HIV on the Rise: ARV Treatment to Blame?

On Monday the 9th, after giving bikes to the village health team workers (VHTs), we went to Coke with Franny to conduct a sensitization session. As we drove up to the familiar cluster of huts scattered in the clearing surrounded by lush vegetation, another youth group waited for us under the shade of a mango tree. Yet again, the men were seated in chairs while the women took to a tarp on the ground. All of them greeted us with warm smiles, handshakes, and the customary “Apwoyo” (meaning both Thank You and Hello).

Distributing bikes as an incentive to the village health team workers (VHTs)

Distributing bikes to the village health team workers (VHTs)

Before starting the sensitization—essentially an open discussion for awareness of community issues– Franny prefaced us by saying that the number of mothers attending antenatal clinic (ANC) has dropped. Meanwhile, those on family planning, which promotes the use of birth control, have increased. The general consensus from the group regarding the low turn-out for ANC was that the recent drop is attributed to stigma and domestic violence. Mothers who suspect that they have the virus fear that their entire village will talk about them. When the women get their medicine, they don’t disclose it to their husbands because they will either lose their relationship or be beaten. To avoid getting beaten, their only option is to take their medication in secrecy. And by the time a woman’s husband finds out, she might have already taken the medicine for a couple of years. For men, it’s even worse. When they test and find they have HIV, they steal medication from their HIV positive wives to avoid going to the health clinic in fear of being seen. One man in the group spoke of divorce as a contributing factor. A man might fear accompanying his wife because he feels if he’s found positive, his wife might leave him and he’ll be left responsible for taking care of the children. As a result, many men live in denial.

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Coke youth group sharing their opinions on the spread of HIV within their community. As custom, women sit on the ground to pay respect to the men, who sit on chairs.

One of the most interesting points of the discussion was the startling trend of HIV/AIDS increase in the community, even higher now than ever before, even in Internally Displaced Persons (IDP) camps. Many members of the youth group agreed that the causes of this trend are that men still drink and won’t allow women to get tested. According to one man, the widespread availability of Anti-Retro Viral medication (ARVs), which keep HIV positive patients looking healthy, is to blame for the increase in HIV. The easier access to medication is a two-sided coin; while it increases the longevity of HIV-positive individuals and allows them to lead productive lives, it also makes the virus less deadly and people more willing to engage in risky behavior. In other words, the easier accessibility to treatment is enabling –and perhaps even encouraging–more people to continue passing on the virus. Despite the fact that most of the community members knew how to protect themselves, people with known HIV status in the villages deliberately pass it on. According to Franny, it’s the thinking that “I will not die alone; I have to die with someone else.” Another cause for the increase in HIV is that when people left camps and returned to their villages, they didn’t know they’d caught the virus from the camps. Most people got sick from the camps and unknowingly spread it to others. By the time people found out their statuses, they were already dying.

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Franny, the GWED-G project officer, conducting a sensitization session

Poverty contributes to the spread of HIV even more so now than it ever did before. Some men use money or small material items like soap, smearing oil, some money for books or pens, to lure and trap young girls. “At the end of the day,” one group member notes, “they’re all infected with the virus.” One woman in the group gave an example of a young girl who might see a man with some soap in the trading center. She will go for him, despite knowing that the man is HIV positive. She might say, “No, I don’t want to go and get married to a farmer. I want this one, who has shop–this one who at least can provide me with small items.” People learned all those behaviors from living in the IDP camps. Franny furthered this example by telling us that people became so “redundant.” All they could do all day was sit and wait for relief. People got so used to living in poverty and idleness in the camps that once they moved back to their communities, they started throwing away their health for pennies.

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Franny delivering her closing statements to the youths

In closing, Franny shared some of her own opinions about the community with us. She used an example of how if a rich man comes to the village with a vehicle, a motorbike, or even a Roadmaster bicycle, “you’ll find these ladies marrying them. Because they feel that is the only way to go.” Franny continued to say that “they’re not informed. They don’t think about the impact. And because people lack knowledge…that is why all this is getting higher and higher.” The fact that knowledge and awareness of HIV prevention and treatment is actually encouraging people to spread the virus is insane. It’s not sufficient to only supply treatment, and we should now work on changing the mindsets that cause people to believe that selling their health is the only solution to end their poverty. In Franny’s words, “The reason why the rate of HIV is getting higher is not just because people don’t have the knowledge—they do! It’s all about attitude and behavior.” To the community, she emphasized that they need to know their own value and that it is this self-value “that will drive [them].” She went on to tell them that they should always work hard and work together to “avoid getting free things from men whose impact at the end of the day will only be to pay back with the virus.” Throughout these closing statements, Franny articulated with the kind of emphasis that made it a real inspiration.

Stay tuned for more updates! GROW Team out.

 

-Emma

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