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AIDS Research and Treatment
Volume 2012, Article ID 749718, 8 pages
Review Article

Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa?

1Médecins Sans Frontières, Avenue Eduardo Mondlane 38, Tete, Mozambique
2Department of Public Health, Institute of Tropical Medicine, Antwerp, Nationalestraat 155, 2000 Antwerpen, Belgium
3Médecins Sans Frontières, Maputo, Mozambique

Received 29 November 2011; Revised 23 January 2012; Accepted 24 January 2012

Academic Editor: Ann Duerr

Copyright © 2012 Tom Decroo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Since the introduction of antiretroviral treatment, HIV/AIDS can be framed as a chronic lifelong condition, requiring lifelong adherence to medication. Reinforcement of self-management through information, acquisition of problem solving skills, motivation, and peer support is expected to allow PLWHA to become involved as expert patients in the care management and to decrease the dependency on scarce skilled medical staff. We developed a conceptual framework to analyse how PLWHA can become expert patients and performed a literature review on involvement of PLWHA as expert patients in ART provision in Sub-Saharan Africa. This paper revealed two published examples: one on trained PLWHA in Kenya and another on self-formed peer groups in Mozambique. Both programs fit the concept of the expert patient and describe how community-embedded ART programs can be effective and improve the accessibility and affordability of ART. Using their day-to-day experience of living with HIV, expert patients are able to provide better fitting solutions to practical and psychosocial barriers to adherence. There is a need for careful design of models in which expert patients are involved in essential care functions, capacitated, and empowered to manage their condition and support fellow peers, as an untapped resource to control HIV/AIDS.