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Provision of antiretroviral therapy in a rural setting – The Nile treatment centre experience, Uganda


The Nile treatment centre is one of the treatment initiatives of Uganda Business Coalition on HIV/AIDS. It is an HIV/AIDS service organization providing care and support to children and adults living with HIV/AIDS for 21/2 years now.

Services Provided

1. Counseling and testing services (voluntary counseling and testing)

2. Treatment: Antiretroviral therapy (ART) and Treatment of opportunistic infections

3. Supportive counseling

By January 2006, there were over 1527 clients receiving care at the centre, of these 1050 (70.1%) were on ART. The average monthly enrollment into care was 81 Clients and the average monthly enrollment onto ART was 57 Clients. ART care and treatment support is clinic based.


1. Increased patient enrollment into care and on ART

2. Free care and treatment services have allowed us to reach and retain more patients in care

3. Despite the poverty levels, over 80% of the clients are able to visit the clinic regularly at least once a month

4. 90+% remain on first regimen

5. 90+% are suppressed after 9+ months on therapy


1. Lack of direct community involvement and therefore lost opportunity in sensitizing the masses about available services, role of community in fighting stigma and discrimination, role of community in fighting poverty and improving adherence on drugs.

2. Low socio-economic status of patients includes lack of transport as one of the most common reasons for missed appointments leading to missed doses

3. There are a number of clients that lack a telephone contact, which is one of the shortcomings of this method of improving adherence.

4. There is lack of strong linkages with other service providers who can be used to supplement services that we are not able to provide (for example, support of orphans and vulnerable children, food baskets, small grants to improve socio-economic status)

Lessons Learnt

1. Clinic based ART care and treatment support models are very possible in a rural setting.

2. Care and support of people living with HIV/AIDS is much more than just providing ART and other treatment.


Over 1,000 people and their families have benefited from the much-needed HIV/AIDS treatment. Care and support of people living with HIV/AIDS is much more than just providing ART and other treatment. For clients to adhere to their meds, they need food, transport to pick their meds, healthy children etc. This is challenging to achieve as a single service provider, hence the need for stronger linkages with other service providers will be crucial in an effort to sustain clinic based ART programs.

Author information

Correspondence to Harriet Bitimwine.

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About this article


  • Service Provider
  • Treatment Support
  • Rural Setting
  • Vulnerable Child
  • Lesson Learn