The Insider: Voluntary Testing and Counselling (VCT): A view from the street

By the end of 2005 an estimated 24.5 million people were living with HIV in sub-Saharan Africa. In that same year 2 million people died of AIDS leaving behind 12 million orphans. In Rwanda alone 21000 people died of AIDS leaving behind 210.000 orphans. Right now the HIV/Aids prevalence is 3% with the most affected people concentrated in the urban areas where the prevalence is 7%. The government of Rwanda together with other organisations working in the country, is determined to see that the prevalence level is reduced to 0.5% by 2015. This year’s theme on HIV/Aids is “Promotion of VCT with emphasis on couples VCT”. The aim of this campaign is to raise HIV/AIDS awareness and also to encourage people to take voluntary testing for HIV as a measure of containing the epidemic and its effects and to especially reduce the number of deaths caused by HIV/Aids in the country. People on the street have a certain response to this message of VCT and this article brings some of those views to light. Most people I talked to on the street thought it was a good move and they welcomed it but most seemed to think the campaign was geared towards those with the disease yet the campaign is aimed at everybody. There are many reasons why people respond differently to the message of VCT and especially to this slogan of “take yourself and the members of your family for VCT”. Some people I talked to responded with a lot of fear, for example. Manishyimwe of Kanombe says, “What if I find that I’m sick. That can be the end of my life. I would rather not know.” He views the idea of VCT with a lot of dread as if it is some carrier of bad news which he would rather not hear soon. There are many people out there who hold that same belief so they decide to live in the dark about their status. These people need counselling and education on the importance of VCT in mitigating the effect and spread of HIV/Aids in society. This fear is especially held by the young generation. Another man I talked to said he would wait for the time his pregnant wife went for antenatal care so that he could get the results from her. Pregnant women are obliged to take VCT in order to prevent Mother to Child transmission in case the mother is infected. Some husbands wait for this time to get a view of their families’ status though this isn’t the safest path since there are cases of discordant couples. There are, however, some people on the street who seemed to see the benefits of VCT, for example, Karangwa, a student at School of Finance and Banking. He says he supports VCT because it helps one to plan for one’s future well knowing how to handle his/her HIV status before it is too late. He said he has so far gone for 2 tests and is aware of his status and is “staying safe” and keeping his girl friend “safe”. Young people tend to use the word “safe” to mean the use of Condoms. Married people have the biggest challenge in going for VCT as a couple as many questions arise during the journey to and fro the clinic. Mistrusts are raised, tensions created and if the couple is found HIV positive, finger pointing may arise which could lead to problems in the home. Shyaka, a taxi driver, says that he would not go for VCT with his family without first making sure that he was safe. He says that he would first go for the test alone and later take his family knowing well his side of the story. This choice is probably born out of fear of the truth. Another married man, Gakuba, who runs a retail outlet in Kimironko says that he can take his Family for VCT without fear because he shares everything with his wife and has been a faithful husband and believes his wife to be faithful too. He also said that he would be willing to take ARVs in case he was found HIV positive but thinks it would be challenging to share the truth with his children. Response to VCT is varied and changes from one person to another. The bottom line, however, is that people need more information and also need to be educated so that the fear for VCT can be demystified to a point where people will be willing to take tests like they do for other diseases. More so, the views on the street highlight the need for more counselling services for people in the society especially for couples. T his calls for the involvement of all stakeholders to take up the challenge and disseminate the information to all levels of society. Teachers, Pastors, Priests, medical practitioners, orphan care group leaders etc should all join hands in taking the information out and giving guidance and counselling. For example, Priests and Pastors have a chance to talk to couples about this through marriage counselling services that these churches usually hold. However, people on the street have been saying pastors and priests usually leave out this information with the pretext that HIV/Aids is not in the church and shouldn’t be. However, the reality is that it is in the church as much as it is outside. Some pastors have even been heard telling church members to stop taking ARVs and to replace this with prayer. Unfortunately, I cannot mention the Pastor’s name but I can say that this is not a proper approach to the HIV/Aids Pandemic. It’s important that all stakeholders in society join hands in the fight against HIV/Aids and through the encouragement of VCT as a weapon to reduce spread and death caused by HIV/Aids. Contact: dusabe21@yahoo.com