Testing, early treatment, positive living: Denying HIV a chance

BY RBC Every December 1st, Rwanda joins the world to mark the World AIDS Day where people turn their attention to the creation of more awareness on HIV/AIDS epidemic that continues to grip humanity. The day, which is one of the eight official global public health campaigns by the World Health Organization, has been marked since 1987, dedicated to raising HIV/AIDS awareness. Since UNAIDS started marking the World AIDS Day and the associated campaigns, a specific theme is annualy selected to increase global HIV awareness. The 2017 World AIDS Day theme is “Right to Health”. The rationale of this theme is that the universal and inalienable right to health provides everyone with the right to realize the highest attainable standard of health without discrimination or stigma. Placing human rights at the centre will ensure that health care is accessible, acceptable, available and of good quality for everyone. Youth testing for HIV Every year, Rwanda identifies a particular theme for the World AIDS Day, which, for 2017 is; “Get Tested for HIV. If Positive, Start and Stay On Life-Saving Treatment”. According to RBC, the justification of this theme is to reaffirm Rwanda’s commitment to giving people the right to know their HIV status as basis for long-term HIV prevention and access to care and treatment.There has been growing availability of HIV testing, care, and treatment services in Rwanda since 2000. Anti-retroviral therapy (ART) was first introduced in 1999 In 2006, it was reported that voluntary testing and counseling was available at 226 sites. Large-scale Prevention of Mother to Child Transmission (PMTCT) and health promotion initiatives were also reported in at least 208 sites which led to the reduction of infections, reduced morbidity and mortality and equal opportunities for persons living with HIV/AIDS as goals. Today, it is estimated that there is accessibility of free HIV testing services in more than 95% public health facilities and all people in need of ARV treatment in the same health facilities that allow care continuum of those tested positive. There is also availability of health facility and community support for those initiated on treatment to stay on treatment With advances in technology, users can get tested for HIV/AIDS using a saliva sample, as results come in just 15-20 minutes. While there is still no cure for HIV/AIDS, progress has been made in raising awareness and education about the pandemic. Local leaders in Kigali city to take on advanced Super Fast Track framework to end HIV/AIDS among children and adolescents. In honor of efforts expended to fight the epidemic, on the World AIDS Day, people across the country through HIV campaigns will show their support for people living with HIV and commemorate those who have died. Although there have been several advances in HIV treatment over the years, the push continues to remove the HIV/AIDS stigma, raise awareness and improve education about the disease. Learning that you are HIV-positive can be one of the most difficult experiences you go through in life. You may feel scared, sad or even angry – this is OK, and a completely natural part of coping with something that can be life changing. But remember, HIV doesn’t have to stop you living a long, happy and fulfilling life. With the right treatment and support, it is possible to live as long as the average person. There are a lot of misconceptions about what it means to be living with HIV. Ultimately, everyone’s lives are different – how you cope with your diagnosis and how you move forward will be unique. Mutesi 55 For Mutesi, a 55-year-old woman living with HIV, says that when she got her diagnosis, her first thought was “it means death.” That was 1987, one of the crisis’ deadliest years in Rwanda. “People were dying everywhere and I discovered I was to follow soon,” says Mutesi. After two years in 1990, her husband succumbed to the deadly disease leaving her with three young kids and practically nothing to survive on. “I was 24 years and naïve at the time and though I had tested for the first time in 1987 with my husband, I got my results a year after when I did a second test having lost the results of the first test,” says Mutesi. As time went by, Mutesi prayed that a cure for AIDS would be discovered but it was not to be. Every year that went by was like an extension of life handed to her by the gods. “The 90s were bad years for us who were living with HIV. Society was wary of us and feared that we would easily infect them. Adults spirited away, leaving the old and the children behind,” she explained. She says that barely a single family remains untouched. Most did not know how or when they caught the virus, many never knew they had it, many who knew didn’t tell anyone as they lay dying. There was no treatment for those with AIDS. “In 1994, I was raped during the Genocide against the Tutsis and I discovered months later that I had conceived and the following year I gave birth to a baby girl who miraculously was HIV negative” says Mutesi. For more than a decade, AIDS had been a death