SPONSORED: How early testing, counseling and treatment help in saving lives

The thought of being raped and getting pregnant against your will at an early age can be a horrible experience. It becomes a live nightmare once the woman- the victim- realizes she acquired HIV in the process. Although she went through an unbelievably traumatic experience, Kayitesi (not real names) says her decision not to abort and to keep living perhaps changed her life for the better. Kayitesi’s life got a dramatic twist when in 2006, at 22 years, she was raped by a much older person of 40 years who was a resident near their home in Kicukiro. She says back then, she had dreams of completing her university education, get married and start a family. “My life was so full of dreams that were shattered that fateful day. I went to pick my clothes from a tailor that lived near our home. I trusted him seeing that he was a much older person. Little did I know that he was HIV positive and had bad intentions of raping me,” Kayitesi recalls. Fearful of what would happen if she talked and after being convinced by her assailant that things are going to be fine, Kayitesi never reported the matter to police or to her relatives. However, after months of chronic illness, she discovered that she was pregnant and though she did not want to be a mother yet, she decided against abortion. A self-testing kit. She says that though the doctors at the antenatal insisted that she goes for an HIV test at the health center, the man that had got her pregnant was against it, and it was much later that she discovered she was HIV positive. “Being diagnosed with HIV was heartbreaking for a woman of my age and about to give birth. My life was over in a second and I knew I was going to die. To make matters worse, the man that had raped me disappeared after knowing my status and I was left alone to fight for my life,” Kayitesi explains. Two years after giving birth and after seeing that she was in very poor health, a friend advised her to visit a place called We Act For Hope a local NGO in Nyurugenge Kigali that provides medical care services, hospital referrals, and HIV counseling and testing for tens of thousands of Rwandans and their families. “By the time I went to We act For Hope, my health was in a sorry state, very weak and weighed only 40kgs. My baby was always sick and very weak because we were not on HIV treatment,” says Kayitesi. Kayitesi started accessing HIV treatment in June 2008. Her life has since changed. She believes that the friend who proposed that she visits We Act For Hope saved her life. “My life is back on track and my dreams have been rejuvenated. I am living a normal healthy life and I intend to go back to school and start a happy family,” she says. Kayitesi’s confession is one that maybe no one would expect from someone who was raped. This victim feels blessed to have her baby. She may have gotten raped, infected and pregnant against her will at a young age, but she is thankful that she kept and raised her child. She is now living positively with HIV and in good health. Kayitesi advises young people who might have gone through similar unimaginable events in life and are HIV positive not to lose hope and to go for treatment because it is possible to live positively. “Before treatment, I thought my life was over and I almost died not knowing that there was a solution. All you have to do is take your medication faithfully. Also to those that have not tested, I advise that you go for testing because it helps to know your status for early treatment,” she advises. Learning that he was born HIV positive at an early age was unbearable Ngabonziza was ten years old when he discovered he was HIV positive. The devastating news that his mother, relatives and close family friends had spent years preparing to break to him in the gentlest manner possible was blurted out by a careless relative after his mother died. “My mum had just passed away and I was left with my elder sister to take care of me. She decided it was time for me to know the truth about the cause of my mother’s death and my fate as well,” says Ngabonziza, who celebrated his 29th birthday this year. “I remember standing there, with my mother gone and my sister’s hand around mine, as these feelings of complete confusion and fear washed over me.” A lab technician takes a blood sample. Ngabonziza credits the HIV medication given to him all those years for saving his life. But, he says, he understands that back then, there was no mother to child prevention and that at the point of delivery, the infection was passed into his own bloodstream. After that day at the hospital, however, Ngabonziza decided to faithfully follow doctor’s instructions and never to miss taking his pills. “I suddenly realised that the pills my mum had been giving me every day – that I had thought were for other ailments – were HIV medicine,” he says. “After my mother passed away, I decided that I would live a healthy life no matter the circumstances and with my sister, we sought the help of “We Act for Hope” he