Improving Access to Housing for People Living with HIV & AIDS in Ethiopia
In the past two years,the number of clients on antiretroviral treatment (ART) for HIV tripled from 50,000 to 167,271 in Ethiopia; however, stigma associated with HIV & AIDS still presents major challenges for some people living with HIV to adhere to antiretroviral therapy (ART) treatment.
Buzunesh, a 30-year-old HIV positive woman, stopped treatment due to stigma she had experienced – which left her unemployed and homeless. Without care or treatment, Buzunesh became sick and bed-ridden, until community volunteers from the MSH implemented U.S. Agency for International Development (USAID) HIV/AIDS Care and Support Program (HCSP) provided her with home-based care services and assistance to resume treatment at Sebeta Health Center. With the help of HCSP, Buzuesh has been able to maintain ART adherence for the last two years.
The HCSP program provides home-based care services, community tracing of patients who do not follow up with treatment, community mobilization against stigma and discrimination, and referrals to various health facilities and community services.
The HSCP staff realized that stigma associated with HIV & AIDS creates a significant barrier for people living with HIV to access and keep rental housing. Many people living with HIV are driven out of their homes and communities. Adequate shelter is important for HIV patients because it promotes treatment adherence and increases access to other health services. The success of ART depends on patients’ adherence – lack of adherence can result in treatment failure and drug resistance.
The HCSP program developed a solution that provides technical assistance to selected kebeles (neighborhoods) to form community core groups (CCGs) comprised of community leaders and representatives from community-based organizations. As part of their facilitation of community support, they at times provide housing opportunities for people living with HIV.
One CCG approached the kebele administration department and successfully lobbied for Buzunesh to access a rental house. Buzunesh now lives in a compound she shares with 10 other people who also lost their home due to stigma.
Through community mobilization, the CCGs at times facilitate communities to build houses for vulnerable people living with HIV. “I am so happy with this program, they gave me my life back,” says Buzunesh.
Sebeta Health Center is among the 193 ART health centers linked to community care and support initiatives through HCSP. Of note, these are typically high patient load health centers that support around 95% of the nearly 65,000 patients of HCSP supported health centers.
HCSP is a U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funded USAID program that is being implemented by MSH. The program promotes provision of comprehensive HIV & AIDS services, including prevention, treatment and palliative care, through support for 550 health centers that serve communities with around 33 million people. HCSP has supported innovative technical approaches to achieve extensive national scale-up, including task shifting, new health care personnel, health systems strengthening, contracting through performance-based financing, and the introduction of case management and standards-based quality assurance approaches.