Dealing with a growing adolescent and young adult population calls for innovative ways to address their unique needs and challenges. More time is needed to deal with complex psychosocial issues which increases the average patient waiting time at the clinic. In order to remedy this situation, the COE working with the Rotary Club of Gaborone started a pilot community medication refill project in March 2015 called Motsweding Project with the aim of bringing services nearer to patients in their communities (using local schools and churches) and decongesting the clinic. Services provided include medication refills, adherence counseling, TB screening, and anthropometric evaluations in non clinical settings. To date only one out of six proposed pilot sites has been operationalised with the rest to follow in the coming months. Our experience so far is that most encounters are quick allowing patients and caregivers to complete their medical visit and go to school or work much earlier than in the traditional clinic setting.
As part of the Motsweding Project described above, Rotary Club provided funding for a ‘See and Treat’ cervical cancer screening program. As patients with HIV live longer, non communicable diseases begin to take a much more prominent role. Cervical cancer is one such condition that has increased in incidence and prevalence. We have now received some of the equipment and hope to receive the rest in the next few months when we expect to start providing services. In anticipation of this, protocols on screening and management of cervical cancer in older adolescent girls and young women are under development. There is a paucity of data about cervical cancer in perinatally HIV infected adolescent girls in the literature and therefore the problem does not receive a great deal of systematic attention in policy and programming. This project is expected to create a cohort of patients and to generate important data which will inform researchers, clinicians and planners on cervical cancer in perinatally HIV infected adolescents.
Funding for the In-reach/outreach project was a four year grant (mid 2007- mid 2012) from the Texas Children’s Hospital. In-reach/Outreach was also funded by the National AIDS Coordinating Agency(NACA) as part of the Botswana National HIV/AIDS Prevention Support (BNAPS) program from January to June 2014. The BNAPS was an initiative to increase the coverage, efficiency and sustainability of targeted and evidence-based HIV/AIDS interventions in Botswana. Since the end of the BNAPS project in July 2014, in-reach activities were scaled down to include only emergency cases and is operated by the social work team.