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The Impact of Increased Availability of Antiretroviral Therapy on Programmes Responding to People Living with HIV and AIDS

This report is the result of research commissioned by CAFOD into the impact that antiretroviral therapy (ART) has on programmes responding to HIV and AIDS.  As ART becomes increasingly available, affordable and accessible it brings undeniable benefits to those served by programme partners in many countries. People accessing treatment are enjoying improved health, sustained -or a return to- employment, renewed ability to become active members of their society and overall improved quality of life for themselves and those dependent on them. With these benefits come new aspirations in people living with HIV and therefore different expectations by them of the programmes that support them.

Where such programmes have been focused on providing health care and psycho-social-spiritual support to people who were sick, this same client group now seeks earning opportunities, work skills, opportunity to continue their education and the possibility of enjoying a renewed social life and community involvement.

These new expectations fall broadly into three categories - ART support services, economic empowerment and advocacy - placing new demands on the skills base of programmes. Questions have risen about how to respond, and, in the case of HIV-focussed organisations, perhaps whether to respond to the economic empowerment needs.  Given the insights into the Brazil experience where ART has been accessible for 12 years, these agencies may want to be prepared for the long term impacts of HIV treatment rather than divert their resources to income generation.  However, the retaining HIV expertise and developing economic empowerment components may not be mutually exclusive.  CAFOD partner organisations in different countries are at different points in the process of encountering, confronting and responding to the challenges and this research offers a valuable opportunity to learn from experiences emerging across a wide span of geographical locations, cultures and HIV epidemiologies, and to share this learning more widely.