Opening of the first ART Adherence Unit in Pakistan

In January of this year, our partner Nai Zindagi, opened a new facility for people who use drugs living with HIV in Pakistan. The primary objective of the new unit is to support people affected by HIV and AIDS and in need of treatment to adhere to medication, stay healthy and live longer. On Monday 17 March, the ART Adherence Unit was officially inaugurated. The event was attended by 130 people, including the Netherlands’ Ambassador for Pakistan Marcel de Vink. An interview with Machteld Busz (Mainline) about this new facility.

What are the services that this new facility will offer?

This is the first unit of its kind in Pakistan. This unit supports people who use drugs living with HIV to adhere to their antiretroviral treatment (ART). In this ART Adherence Unit, clients stay for a period of two months during which they receive counselling, education about treatment, possible side-effects and ways to live with HIV and stay on ART. However, the residential programme goes beyond this.

This place gives you a chance to get your life back  Aban, client at the ART Adherence Unit

The centre provides psychosocial support; teaches people about relapse risks; focuses on managing emotions; and supports clients to find a new place in their community and within their families. The unit has a doctor on board and staff consists of psychologists, nurses and social workers. Adding the very valuable peer support and a stable living environment with sufficient nutrition to this, makes this new facility a comprehensive care unit.

Why is this so important?

Tariq Zafar (Nai Zindagi) explains that only 17%of people who use drugs in need of ART can access treatment. (photo credit: Nai Zindagi)

In Pakistan, HIV infections are mainly driven by needle sharing among people who inject drugs. For example, in the region of Punjab, among the 6,599 people who inject drugs and were tested, 2,385 were HIV positive. However, only 17% of those in need of ART could access treatment services. Although the government funds HIV treatment (through the Global Fund), people who use drugs are seen as ‘difficult patients’ who could never adhere to their treatment. And this is partially true for people who live chaotic lives and often don’t have sufficient means to ensure the stable living conditions that benefit anti-retroviral treatment.

Before coming to the ART Adherence Unit, I had fear for being on ARVs for the rest of my life; ARV is not an issue any longer and I am confident that I will make it and HIV is manageable with regular use of ARVs Tanvir, client at the ART Adherence Unit)

The new unit is a much-needed addition to HIV treatment, care and support in Pakistan. People have many misconceptions about HIV, AIDS and ART. People who use drugs perceive a diagnosis with HIV as a death sentence. They are often not aware of the possibility of treatment. There is also a level of distrust against NGOs in Pakistan. NGOs promoting ART are not automatically embraced and people tend to fear what they don’t know. Much education is still needed to ensure a larger number of people living with HIV to start ART.

 How many clients does the new facility expect to reach?

The unit focuses on people who have just gone through detoxification, are registered with the government clinics and have been prescribed ARVs. The unit can accommodate 100 persons in residence care which will expand to 1000 by the end of 2015. What is particularly effective in the facility is the fact that peers who have resided in it for a few weeks can help to educate newcomers on their medication. The contribution of peers is a powerful tool to reach people with accurate information. This makes the first weeks of the ART Adherence Unit already a great success.

ART Adherence Units are essential and must be replicated across Pakistan to improve adherence and save lives Tariq Zafar, Nai Zindagi

The new ART Adherence Unit has been established as part of the Bridging the Gaps programme, funded by the Dutch Ministry of Foreign Affairs. At the inauguration, Marcel de Vink committed to full cooperation for the establishment of ART units for the treatment of people living with HIV.