sentence to her. In 2004, however, Mutesi started accessing treatment and, 13 years later, she’s healthy and strong. “Today I am healthy and a hard working member of the society. I’ve given my children an education and my last child is at ULK from where she will be graduating next year. As a tailour, my y economic status has improved and I have my own home and financial stability” she concludes In the 30 years since, a lot has changed. Mutesi, and thousands of people like her, has survived. Advances in treatment have vastly increased life expectancy for those who can access the medication. According to Dr. Placidie Umugwaneza, director of the HIV Prevention Unit in HIV/AIDS, STIs and Other Blood Bone Infection Division at Rwanda Biomedical Center (RBC), despite the increase in people living with HIV, Rwanda has made significant progress in the fight against AIDS. She explains that HIV prevalence has remained stable at 3.0% among the general population aged 15-49 years over the last decade, the rate of new infections has declined by 50%, and mother-to-child transmission rate at 18 months has reduced to less than 2% for the last 3 years. “These results have been achieved through continuous efforts supported by top leadership in national HIV response, strong partnership with different stakeholders and implementation of evidence-based interventions,” say Placide. Despite all the efforts, HIV in Rwanda still remains a public health problem; HIV incidence is still high, up to 0.27% in general and higher in urban areas than rural settings (0.65% vs 0.22%). According to 2015 DHS, 24% of men and 16% of women have never had an HIV test, with a high percentage among youth aged 15-24 (67.2%). “HIV self-testing has been adopted and approved by the MoH and its implementation will kick off on 1st December, 2017 during the World AIDS Day” says Dr Placid. She explains that the initiative is expected to increase access to and utilization of HIV testing for those who have never been tested due to different reasons that hindered the use of existing testing approaches. In spite of all these, she says “HIV/AIDS persists as a disease of the marginalized and the poor, perhaps more than ever. So, while stories of our laudable progress have increased, visibility for those who still suffer from this disease has decreased. It is their stories that must now be shared.” And, hand on heart, there are quite a number of humble stories, told by ordinary Rwandans, bespeaking of how they have managed to cope with HIV through early testing counseling and staying on treatment which has given them hope of life. Take Sarah’s story for example. Sarah, 24 Growing up, Sarah, 24, from Kamonyi District didn’t know anything about AIDS.. She thought, it’s for grown up people not her. When she turned 11, she started to get sickly. She started having a burning sensation when she swallowed, and it got to the point where she couldn’t get food down and started to lose weight.. “We grew up two of us, my sister and I without our parents. Mum died when I was three years old and the following year my father passed away in 1995. We were brought up by our aunt who passed away in 2008 and that was it,” says Sarah. In spite of her sister being HIV negative, Sarah was born with HIV and she had always wondered why her Aunt insisted on giving her tablets every day. She was told that it was medicine to help her stay sane and that without it, she would run mad. One day in 2009, she noticed a bump on her arm; it looked like a mosquito bite. Two days later, her arm was covered from the palm to the back of her neck with shingles. The doctor told her the illnesses were symptoms of HIV, and asked if I’d ever been tested. “When I got my diagnosis, the specialist asked me a bunch of questions about things I hadn’t done. If I’d ever had vaginal sex with any man but I hadn’t even heard of the other stuff. My life was shuttered, I was going to die and there was nothing in the world I could do about it,” says Sarah. But when she was taken to an HIV treatment facility called WE ACTx for Hope in Kigali that had a group of young people with a similar background and problem, she was counseled, put on treatment of ARVs and has, since, stayed healthy. “Because we were of the same age group and with similar problems, with the help of WE ACTx for HOPE, we formed a cooperative called Tuyubake, saved some money for capital and started a shoe making project that is a good source of income that earns her 70,000 frw per month,” says Sarah. After accepting the fact about her life, Sarah got the courage to go back to school and with assistance from different orgarnisations, managed to get hands-on skills in shoe making that have helped their project to grow. “I am healthy because I, on a daily basis, have kept myself on treatment. I diligently take my medicine that I get from the clinic every month. But most of all, I do have dreams and am pursuing them whole heartedly,” she adds. People waiting for registration during the Gasabo HIV Awareness Day

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Testing, early treatment, positive living: Denying HIV a chance