After finding out that she was HIV positive, Florence Uwase (not her real name) only accepted to take treatment for the sake of her child, and wait for death once the baby is born.

"I will keep taking these pills until one and a half years of breastfeeding. After that, I might just as well die,” she told her healthcare facilitator.

Uwase got to know about her status while she was pregnant and felt betrayed by her partner who didn’t disclose that he was HIV positive and transmitted it to her.

During her antenatal care, she paid regular visits to the hospital for viral testing and treatment, at that time her viral load was within the bracket of 20 copies per one millilitre of blood.

Under the Undetectable equals Untransmissible campaign, many countries including Rwanda have established that an individual has to keep the viral load below 200 copies per milliliter of blood not to transmit it sexually

However, health centers in the country have taken a step further to a target of 20 copies per millilitre. This can only be achieved if the patient takes their treatment on time and consistently over a period of six months.

The purpose was not the same for the 22-year-old Uwase, who after receiving results that her child was safe from the virus and was no longer breastfeeding, stopped taking the Antiretroviral (ARVs) pills and disappeared.

It is only after six months that the healthcare facilitator brought her back but the damage was done, her viral load had risen to 3220 copies per millilitre of blood coupled with Tuberculosis.

"I managed to convince her to get back on medicines because even her mother whom she had left the kid with was also suffering from cancer. I made her realize the responsibilities she had as a reason more to fight for her life,” the facilitator told The New Times.

As much as there is 95 percent chance that one cannot transmit HIV when they adhere to the schedule of taking medicines, according to available data, it is very difficult for young people to keep up with the necessary discipline of treatment.

World AIDS day is marked annually on December 1, and this year’s theme "Equalize” highlights the need for equality in providing information and HIV treatment to all categories of people without discrimination.

At a national level, Rwanda marks it under the theme "Youth, let’s be at the forefront in HIV/AIDS Response” to increase awareness among young people of the life-threatening virus with access to information, testing, and treatment services.

According to findings from the Rwanda Population-based HIV Impact Assessment (RPHIA) conducted in 2019, HIV prevalence was approximately two or more times greater in older adolescent girls and young women (15-24 years) than in older adolescent boys and young men, 1.2 per cent and 0.5 per cent, respectively.

This is while the latest data from RBC shows that only 59 per cent of young women and 57 percent of young men aged 15 to 24 have comprehensive knowledge of HIV/AIDS.

Eric Remera, Research and Database Registry officer, department of HIV in RBC, said that 30 percent of more than 5000 new infections recorded daily are seen among youth.

"This is very challenging because youth are fearing to get tested, and even those on treatment relapse because of peer pressure,” he explained

He noted that it requires different methods of creating awareness among youth by reaching them through various platforms with tailored messages.

Remera said that HIV prevalence in population remained stable at 3 percent from 2005 to 2015 among people aged 15 and 49, and it decreased to 2.6 percent from 2019 to date. The prevalence is high among women at 3.7 percent while among men it’s at 2.2 percent.

This is because the majority of people at high risk are female, he noted, and also male circumcision has helped to reduce the prevalence among men.

Why young people relapse from treatment

Norman Manzi, Founder of Dream Village, an organisation that aims to reduce new infections, stigma and discrimination among young adults and youth living with HIV, said that youth struggle with having conducive environments to keep up with treatment.

He stated the fear of peer stigma, being forced to move away from health centers they normally receive services, or living with caregivers who don’t understand the importance of medicines to support them.

"If we could all deal with HIV the way we dealt with Covid-19, it would be a big step. We should also destigmatise the disease to allow people to seek treatment,” Manzi added.

According to UNICEF, much has been achieved in the past few decades, saving millions of lives, but the health crisis exacerbated by the Covid-19 pandemic has exposed and often widened inequities in the availability and quality of vital healthcare services.

To eradicate HIV/AIDS by 2030, the organization conducts different programmes that seek inclusive responses to HIV with a focus on mother-to-child transmission, pediatric treatment and care, and new HIV infections in adolescents.

In Rwanda, the average period that one spends on HIV treatment is 15 years, as per RBC data.

Uwase is now back on track with treatment to the level below 20 viral copies per mililitre, after accepting her situation.