A growing number of studies have reported the experiences of antiretroviral therapy (ART) programs in the developing world. The majority of these studies report relatively short term outcomes (6 to 12 months) and most of these inaugural programs are embedded within research and academic settings. Concern has been raised that early reports of antiretroviral success in resource-limited settings may be largely attributable to a short-term “honeymoon” period in nonsustainable environments.

The Reach Out Mbuya HIV/AIDS Initiative (RO) is a community and faith-based program in the urban slums of Mbuya Parish in Kampala, Uganda. This program began providing ART in 2003, along with a holistic package of services and programs directed at patients (referred to as clients), their families, and the larger community. It is staffed almost entirely by nurses, persons living with HIV/AIDS (PLWHA), and community volunteers.

Our study proposes to perform a comprehensive program evaluation of RO’s experience through a cross-sectional study of patients at RO who have been receiving ART for at least 24 months. Using only existing clinic and laboratory data, we will report patient characteristics, clinical/virologic/immunologic outcomes, and adherence measures. We will supplement this cross-sectional study with survival analyses of patients who started ART at RO.

Our hypothesis is that a community and faith-based program that emphasizes a holistic approach to the care of PLWHA can deliver and sustain effective ART over at least a 2 year period as demonstrated by good virologic, immunologic, and clinical responses. This type of rigorous program evaluation is vital in providing evidence to support similar types of programs in the scale-up of ART in the developing world.