Home-based antiretroviral care is associated with positive social outcomes in a prospective cohort in Uganda

J Acquir Immune Defic Syndr. 2007 Jan 1;44(1):71-6. doi: 10.1097/01.qai.0000243113.29412.dd.


Background: Home-based antiretroviral therapy (ART) care in Africa has expanded; but social outcomes of home-based ART programs are unknown.

Methods: Social experiences of participants in an antiretroviral therapy program involving weekly home visits in Uganda were assessed through interviews at enrollment and after 3 months and analyzed using generalized estimating equations.

Results: Of 654 participants, 72% were women; median baseline CD4 cell-count was 123 cells/muL. At follow-up, participants were more likely to report community support (adjusted odds ratio [OR] 2.10, 95% confidence interval [CI]: 1.46 to 3.03, P < 0.001), family support (OR 2.65, CI: 2.01 to 3.49, P < 0.001), and relationship strengthening (OR 2.10, CI: 1.46 to 3.03, P = 0.001) than at baseline; 84% attributed these experiences to antiretroviral therapy program participation. There was no change in incidence of negative experiences (P = 0.3). Forty-six percent of women reported a history of partner abuse, but abuse rates 3 months before and after program initiation were low (1% vs. 2%, OR 3.20, CI: 0.94 to 10.9, P = 0.063). Of five women who reported abuse associated with program participation, all had history of domestic violence. Of all participants reporting outcomes associated with antiretroviral therapy program participation at follow-up, 464 (79%) had only positive experiences, 35 (6%) had both positive and negative experiences, and <1% had only negative experiences.

Conclusions: Participation in a home-based antiretroviral therapy program was associated with multiple positive social outcomes.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • Cohort Studies
  • Female
  • Home Care Services / organization & administration*
  • Home Care Services / statistics & numerical data
  • House Calls
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Uganda


  • Anti-Retroviral Agents