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From First Test to Last Breath

Area residents who test positive for HIV at the Comboni Samaritans center are referred to St. Mary's Lacor Hospital, just a few miles away, for an initial medical examination. If test results show that a patient's weakened immune system requires antiretroviral treatment, the patient is directed back to Comboni Samaritans of Gulu, this time right down the hall.

Working out of an office at the hospital, Comboni Samaritans staff open a case file and confirm that each patient meets low-income eligibility requirements. All potential antiretroviral clients must then attend a two-day pretreatment class with someone they live with who agrees to be a "treatment supporter." The training teaches participants about the drugs, possible side effects and expected benefits. Each patient then decides if he or she wants to start the regimen, returning to St. Mary's Lacor Hospital for top-quality treatment.

"If you force somebody to start the drugs and the side effects come, there is a high risk of them dropping [the regimen]," Opiyo notes. "But if they decide on their own, they will take the drugs perfectly without any problems."

Betty Acellam, left, reviews her medical records with her assigned community support volunteer, Margaret Okello.

Adherence to treatment is extremely important. If patients fail to take doses correctly and consistently, their bodies can build resistance to the medications, requiring them to switch to more expensive regimens, which may not be available. To promote strong adherence, the AIDSRelief program also assigns each client a community volunteer who comes every day for the first few weeks to watch the patient take the medications correctly.