Hope Alive through Sustained Enhanced Adherence Counselling



The goal of antiretroviral therapy is to maximally and durably suppress plasma viral load levels, restore and preserve immunologic function, and prolong the duration and quality of life. In Akwa Ibom State, PEPFAR through USAID is funding the EpiC Project to maintain 143,668 people on antiretroviral therapy. Several innovative interventions have been introduced to support clients to achieve maximum benefit from ART. One of such interventions is the Enhanced Adherence Counseling (EAC) for those who still have unsuppressed viral load. EAC was introduced in 2017 as a model to break barriers in poor adherence to medication amongst PLHIV.  Sixty-seven (67) EAC champions were appointed across supported sites to provide psychosocial support and follow-on management of all virally unsuppressed. This has had a huge effect on client viral suppression

  1. Victor Abia Oro is a 43-year-old male, from Eyo Okponnung village in Udung Uko LGA, who was diagnosed with HIV in on 27th February 2019 by a community ART Management team at his mechanic workshop. However, his health condition deteriorated due mostly to poor eating habits and other associated lifestyles. Through the wife and regular counselling, he was encouraged to cut down all habits that would undermine the efficacy of his ARVs. His baseline viral load was unsuppressed (763,600copies/ml). Three (3) sessions of EAC were provided to him emphasizing the need to adhere to the lifestyle modification. Victor’s Viral load was still unsuppressed (275, 812copies/ml) after 3 EAC sessions were provided. The routine Drug Therapeutic Committee meeting in PHC Eyo Okponnung held at the time reviewed his case and switched him to a 2nd-line regimen after ruling out non-adherence. Adherence was monitored while on the 2nd line regimen and after 4 months, another VL sample was taken for assay. Following the switch and adherence monitoring, Victor was able to achieve Viral suppression with a viral load of 286copies/ml.
  2. Eno Ita Imah is a 30-year-old female trader who also tested HIV positive and was initiated on ART on 3rd March 2019. Eno lives with her 5-year-old son in their village, Anamfan, Oron LGA. A single mother faced with high-level stress of trading most of her farm produce to cater for the family. The community case manager assigned to Eno was tasked with routine visits to her house, as she was inaccessible for follow-up on phone. The community case manager was shocked to find Eno almost in an unconscious state during one of her visits and sought to find her drug bags to inform next line of action, then she realized that she had not been taking her ARVs for a long while. Her viral load sample analysis indicated a viral load unsuppression of 517,198copies/ml. She was placed on Enhanced Adherence Counselling and monitored closely for improvement of medication adherence. After the EAC sessions, a repeat viral load sample was taken for assay. Consequently, she is virally suppressed with a viral load of 622copies/ml. In her words: “make una help me thank HIV people ooo for saving my life”.

The Akwa Ibom State team through the EpiC project funded by the U. S. Agency for International Development (USAID) have sustained these impacts through their strategic programs implementation across all their supported sites, including communities, to ensure viral suppression and improve the quality of life amongst PLHIVs in the state.


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