Rwanda
Total Treatment Sites:		6
Treatment Site Location(s):		Kabuye Kagugu Kimironko Kinyinya Nyakigezi Rwankeri
Patients on ART:		4,078
Patient Enrolled:		8,174
Report in PDF Format:		Rwanda Country Report

Background & HIV/AIDS in Rwanda 

The war and genocide of the 1990s severely damaged Rwanda’s health infrastructure and Rwanda is among the ten African countries most severely affected by HIV/AIDS.  Its Human Development Index ranking is extremely low: 161 out of 177 countries.  The Rwandan government’s second survey on HIV prevalence conducted in 2005 showed an adult HIV prevalence rate of 3% (7.7% in urban settings and 2.3% in rural areas) and though prevalence rates have stabilized in urban areas, they continue to rise slightly in rural regions.  76% of women and 78% of men have never had any HIV test.  HIV/TB co-infection is also high and estimated to be around 50% (WHO, 2005). 

The epidemic’s rapid spread can be attributed to low levels of knowledge on HIV/AIDS, high incidence of multiple sex partners, low rates of condom use, and early onset of sexual activity.  Lack of human and financial resources is a major barrier to universal access to treatment and care.  Further, capacity to scale up treatment of sexually transmitted infections and opportunistic infections is extremely limited.

In Rwanda, the HIV response is mainstreamed and integrated into all sectors, per the 2007 Economic Development and Poverty Reduction Strategy (2008-2012).  Patients can access at least one complete package of HIV services in every district – 65% of those in need of ART are receiving it, coverage of PMTCT services is 56%, and in 2006, 472,194 HIV tests were conducted (UNAIDS, 2008).

AHF Activities in Rwanda

In January 2006, AHF partnered with the Global Fund, the National AIDS Control Commission, and the Shyria, Kibagabaga and Kanombe Health Districts, to roll out ART programs at two government sites.  Today AHF works with two District governments, at six health centers.

AHF supports the health centers through hands-on clinical mentorship and preceptorship training, human resource assistance, infrastructure improvement, medical equipment supply, and operational management.  AHF assures quality of care through regular site visits, assessments, and evaluation of data collected at each site.  Clinical services such as voluntary counseling and testing (VCT), prevention of mother-to-child transmission (PMTCT), antiretroviral therapy (ART), and HIV/TB care are integrated into the provision of other medical services since stand-alone ART programs are not encouraged by the Rwandan national strategy.

In 2006, revised national guidelines called for routine TB testing of HIV-positive patients and for routine HIV testing of TB patients.  These are considered a critical step in consolidating and normalizing HIV service delivery within the Rwandan healthcare system.  Beyond HIV, AHF believes that integrating PMTCT into the primary healthcare service structure substantially improves the quality and efficacy of primary care in general.  AHF’s PMTCT program supports a range of specific services for HIV-positive women and exposed infants that include: educational sessions; one-on-one counseling; ARV preventive therapy in mothers and infants according to national guidelines; and home visits to track women who have not returned for follow-up care.

For the AHF Mass Testing Initiative, which was launched to mobilize and bring together large numbers of people in order to provide HIV testing, AHF Rwanda Cares and its partners performed 153,018 tests at events organized around World AIDS Day 2008, and provided treatment referrals to the 328 individuals who tested positive (3.17%).

Models of Care

Direct Care

Technical Assistance & Supervision

Training

HIV Counseling & Testing

PMTCT