Studie
“You see it, you know it, but you don’t say it” – Community based perceptions of HIV and AIDS testing, counselling and ARV treatment
Since its start at the end of 2007, the MSF OCG TB/HIV project in the Shiselweni Region has made significant progress in scaling up, in collaboration with the MoH, access to diagnosis, care and treatment for people with HIV infection or co-infected with HIV and TB, including MDR TB. But incidence levels of HIV infection and TB remain high in the whole of Swaziland, including the Shiselweni Region. Whereas MSF’s HIV strategy has focused till now on treating people with advanced HIV/AIDS disease, there is an opportunity to push for a change of paradigms: treating HIV+ people for their own benefit well before they develop advanced HIV/AIDS but also for a community (public health) benefit by contributing to the reduction of new HIV infections in their respective communities. Yet this requires much greater community involvement for organizing community-based HIV testing and counseling, for supporting HIV+ people for their ART compliance, for organizing adaptedART re-filling activities and all this supported by much more decentralized diagnostic services in health facilities enabling the monitoring of treatment compliance and response. There is also an opportunity to demonstrate the long term financial benefits for health care systems by treating HIV patients earlier.