Going beyond zero require new thinking in the fight against HIV

Going beyond zero require new thinking in the fight against HIV

H

IV does not discriminate but people do. We should love and patients of HIV and enable them live fulfilling lives since living with HIV is not a death sentence. Mothers can give birth to HIV free babies and raise an HIV free generation.

BY MUSYOKA NGUI

The recent survey by NASCOP (National Aids and STI Control Programme) shows that 53 per cent of Kenyans do not know their HIV status. This is despite the fact that the government offers free testing and voluntary counseling in public hospitals. The private hospitals and NGOs too create awareness but somehow the message is not home yet.

Sub-Saharan Africa accounts for over 75 per cent of the world prevalence of HIV and Aids. These grim statistics have the health workers and government and everybody else who cares worried.

Change of Tack

There are underlying causes which are deep rooted and to yank them from the social fabric, there must be concerted efforts from stakeholders ranging from multifaceted approaches to change of tack in the fight against the scourge that is intricately interwoven in our society.

Despite the depressing reading which the worrying trends make, there is still hope. The supply of condoms by the government has increased from 10 million in 2004 to 180 million in 2013. The government also provides free maternity services to pregnant mothers. This reduces the rate of mother to child transmissions of HIV and also is a realization of meeting millennium development goals of reducing both child and mother mortality rates.

However, over 1.6 million Kenyans live with the HIV virus according to data obtained from the National Aids Control Council (NACC). The World Health Organization (WHO) estimates that Kenya has the fourth highest number of HIV infections in the world.  United Nations Program on HIV/Aids (UNAids) rank South Africa as the global leader in HIV and AIDS prevalence at 5.4 million. Nigeria comes second at 3.3 million and India at 2.4 million. You can imagine Kenya is next at 1.6 million infections.

We must realize that the old methods of HIV protection and cure are not effective anymore. Youths and sex workers are reported to abuse the Antiretroviral Treatments (ARTs) thus causing unprecedented resistance of the HIV virus. This makes the virus mutate and suppress the effectiveness of the drugs administered.   The patients sometimes due to lax follow up and care do not follow the prescription to the letter. When they recover they discontinue the medication. This, again contribute to renewed resistance of the virus.

Blissful Ignorance

Other patients are held back by retrogressive myths and blissful ignorance that hinder the fight against the HIV scourge. They believe in herbal medicine, witchcraft, faith healing and curses. Any wonder that new age “prophets” like Kanyari capitalize on their desperation by claiming to cure HIV/AIDS? The end result of these myths is increased transmission of HIV. Truth is we are far from realizing an HIV free generation. This is particularly so if still the rate of mother to child transmission continues to be witnessed and if our mothers continue to give birth at home under the care of backstreet midwives who risk the lives of the mother, the babies and their own lives.

In Turkana County, the 2012 report titled Kenya Aids Indicator Survey placed the HIV prevalence rates at 7.6 per cent-higher than the national prevalence rate of 6 per cent. In Homa Bay County the situation is worse as a quarter of the population is ravaged by the HIV virus. The prevalence rates stand at a staggering 25.7 per cent. This is according to the Ministry of Health and National Aids Control Council (NACC) findings.

These two counties have striking cultural similarities. There is widespread tradition of wife inheritance and polygamy. Coupled with these are entrenched scape-goating of the people living with HIV and Aids. In Turkana it is an abomination to mention HIV. They call it malaria. People living with the HIV virus(PLWH) are discriminated and suffer from stigma. The fact that they are not accepted leads to the PLWH to develop desperation, despair, hopelessness and stress. They feel they are a bother to themselves and the community. They end up being isolated and waste away without the much needed care and support. This is unacceptable. What happened to loving our neighbors?

Turkana County suffers from grinding poverty and attendant marginalization. The AIDS patients do not get the privilege of boosting their immunity with recommended immunity boosting diets such as fruits and other nutrition supplements that the doctors recommend. What’s more, Turkana is home to the (Kakuma) refugees from war torn countries such as South Sudan and Somalia. The humanitarian crisis is ever real. To access the largest county in Kenya situated in the northern frontier requires massive resource mobilization. This encompasses human resources, medicine and means of transport.

Transactional sex

Turkana is a county that is slowly waking from the slumber of conservatives and embracing modernity at a huge human cost. The discovery of rich deposits of oil in Ngamia I and other wells in the region has attracted investments in the region. In Lodwar and other commercial centers there is rise in transactional sex. This further increases the rate of HIV infections.

In Homa Bay there are many sex rituals that promote the spread of HIV virus. Men do not use contraceptives such as condoms despite the government availing them for free in social centers. Apparently, bodily fluids must be exchanged for the “cleansing” rituals to be properly observed. There are also “kilo” rituals which are conducted overnight. Girls dance in discos as men watch them and place hefty bets on the best dancers. The girl who wins the auction is taken by the highest bidder. The man then goes to sleep with the girl. Money obtained from the auction is shared between the dancer girl and the bereaved family because the disco dances occur at the night festivals aimed at mourning the deceased. I dare say this is a classic case of prostitution.

In Nairobi and other urban centers there is need for the government to develop special programs for sex workers and men having sex with other men (MSM). Apparently, the sex workers get paid three times more when they do not use condom when they have sex with a client. They argue it is more pleasurable.

Proverbial Ostrich

Denial must be confronted. It is encouraging noting that there are community workers who volunteer their time to offer reproductive and sex health education to the infected and the affected. These peer support groups are source of hope and provide solace to those who are living with the virus.

Recently the Church forced an advertiser to pull down an “offending” billboard that advocated for use of condoms among couples who are engaged in the mpango wa kando (clandestine liaisons). The Church denied that cheating among married couples is real and dismissed the advert as a mere channel to promote immorality and promiscuity.  Then what?

Which is better; to watch the cheating couple die of HIV and other related illnesses, give them condoms or continue burying our heads in the sand like the proverbial ostrich?

Abstinence unrealistic

I also take issue with the outdated ABC (Abstain, Be faithful and use Condoms) approach of dealing with HIV and AIDS.  While I do not endorse permissiveness nor do I trash the virtues of faithfulness and self control, there is need to accept the reality that not everybody is accustomed to or lack  the patience to wait, say, till marriage as the Church and parents would want the society to believe. Truth is children are having unprotected sex as early as eight years. Early marriages, school drop outs and abortions point out to a society that is having unprotected sex but is in denial.

When ABC approach does not work it becomes ABCD (D here representing Death).  Youth, especially the campus students fear pregnancy more than STIs and HIV combined. They would rather take morning after pills such ARVs and emergency contraceptives after a night stand than use condoms. The tragedy is that pills do not prevent HIV and STIs. E-pills are most effective when taken within 72 hours but with lack of information on dosage and the fact that the drugs are abused thereby compromising their effectiveness by increasing the resistance and mutation of the HIV virus strains is the stark reality.

In Mombasa and other regions where drug abuse is rife the government should find ways of reaching out to the drug addicts. Most of them are jobless youths who have no purpose in life. The government can get them engaged in gainful employment. This will also scale down youth radicalization and terrorism in the region. Al Shabaab will have no one to recruit into their lost causes of jihad and religious extremism.

They say HIV does not discriminate but people do. We should love and patients of HIV and enable them live fulfilling lives since living with HIV is not a death sentence. Mothers can give birth to HIV free babies and raise an HIV free generation. But this will only happen if they have goodwill from those around them.

Musyoka Ngui is a final year Bachelor of Arts student in Communication and Media at Chuka University. He manages his own blog called Youth Issue        ( musyokangui.blogspot.com) and is also technology reviewer with culturemob.com.