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Community Outreach Volunteers Help Clients Navigate HIV Prevention, Care, and Treatment in South Sudan

How tracing changes health outcomes in Juba.

Rose,* a 54-year-old widow and mother of five in Juba, South Sudan, is HIV-positive. She started antiretroviral therapy (ART) as soon as she was diagnosed with HIV in 2018 but did not disclose her status to her children right away—she knew her family might be at risk of contracting HIV and recognized that her children should be tested, but she felt a lot of self-stigma, which held her back from talking about it with them.

Rose was also part of a religious community that preached against modern medicine and after listening to healing testimonies from others, she was convinced that she could be healed of HIV through prayer. She stopped taking ART for over two years and her health deteriorated. She lost weight and suffered from other infections related to HIV.

Luckily, Rose met Sarah,* a community outreach volunteer working with IntraHealth International’s Advancing HIV/AIDS Epidemic Control (AHEC) Activity, a USAID-funded project. Sarah is also HIV-positive and, as a community health worker, she conducts outreach in her community. She shares her experiences with her clients and encourages them to test and know their HIV status, to adhere to ART treatment, and to visit health facilities regularly for viral load sample collection to attain viral load suppression.

Sarah's support encouraged me to adhere to my treatment.

Sarah met Rose while doing community outreach and Rose became one of Sarah’s clients. Sarah provided her with psychological support, such as providing ways Rose can focus on her health and well-being, and adherence monitoring, making sure Rose maintains her medication regimen to achieve viral load suppression. She also talked to Rose about the importance of disclosure and how to live positively without passing on the infection to others.

“The community outreach volunteer assigned to me was an evidence-based example that even with HIV, one can live a long healthy life while on ART,” Rose says. “Her support encouraged me to adhere to my treatment.”

Sarah talked to Rose about restarting her HIV medication and the importance of disclosing her status to her family. Rose was hesitant at first, but eventually took her children to the Munuki Primary Health Care Center, an AHEC supported health facility. While at the facility, all five of her children tested HIV negative. The ART provider at the facility counseled Rose on the importance of adherence to care and treatment, and she was reinstated on ART.

Rose is now a community outreach volunteer champion who visits clients in her community and helps refill ART prescriptions for those who are unable to visit their health facilities. She shares her knowledge and experiences with other HIV-positive members of her community and encourages clients to continue with their treatment.

The AHEC project has given us a second chance to live.

“Community outreach has helped us reach many people, including men, who have then been diagnosed with HIV and linked to ART,” Rose says. “I’m very happy because IntraHealth, through the AHEC project, has given us a second chance to live. We’re looking forward to the start of PrEP intervention in the country that will protect those at high risk of HIV from acquiring new HIV infections.”

There are currently 8,825 clients on care and treatment in all AHEC-supported facilities. Through community outreach volunteer tracing efforts, 932 clients (66% of those who stopped treatment between October 2021 and May 2022) have returned to the health facility as of May 2022.

AHEC is funded by the US Agency for International Development.

*Not her real name.