Providing Antiretroviral Therapy (ART) in Rwanda

In February 2003, HIV-positive patients at the Biryogo Medical and Social Center in Kigali began antiretroviral therapy (ART) through a project sponsored jointly by the U.S. Agency for International Development (USAID) and Family Health International (FHI). The Center—one of two "learning sites" in Rwanda for introducing ART—was selected based on several criteria, including presence of seropositive staff and a program to prevent mother-to-child transmission of HIV.

The Center and project staff identified nine patients as candidates for ART based on clinical staging (CD4 count below 200) and evidence of adherence to prophylaxis medication for opportunistic infections. Four patients began treatment in February; it is expected that two to four additional patients will begin ART at the Center each week until 130 patients are undergoing treatment.

Before beginning treatment, the first four ART patients met with project staff to share their thoughts. With permission, project staff developed profiles to introduce each of these remarkable individuals. The profiles describe the health status of the patients, but also the impact of HIV on their lives and the meaning of ART to them and their families. This document highlights the profiles of the four ART patients.