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The charms and challenges of antiretroviral therapy in

Uganda: the DART experience
a b a c
Barbara Nyanzi-Wakholi , Antonieta Medina Lara , Paula Munderi , Charles Gilks & on
behalf of the DART Trial Team
a
MRC/UVRI Uganda AIDS Research Unit, Entebbe, Uganda
b
Centre for Research on Health and Social Care Management, Bocconi University, Milan,
Italy
c
The Joint United Nations Programme on HIV/AIDS (UNAIDS), New Delhi, India
Version of record first published: 21 Jul 2011.

To cite this article: Barbara Nyanzi-Wakholi , Antonieta Medina Lara , Paula Munderi , Charles Gilks & on behalf of the
DART Trial Team (2012): The charms and challenges of antiretroviral therapy in Uganda: the DART experience, AIDS Care:
Psychological and Socio-medical Aspects of AIDS/HIV, 24:2, 137-142

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 AIDS Care
Vol. 24, No. 2, February 2012, 137
142

The charms and challenges of antiretroviral therapy in Uganda: the DART experience
Barbara Nyanzi-Wakholia*, Antonieta Medina Larab, Paula Munderia and Charles Gilksc on behalf of the
DART Trial Team
a
MRC/UVRI Uganda AIDS Research Unit, Entebbe, Uganda; bCentre for Research on Health and Social Care Management,
Bocconi University, Milan, Italy; cThe Joint United Nations Programme on HIV/AIDS (UNAIDS), New Delhi, India
(Received 14 January 2011; final version received 7 June 2011)

Antiretroviral therapy (ART) improves the quality of life of people living with HIV/AIDS. However, adherence
remains a challenge. A total of eight focus group discussions (FGD) were conducted with participants from a
randomised controlled trial that monitored strategies for managing ART in African adults: Development of
Antiretroviral Therapy. All FGD participants had received ART for at least one year. Perceived benefits of ART
were key motivators for adherence. These benefits included improved physical health, restored self-esteem,
acceptance in the community and hope for a longer and healthier life and reduced fear of HIV/AIDS-related
Downloaded by [University of Liverpool] at 09:41 28 February 2013

death. Barriers to adherence included a high pill burden, ART side effects and socio-economic constraints,
including lack of food and safe water for taking the pills. Visible ART side effects and involvement in an
exclusively HIV/AIDS clinic could expose their HIV status, thus exacerbating stigma. Gender and socio-
economic differences were found in the variety of strategies employed to ensure adherence. ART was perceived as
improving the overall quality of life of recipients; however, it is crucial for ART programmes to be gender and
socio-economic cognizant in order to enhance adherence to a lifelong therapy.
Keywords: adherence; antiretroviral treatment; focus group discussions; gender; HIV/AIDS; side effects;
Uganda

Introduction for many individuals what are the non-monetary

Before the advent of antiretroviral therapy (ART),
testing positive for Human Immunodeficiency Virus
(HIV) was associated with an early death (Meursing
& Sibindi, 2000). Over the last decade, availability of
ART has increasingly provided HIV-positive indivi-
duals with longer and healthier lives (Aracena-Genao,
Navarro, Lamadrid-Figueroa, Forsythe, & Trejo-
Valdivia, 2008).
However, in order to sustain a healthy life on
ART, a high level of adherence is required. In order
to achieve maximum HIV suppression and minimise
risk of treatment failure, an individual on ART needs
to be able to keep appointments, take medications
and make lifestyle changes (Conway, 2007). Although
ART is usually well tolerated, a significant number of
individuals experience adverse events and side effects
(Clark, Wilcox, & Besch, 2004) that can expose their
HIV status (Hawkins, 2006).
In Uganda, studies have shown that high costs of
ART affect adherence (Astrid & Anyama, 2002;
Byakika-Tusiime et al., 2005). Over 75% of Ugandan
ART recipients receive ART at subsidised costs or
no charge through the Ugandan government in
partnership with international donors (World Health
Organization [WHO], 2009). If cost is not a barrier
barriers for adherence?
Methods
The study was conducted among individuals partici-
pating in the Development of Antiretroviral Therapy
(DART) Trial that investigated whether delivery of
ART with or without routine monitoring led to
similar health outcomes. The trial was conducted
between 2003 and 2008 in three African sites; two in
Uganda (Kampala and Entebbe) and one in Zim-
babwe (Harare). Qualitative data were collected in
2005 through focus group discussions (FGD) to
explore knowledge, attitudes, experiences and con-
cerns of individuals who had taken ART for at least
12 months at the Entebbe site.
Owing to the difficulty of mobilising participants
of the same age and socio-economic category to
attend the same FGD, the groups were divided by
gender only. Eight FGDs, four with women and four
with men were conducted in the local language,
Luganda. Each FGD consisted of 9
11 participants.
An open-ended question guide was used to facilitate
the discussion on various topics including: (1) What
led to the decision to start taking ART? (2) How has

