Positive predicament

TRACKING the sexual partners of HIV clients and ensuring people diagnosed with the virus stay on their medication are some issues that make the job challenging for HIV/AIDS contact investigators and case managers.

As plans are stepped up to mark World AIDS Day on Thursday, December 1, workers from Health Connect Jamaica (HCJ) shared their experiences during an exclusive interview with the Jamaica Observer.

One HCJ contact investigator shared that there are times when incomplete information — including incorrect addresses and shortened names of the contacts — is provided.

“I am trying to get all who they have been in contact with sexually, who might have been exposed to this same infection they now find themselves with, because those persons would need to be offered a test, and then when we get them tested we see if they are negative or positive and — depending on how that goes — we will know how to advise them or put them into care and get them on their medication,” said the contact investigator whose name is being withheld.

“You will sit and talk to the person and gather all the information; they give you names, phone numbers, addresses — or sometimes you only get a name or get all the information you want — and when you go, it’s a big open lot. You will even gather all the information but you cannot find the person, and I want to get those persons tested so that’s challenging,” she added.

According to the investigator, there are instances in which some clients will find excuses to avoid getting treatment, but she still attempts to maintain contact with them.

“In helping persons you get somebody at a certain stage and when you look at their first viral load and you counsel and take them through and they get their medication, although the case manager will do most of that, I follow up with my patients so I have them where they should be — and somehow it helps me. The interaction with them, hearing them say ‘Thank you’, the smiles, are really moving,” said the contact investigator.

Health Connect Jamaica is a special project of the Faculty of Medical Sciences at The University of the West Indies, in collaboration with the Ministry of Health, which is mandated to expand access to and utilisation of high-quality, HIV-specific primary health services.

An HCJ case manager told the Observer that the people who were diagnosed with HIV long ago are less cooperative than those who are newly diagnosed.

“The newly diagnosed clients are usually the ones who are more receptive to care. They are usually eager to start medication, they want to learn about the antiretroviral drugs, they follow through and they usually comply and usually achieve viral suppression in a short time and go on to do well,” said the case manager.

“Clients who [were] diagnosed many years ago defaulted. Those are usually the most challenging ones because it is a lot of re-education about what they need to be doing. Getting them back into the habit of what they should do is a lot harder than dealing with somebody who is new,” she explained.

The case manager pointed out that most of the newly diagnosed clients get in contact with HCJ through text messages as most of them are between the ages of 19 and 25.

“We do text blasts through the different cellphone networks so that persons get these messages and we do get calls of people saying, ‘Hey, I got this message on my phone and I am part of the population and I would want to come private,’ so we do get a lot of clients that way. That is our main strategy right now,” the case manager shared

“The other day we were having discussions as case managers and we were saying, ‘Have you noticed that most of your clients are young, some between 19 and 25?’, and we were all having that experience; there is also a subset of the older set — late 50s, early 60s — as newly diagnosed,” she said.

For fiscal year 2022/23 the Government is spending $1 billion on the National HIV/AIDS Response in Jamaica project. In just two years of operations HCJ has significantly expanded access to HIV treatment and care services through Jamaica’s private sector.

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