Government is pushing more men to take HIV tests and cover the 16 per cent gap that is needed to achieve the 90-90-90 ambitious treatment target to help end the HIV pandemic.

The 90-90-90 target hoped that by 2020, at least 90 per cent of all people living with HIV will know their HIV status, 90 per cent of all people diagnosed with HIV will receive sustained antiretroviral therapy and 90 per cent of all people receiving antiretroviral therapy will have achieved viral suppression.

However, speaking to The New Times in an exclusive interview, the HIV Division Manager at Rwanda Biomedical Centre (RBC), Dr Gallican Rwibasira, said that although UNAIDS set their target at 90 in terms of those who should be knowing their status, Rwanda raised its bar higher and set it at 95 instead.

However, he said that although 84 per cent of Rwandans know their status in general, men are lagging behind in this area, contributing largely to the 16 per cent gap.

"Women who know their status stand at 87.6 per cent while men are at 81 per cent. Men are not only lagging behind on this indicator but also in the area of taking medication and viral load suppression,” he said.

Rwibasira explained that while women do go to see health professionals and take more tests, the African culture that pushes men to be strong and ‘macho’ means that most will opt to self-medicate unless their condition escalates.

"Regardless of whether a man is educated or not, their curiosity to know their status is much less than that of women. A woman can take a child to hospital and decide to take a test but you don’t see the same zeal with men. We are soon launching a testing campaign that only targets men,” he said.

He explained that men have to be prioritised in their campaigns since they are the main spreaders of the virus.

"For instance, if a married man has unprotected sex with a sex worker and contracts HIV, his wife will definitely be a victim of her husband’s attitude. He is driving the virus from a high risk group to the general population.

The numbers

An estimated 230,000 people in Rwanda are HIV positive. Of these, at least 200,930 (97 per cent) are on medication, surpassing the 90 per cent target set by UNAIDs for 2020.

Rwibasira explained that every year, treatment is initiated for around 11,000 people.

"That doesn’t mean that these people are newly infected. It means that they could have been infected a year or years before but they were not ready to start taking medication due to personal reasons. Our duty is to sensitise them but the decision to go on medication is personal,” he said.

Civil society involvement

The Executive Director of the Health Development Initiative, which is a member of the Umbrella Organisations Fighting HIV, Dr Aflodis Kagaba told The New Times that while women have more chances of getting tested during their antenatal visits, their partners are still lagging behind, although they are normally encouraged to take tests.

He said that targeted sensitisations program are beginning to yield some results especially within the high risk groups where sex workers are encouraged to come with their regular clients.

"We have been consistently paying for prime time adverts and programmes on local radios and TV stations that target men and we are beginning to see very good results,” he said.

Kagaba said that men who have sex with other men have showed a very high prevalence rate and they are being approached and encouraged to take these tests to ensure that they get timely treatment and continue living healthy lives.

Disclosure process

Previously, Rwibasira said that although 18 is the legal adult age, children as young as 12 can now take HIV tests.

"We must admit that young people are getting sexually active at a very young age. A 12-year-old can take a test although we require that he or she receives the results in the company of an adult. We want them to have the right information, at the right time and with the right psychological support,” he said.

Rwibasira explained that although parents whose children are HIV positive are encouraged to constantly have open conversations with them, RBC has its own disclosure process where the child is talked to about their status as early as when they are five years old.