*Corresponding author. Email: barbara.nyanzi@mrcuganda.org

ISSN 0954-0121 print/ISSN 1360-0451 online

# 2012 Taylor & Francis
http://dx.doi.org/10.1080/09540121.2011.596518
http://www.tandfonline.com
 138 B. Nyanzi-Wakholi et al.
life changed since you started taking ART? (3) What
challenges emerged as a result of taking ART?
The discussions were audio recorded, transcribed
verbatim and translated to English. Codes were
developed in relation to the study objectives, and
thematic content analysis was managed using NVIVO
2.0. Information that did not fit under the initial
codes was coded under the ‘‘emerging themes’’
category. Associations between themes were estab-
lished, and data were compared by gender.
Ethical considerations
Written or thumb print consent was obtained from
FGD participants. Ethical approval was obtained
from the Science and Ethics Committee of the
Downloaded by [University of Liverpool] at 09:41 28 February 2013
Uganda Virus Research Institute, and the Uganda
National Council for Science and Technology in
Uganda and the Liverpool School of Tropical Med-
icine, Ethics Committee in the UK.
Findings
Study sample
A total of 42 women and 40 men participated. The
women’s age ranged from 19 to 54 years (mean 36.64
years) and 30 to 63 years (mean 40.73) for the men.
The majority of individuals had primary education
(50% women and 60% men) and worked full time
(64% women and 68% men).
Perceived benefits of ART
Participants vividly described their deteriorated
health condition prior to starting ART and empha-
sised the perceived effectiveness of ART in alleviating
the disease symptoms and restoring their physical
strength and appearance. They reported recovering
their mobility and ability to resume daily activities,
which relieved them of dependence on caregivers.
When I first came here I looked horrible. I was very
thin and people knew I was dying. I was scratching
myself all over and the skin rashes were oozing puss.
However when I started taking the medicine, the
itching stopped, the rashes started drying and the
other disease I had ceased. I am now fine (laughs
heartily!). (Female, Group1)
Recovery gave them a sense of acceptance, which
replaced feelings of stigma and discrimination.
Before taking the medicine, I looked so bad that my
daughter told me to stop going to her school because
she was ashamed of me. When I started taking this
medicine, I recovered and the children were happy to
see me. (Female, Group3)
They provided advice on HIV testing and treatment,
and exchanged their identity as ‘‘AIDS sufferers’’ for
that of value as HIV advisors.
Some people would never admit that they are infected
however after seeing how sick my husband was, and
how well he has recovered they approach him, and
ask him to bring them to the clinic so they too can get
the same treatment. (Female, Group1)
Participants asserted that access to free ART gave
them hope for a better quality of life and helped them
overcome the fear of an early HIV/AIDS-related
death.
I had lost hope and didn’t think that there was any
purpose of living. My life had ended. However during
the time that I have spent at this clinic, my life has
been restored. . . .I now have a future and I am going
ahead with the projects that I had laid off. (Male,
Group3)
The HIV treatment clinic created an opportunity for
individuals to find psychosocial support from one
another.
In the past I felt hopeless and did not have someone
to confide in and ask for advice. However when I
come here, I meet other ladies who also have HIV
and share with them like I would do with my own
sisters. (Female, Group2)
Strategies for adherence
To keep to a consistent pill taking schedule, men used
wristwatches and mobile phone alarms, whereas the
women who mostly stayed home cited the use of wall
clocks and regular radio jingles. Some reported taking
the medicine alongside a routine activity such as
mealtimes and brushing teeth. Others got so accus-
tomed to taking the medicine that there was no need
for reminders. Some cited family members, primarily
spouse and children, as medicine companions who
would remind them to take their medication.
My son reminds me to take the medicine before he
goes to school. He says, Mummy, take one pill from
this bottle and one from the other bottle. He also
does this in the evening before I go to sleep. (Female,
Group3).
The men reported that their spouses not only served
as medicine companions but also as behavioural
change agents, keeping them from indulging in
detrimental behaviours such as consuming alcohol,

