The COE runs the Challenge Clinic for patients who are failing treatment. The clinic has enrolled 60 patients at the COE and more than 100 patients at outreach sites. Through our multidisciplinary team composed of social workers, psychologists, dieticians, nurses and doctors, we explore factors that pose barriers to ARV adherence in individual patients.
We then offer extensive counseling and, if the need arises, we carry out home visits to assess social circumstances that may interfere with adherence to ARV therapy. The retrospective analysis of our data has shown that the home visits favorably impact adherence. All challenge cases at the COE are discussed with our experienced attending physicians and members of the multidisciplinary team.
The COE receives referrals from the national HIV prevention of mother-to-child transmission programme for postnatal HIV screening tests at six weeks using dried blood spot HIV DNA PCR. In addition to DNA PCR testing, we also offer HIV screening to relatives and siblings of our patients - or anybody who voluntarily seeks HIV testing - using the double rapid test. Those who test positive receive extensive counseling before enrollment in the national antiretroviral (ARV) programme.