says. He shrugs sheepishly. “I have never stopped taking my pills even though my CD4 count is very high and the virus cannot be easily detected in my blood. I know it is the right thing to do,” he says truthfully, but with studied nonchalance. An exuberant young man, full of life, he laughs at look on my face. Pulling his coat tightly around his body, he turns as someone opens door obviously hating the intrusion to his narrative. But there’s nothing funny about Ngabonziza’s attitude towards his HIV status. A decade of sporadic adherence to his drug regime has made him strong. Today, Ngabonziza works as a receptionist at WE ACT for Hope and is about to complete his studies at Mount Kenya University in Rwanda. He has dreams of marrying and starting a family soon. Voluntary Counseling and Testing at a glance Currently, HIV testing and treatment services are being offered in local health centers clinics and hospitals for youth and adolescents in Rwanda. To ensure that people can exercise their right to know their HIV status, and that people with HIV can benefit from increased access to antiretroviral (ARV) treatment provided in the 3 by 5 Initiative, HIV testing and counseling must be radically scaled up, using innovative, ethical and practical approaches to delivery. According to Chantal BeneKigeri the We-Actx Clinical Director, of the NGO that collaborates with grassroots partners and the Government of Rwandan to provide Voluntary Counseling and Testing services (VCT), HIV testing and counseling is the door and the first step to care, treatment and support for persons in need. “We provide VCT using a family-centered model, with all family members of people living with HIV/AIDS being encouraged to test. We identify HIV infection in multiple family members and refer them to immediate medical care which prevents the family from having to choose which members will receive treatment and from sharing their medications which results in inadequate treatment and can lead to virology resistance to ART” says Benekigeri. A staff offering counselling services to a patient. People should have access to testing and counseling services which must become commonplace in settings where those most likely to benefit from knowledge of their HIV status can be reached, such as services for tuberculosis, sexually transmitted infections and acute medical care as well as antenatal care services. The World Health Organization (WHO) recommends that, in the context of community mobilization around the importance of learning one’s HIV status, HIV testing and counseling should be offered whenever a patient shows signs or symptoms of HIV infection or AIDS. It should also be offered whenever this will aid their clinical diagnosis and management. Under these circumstances, the offer of testing and counseling should be considered the standard of care. After having been provided with sufficient information to enable informed consent, all patients can “opt out” of being tested if they do not want the test performed. In Rwanda, voluntary counseling and testing is available in 99% of health facilities and 96% of these health facilities provide a complete package of HIV services including, PMTCT and ART services. On average, more than 3,000,000 tests were performed across the country and approximately 26,497 positive cases giving an overall HIV positivity rate of 0.7%.Government intervention In Rwanda today, medical experts with the Ministry of Health are making a major headway toward introducing changes in the treatment and prevention of HIV/AIDS in the country. The Government has developed a policy to improve the quality of HIV management. Speaking to the media, Dr Sabin Nsanzimana, the head of Division HIV and other Infectious Diseases at Rwanda Biomedical Centre, said they will start from the preventive part, by introducing a new self-testing system. This, he said, will be rolled out as early as December this year. According to Dr Nsanzimana, with the self-test system, people will be given devices with which they will be able to take test from anywhere for HIV. He said this will be as simple as carrying out a self-testing pregnancy kit. “It will help many people to know about their HIV status, especially those who are normally shy away from voluntary testing conducted at health centres,” he said. The system will not use blood alone for testing but also other body fluids like saliva. Self-testing has been tried in three countries in southern Africa. MoH has already made steps toward the system. On the side of treatment, the medics are also looking to include new drugs into the guidelines as well as removing others basing on factors like side effects, potency or resistance to HIV/AIDS. Rwanda has managed to stabilize HIV prevalence at 3 per cent in the general population (15-49 years) over the last decade, and reduced transmission rate of HIV from mother to child to less than 2 per cent over the last 3 years.

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SPONSORED: How early testing, counseling and treatment help in saving lives