skipping meals, having multiple sexual partners and
unprotected sex.
There are times I am tempted to take alcohol but my
wife knows it is not good for one who is taking this
medicine so she insists that I do not take it. I have
managed not to take alcohol because of her insis-
tence. (Male, Group2)
The fear of deteriorating to their pre-ART health
condition was repeatedly described as a key motiva-
tor for adherence.
I know how sick I was so I have to take the medicine.
These pills are my life! They are life! (Male, Group2)
Testimonies and observation of ART recipients
whose health improved was a motivator.
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When I came to this clinic, I saw many women
looking good. There was a lady here who was big and
looking good. I asked whether she too was infected
and they told me she was. That surprised me a lot. I
then realized that taking the medicine was for my
own good. (Female, Group4)
Parents cited the need to live long to build economic
support for their children as another motivator.
As long as I keep taking this medicine, I will live long
enough to see my children finish school. My desire is
to work hard and ensure that they have a source of
income. (Male, Group2)
Challenges of ART
Dealing with psychosocial and economic challenges of
ART
Even with their commitment to take ART for life, the
prospect was described as burdensome and the
amount of pills as daunting. Consequently, they
inquired about the possibility of having one pill for
a whole day’s or even a whole week’s dose.
How I wish they would manufacture one pill that we
could take weekly instead of taking pills daily. It gets
even harder when we have to take additional
medicine for other diseases. (Male, Group3)
Participants described the need for safe water to drink
and a snack while taking the pills, particularly when
they travelled away from home. They complained
that taking medicine on an empty stomach left them
weak and nauseated.
If I take the medicine without eating something, I get
hunger pangs. I feel my intestines twisting. You need
to take this medicine after eating something. (Male,
Group2)
AIDS Care 139
One strategy for the women was to boil water, cool it
and fill bottles that they carried along with meal
leftovers. Men were more likely to buy bottled water
and a snack.
I had to travel to a far place so I carried my medicine
with me. I boiled water, bought a cluster of bananas,
threw it in my bag and went on my way. (Female,
Group 4)
Unlike the women, some men reported swallowing
pills without drinking water and emphasised that the
absence of safe water was not an excuse for not taking
the pills.
I often carry my pills with me. I often swallow them
without taking any water. You cannot always get the
water to drink. I well up saliva in my mouth and
when it is a lot, I throw in the pill and swallow it.
(Male, Group2)
A few who kept their HIV status secret expressed the
need for privacy when swallowing pills and had to
find private areas, disguise the act of pill swallowing
or conceal their involvement in an HIV/AIDS clinic.
I simply hide under my veil and take my medicine. I
pull out my medicine with my face covered and then
swallow it. (Female, Group2)
However, some participants argued that the medicine
was relatively unknown and not labelled as HIV/
AIDS treatment, and thus it could be taken even in
public places.
Travelling away from home and unforeseen delays
often disrupted the treatment routine. Some com-
mended scheduling their pill taking time to the early
morning or late at night when they were sure to be
home.
That is the advantage of taking the medicine at 6:00
am, since it is rare that one would be travelling at that
time and people are often back home by 6:00 pm.
(Female, Group1)
Enrolment criteria restricted recruitment to indivi-
duals living in Entebbe Municipality. However, when
participants felt better, many moved away to find or
resume work making the monthly clinic visits oner-
ous. Monthly absenteeism from work was particu-
larly difficult for those who had not disclosed their
HIV status to employers.
I lost my job in 2001 when they found out that I had
HIV. If you tell them the truth about your status,
they chase you away. It is better to find another
reason or lie to them about why you need to be away
for a day. (Female, Group1)
 140 B. Nyanzi-Wakholi et al.
Women described a number of excuses for attending
the clinic such as sick children, illness, emergency calls
from distant relatives and even the unquestionable
traditional clan gatherings evoked by gods.
