Pilot project demonstrating the feasibility of HIV antiretroviral therapy waste bottle collection and recycling

Background HIV remains a leading cause of morbidity and mortality in Uganda. At current levels of antiretroviral therapy (ART) coverage, ART waste bottles are becoming a challenge to both patients and the environment in Uganda. Additionally, ART improperly disposed of in the environment can end up in the food chain and lead to antimicrobial resistance. We aimed to pilot a feasibility study of collecting and recycling the used ART pill bottles at a large urban HIV clinic in Kampala, Uganda. Methods Patients were first engaged randomly during their clinic visits and asked how they disposed of the waste medication bottles. Verbal information on proper disposal options of these medication containers was provided to patients. Patients and caretakers were then encouraged to return the waste medication bottles to the clinic at the time of their next appointment. Posters conveying information about bottle returns were displayed and information leaflets were distributed. Finally, recycling partners were engaged to explore options for the bottles. Results From the group oral engagements performed, patients reported that a means to discreetly dispose of pill bottles was welcome due to the stigma associated with these bottles in the community. They reported previously throwing these bottles in pit latrines, informal rubbish pits, nearby bushes and burning them, all methods that endanger the environment. The process of returning bottles was widely adopted. 53kg of returned bottles were recycled to make each bench that are used by patients in the clinic. Conclusions This pilot study showed a high willingness among people living with HIV to return their used pill bottles. Collecting, storing and recycling was feasible and successful at one large urban HIV clinic in Kampala, Uganda. We, therefore, recommend expanding this model to more HIV clinics country-wide to reduce the environmental impact of HIV programmes.