Social determinants of health: HIV/Aids

...InnovationsinHIVtesting

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Vulnerable populations for example, prisoners, commercial sex workers, youths and adolescents, orphans, people living with physical and mental challenges, men who have sex with men and intravenous drug users may need innovative ways to reach out to them.

I am reliably informed that some innovative NGOs are now offering prevention services (pre-exposure prophylaxis and post-exposure prophylaxis) to commercial sex workers at night in areas where they ply their trade, offering convenience and minimal disruption to their daily activities.

These are now directed for comprehensive services at Khami Clinic where testing, prevention, treatment, monitoring and evaluation are on offer.

Prisoners, people with physical and mental disabilities as well as other isolated communities like informal mining settlements and closed religious groups may require scheduled visits in order to encourage them to get tested and access other services.

Youths and adolescents will need youth centred services with specially trained personnel. Paternalistic services may not be appropriate for this group.

Paternalistic services are services that are given to a group of people where the provider of the services assumes or advises according to what he feels would be in the best interest of the group according to his/her understanding.

This acts as a barrier to the group as what may be deemed “best” may not actually be in that group’s interests.

Upon testing there are two possibilities; an HIV negative or an HIV positive result.

Whatever the outcome you still need to get your partner tested. Some people, whose partners test HIV negative, go on to assume that they share the same HIV negative status.

It seems the story is the same for those who test HIV positive. There is an assumption that their partners would be positive.

The take home message is please, your HIV status is not your partner’s status. Let’s all get tested as individuals. It is possible to be HIV negative and for your partner to be HIV positive. This is HIV discordance statuses.

This means that one partner will be HIV positive and the other one HIV negative.

While doing preliminary work for a research project, it became apparent that negative partners are at high risk of HIV infection from their HIV positive partners.

A few HIV/Aids service providers have developed effective counseling messages for HIV-discordant couples. Sexual transmission of HIV accounts for the majority of the new cases that occur on a daily basis.

I await your feedback on what you know and believe about HIV discordance. For anyone tested for HIV and found to be HIV positive, the Ministry of Health and Child Care encourages a “test and treat approach” whereby one is immediately initiated on ART if they are ready.

It is hoped that with the 90:90:90 targets, majority of the people will heed the message and rush for testing.

As a primary care practitioner I believe in prevention rather than cure. If you are found to be HIV infected, there is room to prevent yourself from complications of HIV. Your effort to be tested and use the ‘ test and treat’ approach will assist you by: Preserving your immunity Rebuilding your immunity Getting treatment early for infections that go with HIV such as TB and Hepatitis B and C.

Enjoying a very long happy life just like that enjoyed by those without the virus.

Curbing new HIV infections and protecting your loved ones.

You could be a peer educator to others by offering practical solutions derived from real life experiences

Therefore, testing for HIV is a winwin situation for everyone. If you have not tested you should be making your way to get tested now. Until we meet again next week, may God bless you.