While some described being abandoned by kin
when they were ill, others spoke of the exceptional
care they received. However, some reported that
those who provided material and financial support
withdrew it when their health improved.
In the past they used to care a lot for me and even
care for my children. Now that I am strong and
better, they leave me to provide for myself. (Male,
Group2)
Dealing with ART side effects
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Participants received detailed information on the
possible side effects of ART at enrolment and this
prepared them for the onset of side effects.
We were warned that some people would get drug
reactions. This helped me not to worry when I fell
sick. (Female, Group2)
The most common side effects were nausea, vomiting,
headaches, dizziness, body odour, skin rashes, dar-
kening of the skin, nails, palms and feet, increased/
decreased appetite and men reported increased/de-
creased sexual desire.
Drinking a lot of fluids and resting were claimed
to reduce dizziness, while eating a snack or meal
before swallowing pills controlled nausea. However,
many participants reported not having enough food
because the illness had debilitated them leaving them
unable to meet their basic needs.
A number of strategies were employed to disguise
the visible side effects. Long sleeved clothes, ankle
reaching skirts and trousers were worn to cover
the scarred skin. They wore boots to hide darkened
feet and women reported wearing dark nail polish to
cover darkened nails.
I had never worn nail polish in my life. However
these days I have to wear dark nail polish because my
nails are black. (Female, Group1)
While some participants worried that the visible ART
side effects could expose their status, others were not
embarrassed by their HIV status.
I see many people with dark feet and nails and I
know they are taking ART. They do not need to tell
me. (Male, Group1)
On the whole, the improved health and quality of life
was felt to be worth the side effects.
If you were once very sick, got medicine and then
recovered, though turned black, you would not mind
it. You would be proud about it because you are
better. For one who had once lost hope and has now
recovered to this stage, the change in skin colour is
no big issue. (Male, Group1)
Discussion
These results reveal factors that challenge ART
recipients to adhere to treatment, and demonstrate
how to enhance adherence. Although medical profes-
sionals use clinical markers to assess treatment
success, these were not necessarily the perceived
benefits of ART from the recipients’ perspective.
The perceived benefits included improved physical
health, appearance and self-esteem, acceptance in the
community, restored hope and overcoming the fear of
death. Medical personnel need to acknowledge and
embrace the recipients’ perceptions. Conversely, in-
formation on how the immune system is affected by
ART should be reiterated to recipients, as this has
been proven to encourage adherence and positive
living (Garcia, Ponde, & Lima, 2005).
As revealed in other studies, the need to adhere to
treatment was a personal responsibility generated by
the need to live a longer and healthier life (Lewis,
Colbert, Erlen, & Meyers, 2006).
Our findings indicate gender and socio-economic
differences in adherence strategies. While men em-
ployed items of monetary value to enhance adher-
ence, women employed non-monetary means
including scheduling pill taking along routine activ-
ities, medicine companions and carried home-made
safe water and meal leftovers to tame the ART
associated increased appetite. Men appear to cope
better with certain aspects of the treatment such as
swallowing pills in the absence of water and/or food
as reported elsewhere (Côté, Godin, Garcia, Gagnon,
& Rouleau, 2008).
These findings support the role of medicine
companions to remind about pill taking and check
against detrimental behaviour (Foster et al., 2010;
Ssali et al., 2010). Providing medicine companions
with information and counselling skills could enhance
their role. It should however be noted that not all
participants had medicine companions, and research
has shown that some ART recipients prefer not to
have one (Liechty & Bangsberg, 2003).
Visible treatment side effects potentially exposed
the recipients’ HIV status, which has been reported as
reason for non-adherence and treatment discontinua-
tion (Johnson et al., 2005; Lee, 2006). Whilst side
effects affected their daily lives, participants in this
study perceived them to be an acceptable trade-off for

