Home-based programs cut African AIDS deaths: study

By Michael Kahn

LONDON (Reuters) - Providing HIV drug cocktails to people in their homes can cut AIDS-related deaths substantially in poor, rural areas of Africa, researchers said on Friday.

A study in Uganda showed that hiring local health workers to help people stick to a strict regimen of drugs cut the number of AIDS deaths by more than 90 percent.

"These results were achieved even though no routine clinic visits were scheduled after initial enrolment, and home visits were provided by trained lay providers," Jonathan Mermin, a researcher at the U.S. Centers for Disease Control and Prevention, and colleagues wrote in the journal Lancet.

Drug cocktails called highly active antiretroviral therapy, or HAART, can keep people healthy for years even if they never eradicate the AIDS virus, which infects more than 20 million people in Africa.

The treatment is increasingly available in the region but patients need to follow medication instructions and require constant monitoring. This can prove difficult for people in poor areas where health clinics are far away, Mermin said.

"We wanted to find a way where people could avoid going to the health clinic," Mermin, who is based in Kenya, said in a telephone interview.

The researchers hired local health workers and taught them skills such as administering the drugs and conducting HIV tests. Weekly visits helped identify people unaware they were infected and got them on the life-extending drugs, Mermin said.

Deaths of people on antibiotics and the HIV drugs fell 95 percent, the study found.

The number of orphans dropped 93 percent and deaths of children under 10 dropped 81 percent, the researchers said.

The home visits were also linked to a large reduction in deaths of children who did not have HIV, a finding that suggests getting people on to the drugs benefits the entire family, Mermin said.

"It worked incredibly well," Mermin said. "We had some of the highest adherence rates ever recorded."

More than 33 million people globally are infected with HIV which is incurable. There is no vaccine and drugs that can help control the infection do not stop its spread and are not available to most people.

(Reporting by Michael Kahn, Editing by Maggie Fox and Robert Woodward)