Stigma still major threat to HIV testing

Everyone in the room had voluntarily come for HIV testing and counselling, but the one and half hour exercise was proving to be a real test of character, resolve and endurance.
This was my second HIV testing and counselling experience in three years and while I noticed that the numbers had greatly improved from the few that trickled to the testing centre in central Harare years ago, one thing struck me. People are still afraid of knowing their HIV status.
The entire testing and counselling process is still agonising even for the seasoned as stigma remains the biggest stumbling block to the fight against HIV and AIDS.
While the country’s testing and counselling centres are doing a sterling job to get people to know their HIV status, little has changed as those who test HIV positive have been “marked for death”.
Even some of the statements by counsellors serve only to instill fear in volunteers.
“Once you test positive you cannot reverse it. You can go for further tests somewhere else, the results will remain the same,” said one counsellor during one of the counselling sessions, a statement that immediately reawakened the fear I had initially conquered when I decided to come for the tests.
That AIDS is incurable is a fact, but the counsellor’s remark co-ming some 20 minutes after I had been asked whether I would consider committing suicide if I tested positive simply was too hard a pill to swallow.
As I patiently sat in the waiting area, which resembled an airport departure lounge, the behaviour of many ahead of me, especially the youths, caught my attention.
“Mudhara ndiri bho (I have tested negative). Come and see my results,” bragged one delighted youth as he dragged his two friends to go and see his results in an act which immediately shamed one of the New Start Centre’s key policies — confidentiality.
My heart sank as I looked around the room and wondered how any one of us in the room would react if tested positive after the theatrics of this youth who could not contain his joy.
I thought of excusing myself from the room and disappear into the street. I however, abandoned the idea and decided to stick it out once more after recalling the fact that the delighted youth would soon sober up once he remembered that for the next three months before he comes back for another test he was in what is called a “window period”.
According to the web-based hivguidelines.org: “HIV testing offers no ‘protection’ from HIV infection.”
Explaining the concept of “window period” the site writes: “The window period is the length of time after infection that it takes for a person to develop enough specific antibodies to be detected by current testing methods.
If an individual engages in unsafe sex or shares drug injection equipment and becomes infected, the body will make antibodies to fight HIV. When enough antibodies are developed, the HIV antibody test will come back positive. Each person’s body responds to HIV infection a little differently, so the window period varies slightly from person to person.
“Most people infected with HIV will develop enough antibodies to be detected by our current HIV antibody tests four weeks after the exposure.
“It is possible that someone who tests negative four weeks after an exposure may be infected, but his/her body has not had sufficient time to develop antibodies. The-refore, to rule out HIV infection, it is important to retest three months after the exposure.
“An individual who tests negative three months after an exposure does not require further testing unless he or she has had repeated exposures or if their antibody test results are incompatible with their clinical history.”
As I continued to endure the process, I realised that little or no knowledge of HIV and AIDS issues is also one of the many key factors driving the pandemic in Zimbabwe and on the continent.
“In the Zimbabwean society, discussion and education about sexual matters is frowned upon because it defies cultural norms and values and the belief is that ‘the less young people know, the better of they are’,” says a recent Central Statistical Office survey on the levels of awareness of vulnerability to HIV and AIDS.
The survey carried out on a sample of 4 449 students from the country’s tertiary institutions also revealed that the levels of knowledge among the female students, who numbered 3 295 of the total, with regard to their sexual and reproductive health rights or HIV was critically low.
The 2005/06 Zimb-abwe Demographic and Health Survey also indicates that 52 percent of male adults and 59 percent of female adults do not support condom education, which shows that adults still find it controversial to educate the younger generation on condom use.
However, for the developing world it is increasingly becoming critical that information and education on all diseases and general health matters need to be seriously addressed otherwise these communities remain sitting ducks to the host of fatal diseases looming ahead.
Though HIV and AIDS is most dreaded, not many people are aware that it is teaming up with other human killers, making it even more lethal than ever before.
While much has been said in recent years about the deadly marriage between HIV and Tuberculosis little has been said about the union between the virus and one of the world’s biggest killers — cancer.
Cancer, for instance, is not sexually transmitted, but is killing more people than HIV and AIDS.
But the fear of getting cancer is not as devastating as the fear of getting infected with HIV and AIDS. And herein lies the disaster that awaits many in the developing world.
In other words, as the burden of cancer shifts from the developed world to the developing countries, entire communities will be wiped out by what they fear least than what they fear most.
Researchers at the New York-based Body Health Resources Corporation say cancer is a significant cause of mortality and morbidity in people infected with HIV.
“The majority of cancers affecting HIV-positive people are those established as AIDS-defining: Kaposi’s sarcoma, non-Hodgkin’s lymphoma, and invasive cervical cancer. However, other types of cancer also appear to be more common among those infected with HIV. While not classified as AIDS-defining, these malignancies are affecting the HIV/AIDS community greatly and have been referred to as ‘AIDS-associated malignancies’ or ‘opportunistic’ cancers. Analyses have revealed a two to three-fold increase in overall risk of developing these cancers,” says a research paper by the company.
Cancer, which affects people of all ages including fetuses, causes about 13 percent of all human deaths and 7,6 million people died from the disease globally in 2007 compared to two million HIV and AIDS-related deaths during the same period.
According to a World Cancer Report, by next year, cancer will be the leading killer in the world surpassing heart diseases and causing more deaths than AIDS, malaria and TB combined.
With the chief medical officer of the American Cancer Association, Otis Webb Brawley noting that “the burden of cancer is shifting from developed countries to developing countries”, the fight against HIV and AIDS will become even more difficult.