a better quality of life. Providing information on
expected side effects increased participants’ ability to
cope with them as also found in previous studies
(Garcia et al., 2005). These findings support other
studies in calling for the adoption of simple regimens
with fewer pills, doses and side effects (Atkinson &
Petrozzino, 2009; Parienti, Bangsberg, Verdon &
Gardner, 2009).
ART programmes in Africa provide a strong
association between adherence and financial con-
straints. Participants in this study received free
treatment but expressed other barriers that could
potentially challenge adherence including work
absenteeism, lack of food and safe water, side effects,
pill burden, transport costs and the possible exposure
of their HIV status, as reported elsewhere (Kip,
Downloaded by [University of Liverpool] at 09:41 28 February 2013
Ehlers, & Wal, 2009; Laniece et al., 2003). ART
programmes need to take into account both monetary
and non-monetary factors that can limit adherence.
Confidentiality and the management of stigma are
particularly important (Wolff et al., 2005). Further-
more, there is an increased need to establish HIV/
AIDS work place policies to protect the rights of
HIV-positive workers (The Joint United Nations
Programme on HIV/AIDS [UNAIDS], 2008).
In conclusion, these data broaden our under-
standing of adhering to a lifelong therapy. High-
lighting the benefits of ART as perceived by the
recipient and establishing gender and socio-economic
sensitive strategies for compliance will undoubtedly
aid the struggle to improve adherence to ART.
Acknowledgements
The authors would like to express their gratitude to the
study participants from the DART Trial who gave in their
time and contributed to the discussions that provided the
findings presented in this article. We acknowledge Prof
Grosskurth Heiner who contributed to the writing of the
manuscript. This research was funded by ABBA RPC-
Addressing the Burden of Balance in AIDS Research
Programme Consortium, Liverpool School of Tropical
Medicine
References
Aracena-Genao, B., Navarro, J.O., Lamadrid-Figueroa,
H., Forsythe, S., & Trejo-Valdivia, B. (2008). Costs
and benefits of HAART for patients with HIV in a
public hospital in Mexico. AIDS, 22(Suppl. 1), S141

