Why HIV and AIDS care in the home?

The diminished capacity of many countries’ health sectors makes the prospect of having people with HIV treated at home all the more attractive to governments. One South African hospital reported patients’ average stay decreased from 14 days to 3.5 days when referred to a home-based care organisation.⁶

A potential benefit of being cared for at home is that sick people are continually surrounded by people they love and are familiar with, so they can also receive more flexible and nurturing care. They will also not be exposed to hospital-based infectious diseases. As people with terminal illness generally spend their final moments at home, strengthening the capacity to be cared for also removes the cost and distress of travelling to and from the hospital when they are weakest.

In the UK, the majority of people die in hospital despite between 56% and 74% of people preferring to die at home.⁷ One cancer patient stated his preferred location of care as:

“Here at home. It’s because I have got my family support here, because the kids are good. My stepson lives with us and my step daughter turns up every now and again.“⁸

Furthermore, in being cared for at home, a person with HIV may be in a more ready position to work or look after family members for short periods of time while the primary earners work. The family’s time that would otherwise be used travelling to and from hospital can instead be spent doing house work and looking after other family members. Expenditure on transport and hospital costs is also reduced.⁹

Despite the potential benefits of being cared for at home, often there is little choice as to where someone with HIV is cared for. As mentioned, health facilities may not be able to cope and furthermore, fear of stigma and discrimination from doctors and nurses directed towards people living with HIV could deter people from seeking care in a medical setting. So too could a lack of knowledge that effective treatment is available.¹⁰