Editorials

Adherence to combination antiretroviral therapy in complex emergency settings

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.a2662 (Published 18 February 2009) Cite this as: BMJ 2009;338:a2662
  1. Shevin T Jacob, infectious diseases fellow1,
  2. George Abongomera, head2
  1. 1Division of Allergy and Infectious Diseases, University of Washington, Roosevelt Virology Clinic, Seattle, WA 98105-6920, USA
  2. 2JCRC Gulu Regional Centre of Excellence, Joint Clinical Research Centre, PO Box 10005, Kampala, Uganda
  1. sjacob{at}post.harvard.edu

    Can be high, with contingency plans and dedicated resources

    In 2006, about 1.8 million people living with HIV had been affected by conflict, disaster, or displacement.1 People living within these often transient and volatile settings are vulnerable to violence, poverty, and natural disaster, all of which make consistent management of HIV a challenge. In the linked prospective cohort study (doi: 10.1136/bmj.b201), Kiboneka and colleagues describe their experiences in providing combination antiretroviral therapy to a large cohort of HIV infected patients from a camp for internally displaced people in northern Uganda.2 The study shows how some of the barriers to treating people infected with HIV in conflict settings can be overcome.

    Before the initial scale up of combination antiretroviral therapy in sub-Saharan Africa, policy makers from industrialised countries expressed concerns and scepticism about the feasibility of providing this treatment in resource poor settings. Factors associated with poverty, including lack of education and access to care, were …

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