S148.
Astrid, M.J., & Anyama, N. (2002). Access to antiretroviral
therapy in Uganda. Kampala: Oxfam UK.
Atkinson, M.J., & Petrozzino, J.J. (2009). An evidence-
based review of treatment-related determinants of
AIDS Care 141
patients’ non-adherence to HIV medications. AIDS
Patient Care and STDs, 23(11), 903
914.
Byakika-Tusiime, J., Oyugi, J.H., Tumwikirize, W.A.,
Katabira, E.T., Mugyenyi, P.N., & Bangsberg, D.R.
(2005). Adherence to HIV antiretroviral therapy in
HIV Ugandan patients purchasing therapy. Inter-
national Journal of STD & AIDS, 16(1), 38
41.
Clark, R.A., Wilcox, R., & Besch, L. (2004). Antiretroviral
therapy in the antiretroviral experienced patient.
American Journal of Medical Science, 328(1), 10
16.
Conway, B. (2007). The role of adherence to antiretroviral
therapy in the management of HIV infection. Journal
of Acquired Immune Deficiency Syndrome, 45(1), S14

S18.
Côté, J., Godin, G., Garcia, P.R., Gagnon, M., & Rouleau,
G. (2008). Program development for enhancing ad-
herence to antiretroviral therapy among persons living
with HIV. AIDS Patient Care and STDs, 22(12), 965

975.
Foster, S.D., Nakamanya, S., Kyomuhangi, R., Amurwon,
J., Namara, G., Amuron, B., . . .Grosskurth, H. (2010).
The experience of ‘‘medicine companions’’ to support
adherence to antiretroviral therapy: Quantitative and
qualitative data from a trial population in Uganda.
AIDS Care, 22(Suppl. 1), 35
43.
Garcia, R., Ponde, M., & Lima, M. (2005). Lack of effect of
motivation on the adherence of HIV-Positive/AIDS
patients to antiretroviral treatment. British Journal of
Infectious Diseases, 9(6), 494
499.
Hawkins, T. (2006). Appearance-related side effects of
HIV-1 treatment. AIDS Patient Care and STDs,
20(1), 6
18.
Johnson, J.A., Li, J., Morris, L., Martinson, N., Gray, G.,
Mclntyre, J., & Heneine, W. (2005). Emergence of
drug-resistant HIV-1 after intrapartum administration
of single-dose nevirapine is substantially underesti-
mated. Journal of Infectious Diseases, 192(1), 16
23.
Kip, E., Ehlers, V., & Wal, D. (2009). Patients’ adherence
to antiretroviral therapy in Botswana. Journal of
Nursing Scholarship, 41(2), 149
157.
Laniece, I., Ciss, M., Desclaux, A., Diop, K., Mbodj, F.,
Ndiaye, B., . . .Ndoye, I. (2003). Adherence to HAART
and its principal determinants in a cohort of Senegalese
adults. AIDS, 17(Suppl. 3), S103
S108.
Lee, J. (2006). The role of the pharmacist in improving
adherence to HIV therapy. Review, 5(4), 114
119.
Lewis, M.P., Colbert, A., Erlen, J., & Meyers, M. (2006). A
qualitative study of persons who are 100% adherent to
antiretroviral therapy. AIDS Care, 18(2), 140
148.
Liechty, C., & Bangsberg, D. (2003). Doubts about DOT:
Antiretroviral therapy for resource poor countries.
AIDS, 17(9), 1383
1387.
Meursing, K., & Sibindi, F. (2000). HIV counselling-a
luxury or necessity? Health Policy and Planning, 15(1),
17
23.
Parienti, J.J., Bangsberg, D.R., Verdon, R., & Gardner,
E.M. (2009). Better adherence with once daily anti-
retroviral regimens: A meta analysis. Clinical Infectious
Diseases, 48(4), 484
488.
 142 B. Nyanzi-Wakholi et al.
Ssali, S.N., Atuyambe, L., Tumwine, C., Segujja, E.,
Nekesa, N., Nannungi, A., . . .Wagner, G. (2010).
Reasons for disclosure of HIV status by people living
with HIV/AIDS and in HIV care in Uganda: An
exploratory study. AIDS Patient Care STDS, 24(10),
675
681.
The Joint United Nations Programme on HIV/AIDS
[UNAIDS]. (2008). Reducing HIV stigma and discrimi-
nation: A critical part of national AIDS programmes. A
resource for national stakeholders in the HIV response.
Retrieved from http://data.unaids.org/pub/Report/
2008/jc1420-stigmadiscrimi_en.pdf on 1/04/2008
Downloaded by [University of Liverpool] at 09:41 28 February 2013
View publication stats
Wolff, B., Nyanzi, B., Katongole, G., Ssesanga, D.,
Ruberantwari, A., & Whitworth, J. (2005). Evaluation
of a home-based VCT intervention in rural Uganda.
Health Policy and Planning, 20(2), 109
116.
World Health Organization [WHO]. (2009). Towards uni-
versal access: Scaling up priority HIV/AIDS interven-
tions in the health sector. Retrieved from http://www.
who.int/hiv/pub/2009progressreport/en/index.html on
12/10/2009