an incident where she strived hard to keep the confidentiality of the patient and delivered ART medicine. A client residing in a village has not revealed her status to her in-laws. During the lockdown period, her ART medicine got over and she was not allowed to go out. She tried to get ART medicine from nearby chemist shops but was not available. She made a panic call to the CSC (Care & Support Centre) team, requested their help, and also requested them to keep the confidentiality. CSC team chalked out a plan. The outreach worker visited the family as a stranger and requested a glass of water. While giving back empty glass, she intelligently put the medicine box inside the glass which only the patient could make out. CSC team was successful in their attempt to provide medicine to the patient maintaining confidentiality. After narrating this incident, Girija with a smile says that she had changed the abbreviation of HIV into “Human Intelligence Victory” and if we are determined to do some work, we will ultimately find ways and means to achieve the same.
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