HIV&AIDS Home Based Care

The organisation ProPride has been a medical support organisation for marginalized people in Addis Ababa for many years. ProPride’s HIV/AIDS projects are part of their overall medical programme. The HIV/AIDS projects consist of the following components:

1. Community awareness
2. Home Based Care (HBC) + HBC training for family members of people living with HIV/AIDS
3. Medical support for people living with HIV/AIDS
4. Voluntary counselling and HIV testing
5. Orphan support

Home Based Care

ProPride’s Home-Based Care programme is strongly linked to its community health programme. ProPride community health workers (CHW) assist the HBC volunteers when they deal with patients with serious medical conditions, and it is not uncommon that clients are first treated by a community health worker for a seemingly ordinary infection, before they take a HIV test (often on advise of the same CHW) and, if found HIV positive, get referred to the HBC programme.

This was the case Baheru Bekele, a 50-year-old patient, who took a HIV test after being treated for herpes by a ProPride CHW. Baheru was referred to Tigist Degeve, a ProPride HIV community worker, who advised him to go for an AIDS test and gave him pre-test counselling.

When Baheru’s result came back positive, Tigist arranged for Baheru’s wife and his teenage son to attend home-based care training at ProPride. Both are now competent carers. They received a HBC kit with medical supplies that get refilled by ProPride every three months. The kit contains gloves and a mask, dressings for wounds, disinfectants, painkillers etc. Baheru is still relatively mobile, so he comes to the ProPride office at times to receive medical care and to attend ‘self care’ meetings in which patients are taught about the psychological impact of their HIV status. Baheru explains: “The meetings are good, I feel at ease meeting other people who face the same facts. I am a social person; I like walking around and meeting people. The things they talk about are useful; they deal with how to fight depression and anxiety. They also deal with practical stuff like personal hygiene and life with your family at home. I am very grateful for all the help I get from ProPride, their medical support is excellent too.”

When asked how he felt about the counselling and testing facilities at ProPride, Baheru says: “The facilities are good, you get the result the same day. The counselling was also good, although I was still shocked when I found out my result. I didn’t expect to be HIV positive, I had no other symptoms, no TB, nothing, and I don’t think my behaviour was bad.”

This, Tigist explains later, is a problem for a lot of patients; many are in denial about their past behaviour and feel they do not deserve to be HIV positive. On the way out, Baheru’s 37-year-old Meseret walks to the end of the road with us, talking to Tigist with a serious and distressed voice. She insists Tigist translates what the problem is: herself and her husband have what they call ‘discordant test results’, in other words, he is HIV positive and she has tested negative. This is not uncommon, explains Tigist, “because in many cases in Addis Ababa, it is the husband who sleeps around and contracts HIV. Sometimes when the husband and wife have had little sexual contact or the wife has been fortunate enough to not contract the virus from her husband yet, this is what happens.”

“For Meseret’s husband Baheru, the fact that she was not infected has come as almost as big a shock as his own HIV positive status”, Tigist explains. “Unfortunately, Baheru has developed mental problems as a result of the infection and this manifests itself in behaviour that is posing a threat to Meseret’s health. We try to monitor the situation, but it is difficult. If a husband demands to sleep with his wife, even though he is HIV positive and she runs the risk of getting infected because he refuses to use condoms, it’s very difficult for his wife to say no in order to protect her health. I try to come here a few times per week and talk to him about the importance of the care his wife and his son give him. Because she has been standing her ground on the sex issue, he believes she’s a bad woman and he also thinks his sons are bad, because they try to protect their mother. It’s a very difficult situation and we at ProPride find it hard to think how we can help.”

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