providing access to hiv Care
GAIA has a long legacy of HIV prevention in Mali that dates back to 2001, when our organization was founded. To accomplish our mission of infectious diseases prevention among developing world populations, we engage at multiple levels: research initiatives, programs for prevention, education, access to care, and technology and infrastructure support.
The impact of our investment in Mali has been dramatic. The Hope Clinic in Bamako, the center of our clinical activity, has become one of the best known “infirmary-style” community clinics in the country, due to the unique integration of HIV treatment into the regular activities of the local primary care clinic. The number of individuals tested at the clinic has increased by five fold over the last 6 years, and the number of patients in treatment at the clinic has risen in parallel:
L: Haby Bakalie is the president of the HIV+ women's association and leader of the nutrition and peer support program. She is a long-time participant at the clinic and a strong advocate for the HIV+ population.
R: Fatim, member of the HIV+ women's group, takes a picture with GAIA's free condoms.
At-risk patients often travel from other regions in Bamako to access HIV testing at our clinic. Once tested, those that are found to be positive can select the Sikoro clinic as the location for their treatment. In fact, 50% of people who test positive each year enroll in treatment at Hope Center Clinic. Due to local treatment guidelines, many of the patients that are found to be HIV-infected are not yet be eligible for treatment (T-cell count of 500 or lower, according to local guidelines. Patients with t-cell counts higher than 500 are listed as “under observation” in the figure above). In previous years, follow-up for these patients has been limited due to resources; this is a problem that we plan to address in 2017.
Looking to the future, we expect that HIV treatment will be expanded in Mali, following global trends, to all patients who test positive for HIV. This is consistent with the theory that improving access to treatment can eradicate HIV (known as Treatment as Prevention, or TasP). In 2017, we will work to improve the follow up of HIV+ patients that are not yet on treatment, in preparation for introducing TasP to our clinic when the approach is approved in Mali.
"Espoir" (hope) Peer support group
A key feature of our HIV care program at the Hope Clinic in Sikoro is ongoing support for the HIV-infected patients through their own peer support group, named Espoir, “Hope”. This group makes every newly diagnosed HIV patient feel welcome and supported. Thanks to the initiative of our Executive Director, Eliza Squibb, GAIA doubled the funding for nutritional support, and the group now provides twice-weekly lunches to all of the patients. For some of our patients, food insecurity at home is their primary concern. A testimony from one of our HIV+ patients interviewed for a UNICEF article on the clinic in 2013 explains:
When I revealed my status to my immediate family, they were supportive. But in the compound where I live with the extended family, it has not gone so well. My aunts have completely rejected me. They refuse to eat any food I prepare – and that, in Mali, is a terrible thing for a woman to endure
Ms. Sissoko would have been able to count on the support of her own children, but her husband died from a heart attack. “His family took the children – that's customary – so now I feel really alone. The company of other HIV-positive people helps.”
In 2017 we intend to continue this important initiative (supported by donors), which can reduce the stigma of HIV infection while providing much needed nutritional support for the patients enrolled at the Hope Center Clinic.
Aissata, Haby, and Sali: Members of the HIV+ women’s group.