Antiretroviral therapy (ART) has become more and more accessible for those infected by HIV.  Nevertheless, availability is only part of the challenge. ART is a lifelong commitment that requires patients to adhere to a daily regimen of medication.  Strict adherence to treatment is crucial to improve health, increase survival, and prevent the spread of HIV to partners and their offspring.

Consistent with experiences in treating chronic diseases globally, a systematic review of patients who initiated ART across sub-Saharan Africa found that approximately 25 percent were no longer in care one year after initiation. After two years, the percentage rose to 40 percent. Among this group of patients, a minority had died, while the majority was classified as "lost to follow up."

How TRIO Works

TCE works to reduce the challenges of ART through a care system called TRIO. As the name implies, TRIO consists of three people: one person who is on ART or Isoniazid Preventive Therapy (IPT) for tuberculosis, and two individuals who comprise an active support group.  The two supporters ensure that the infected individual is taking his or her medications regularly and properly, making arrangements to personally witness the medicine being taken each time.  They also assist the infected individual in coping with reactions or side effects.

Listen to a field officer from South Africa explain the TRIO approach.

The TCE field officer facilitates the creation of the TRIO, helping the HIV positive individual identify who might help him or her.  Candidates are generally trusted and close personal friends, family members, neighbors or a TCE volunteer. Once a month the TRIO group meets with the TCE field officer to discuss adherence and any other issues that may have arisen. 

Read more about TRIO by downloading this trifold pamphlet.