Why WASH matters: Integrating safe water, hygiene and sanitation into HIV care and support

Issue: People living with HIV/AIDS (PLWHA) are at increased risk for diarrhea, and are far more likely to suffer severe and chronic complications if infected. There is terrible irony in fighting to provide PLWHA with antiretroviral agents (ARVs), and washing them down with water that may infect with life-threatening diarrhea. Recent evidence demonstrates the efficacy of hand washing, safe water and sanitation (WASH) in reducing diarrhea among PLWHA by 25% or more, and increasing the absorptive capacity of ARVs.

In addition to the negative impact on life expectancy and quality of life that diarrheal illnesses cause PLWHA, diarrheal disease in PLWHA adds significantly to the burden on caregivers in clinics and at home, and puts family members at increased risk for diarrheal disease, further weakening the resilience of families struggling to cope with the challenges of HIV.

Description: This presentation outlines the evidence for integrating WASH into HIV home-based care; then highlight practical and participatory research methods and findings from Ethiopia and Uganda used to identify behavioral options, and finally describe two countries community-based approaches to increase WASH behaviors within home-based care programming. At the heart of integrating WASH into home-based care is identifying a range of “small doable actions” that caretakers and PLWHA find feasible (and are proven effective) in various resource and disease contexts: washing with limited running water; feces disposal when mobility is limited in different family/care contexts. Programming implications for water and sanitation sectors will be highlighted: modified latrine designs, homemade potties, augmenting access to water.

Tools, research guides and program resources will be available to share.