Stigma slows down ART interventions in Chegutu

CHEGUTU a farming and mining community in Mashonaland West is one of the few districts that have Medium Antiretroviral Therapy (ART) coverage gap in Zimbabwe.

Due to low levels of education amongst most people from farming communities, the levels of stigma are still high, hence the ART coverage gap (1,500-3,000) people living HIV.

Due to interventions by ITECH a United States Government President’s Emergency Plan for AIDS Relief (PEPFAR) partner spearheading viral load testing and monitoring in at least 31 clinics, Antiretroviral Therapy (ART) coverage has improved over the years.

However, stigma remains the major drawback in the Chegutu communities as many still believe an HIV positive test result means a death sentence.

For Patricia (35) who has been living with HIV for 12 years, she says stigma is still rife in Pfupajena where she stays and despite her having come out openly about her status, the community still has a negative attitude towards HIV.

I went for testing after falling seriously ill to an extent that I thought I was going to die. My encouragement would be for people not to go for testing when they are seriously ill.

“When you tell people that I used to be that ill, they won’t believe it. At times I laugh at myself asking why I had to let the illness reach that stage. My son is 13 years old. He was found HIV Positive last year. We didn’t see anything wrong with him.”

In 2017, Patricia weighed about 30 KGs when she got an HIV positive diagnosis.  Acceptance was not much of a challenge for her as she was caring for her mother who has been living with HIV for the past 15 years.

“If you don’t want to disclose your status its OK but people should get tested. Getting tested doesn’t mean it’s the end of the world. Look at me now. Going to the hospital for testing, I weighed almost 30KGs but now I am 85KGs,” she says.

Patricia’s neighbour is still as ignorant. In Pfupajena, they still view people living with HIV as outcasts but Patricia and her family are not affected by what people say. Patricia’s mother has been a pillar of strength. Patricia says her son also plays an important role in ensuring she does not skip her medication.

“I am getting much support from my mum. She has been living with HIV for the past 15 years. She is living healthily. I don’t have a problem when it comes to support. Last time she received her Viral load results which was at -20. For me, it was my first time and because I was diagnosed with HIV in May and viral load was done on January 31. It was Target Not Detected (TND) and my son’s VL was also at -20. So I would say acceptance and taking medication helps us a lot.

“My children are a blessing especially my son who prioritises the time. Even when we are watching TV, or there could be visitors who he doesn’t want to know they are on ART, he calls me to the bedroom as if he is looking for some stuff and then I take my meds. Or at times, he says probably his grandmother knows where the stuff would be. That way, we help each other on taking our medication timeously,” says Patricia who adds that defaulting medication leads to more disastrous outcomes.

Since easily accepting her status, she manages stress very well.

“In terms of stress, I don’t know anything like that inasmuch as living with HIV is concerned. The stress I would encounter would be related to having to feed my mum and children.

“There are many cases we hear of people just collapsing and dying yet they will be HIV Negative. As long as I am taking my medication on time I am fine. I encourage people not to default. If your time for medication is 8pm let it be that. If you have problems of forgetting, set your alarm,” advises Patricia.

Patricia hopes to start a buying a selling business soon in order to boost her income.

“But back then I used to do buying and selling of several wares from South Africa. When I got ill I used all the money and ended up being bankrupt. I don’t have capital to pick myself up.

“People would buy my goods like hot cakes back then. The first time I started this business, I remembered ordering a bale of blouses which was bought in just two days. But now due to stigma, even my old customers have left me, they all think I will somehow infect them by merely buying from me,” she said.

She yearns for a society which does not distigmatise against people living with HIV and get rid of the notion that having HIV is a death sentence. Patricia’s mother says it was a difficult time for her as she was reminded of Patricia’s father who was similarly ill.

“I didn’t think these where misplaced thoughts. Looking at her, you see a fit lady because of where she came from and where she is now. Those who saw her then and now might not recognize her,” she said.

Patricia says she discloses her status to whoever she is dating from the onset.

“I disclose my status. But on how these men take it, you know how it is if you disclose to someone you are dating that you are HIV positive. They find it hard to accept and support you,” she says.

“In terms of stigma and discrimination, people still need more education. People are dying out there due to fear of testing because they are afraid of people knowing their status. That’s where you see people getting ill and die.”

Chegutu Hospital Counsellor Mr Peter Zinyani’s first encounter with Patricia was traumatizing although he hid it from her.

“Patricia has been an interesting experience. When I first saw her, I asked myself where she had been all this time. She looked wasted.

“She was…I cant express it but I was touched seeing her. Her mother came supporting her to get into the tent. In my line of work, you can’t be that emotional so you work with what is there.

“When tested, she didn’t express negativity towards the results. She embraced the results and picked herself up. So this is her story. Like she is saying her weight is now 85KGs, that’s very true. She looked frail and thin when I first saw her,” he said.

Itech Chegutu District Site Improvement and Community Linkages officer Cloud Nyarwendo said they have challenges in getting viral load results for their district.

“Itech is supporting 31 clinics in the district. Eleven of them being supported with manpower and the other 20 are supported with technical assistance. As a district, currently we have about 24 000 clients on treatment.

“In the past quarter we managed to link our clients on treatment with an achievement of around 94 percent. We didn’t actually reach the 95 but we are close. The 94percent is for those whom we link to ART treatment and would have tested positive. That is the test and treat.  For the other 95, that’s where our challenge is in terms of viral load monitoring. We are having challenges with the results taking a bit longer to come back but we are making follow ups with Kadoma District hospital which is doing the viral loads,” he said.

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