The clinical psychology department continues to address, manage and improve adherence challenges with validated psychological interventions. Multiple psychological techniques and interventions that evaluate and treat negative behavioral issues such as self-stigma, depression, anger, and trauma due to being HIV positive, are used by the clinical psychologists. During the reporting period there were 314 cases of depression among patients with adherence challenges indicating that poor adherence is highly correlated with depression. This is an indication that every patient with adherence challenges should be screened for depression. The clinical psychologist supports every COE program that needs specialised psychosocial inputs such as Teen-mothers program, Youth Empowerment Program and Challenge Patients Support Group. This year, around 40 adolescents and young adults attending the out-of-school program were screened with more 10 assessment tools and those diagnosed with psychosocial problems received appropriate interventions.
The Social Work department continues to coordinate all social welfare and counseling services of the COE. This includes attending to emergency and lost to follow up (LTFU) cases. Since January 2015, the social work team has been able to track 25 LTFU patients with over 50% of these patients having returned to the clinic for continuity of care. However, follow up of some LTFU cases is complicated by the lack of clear directions to homes, frequent change of contact information, caregivers’ unwillingness to be visited at home for unknown reasons and because the caregiver’s work commitments make them unavailable during working hours.
Additionally, 22 emergency home visits were made for patients with poor adherence, lack of family support, pre- HAART assessment, etc. The department also handles assessment for monetary transport assistance for needy patients. Upon re-assessment for continuation of support, 21 out of 32 patients were found financially stable enough to afford transport costs to the clinic and so their monetary support was terminated. Table 4 shows the number of cases by type attended to by the Social Work Department during the reporting period.