ZAMBIA: Wanted - more people for HIV testing

Lusaka, 9 July 2008 (PlusNews) - The drugs to manage HIV are available, and so is knowledge about how to prevent it, but far too few people in Zambia are coming forward to be tested.

"I would rather die than go for VCT [voluntary counselling and testing]," Joseph Mwewa, 28, a resident of the capital, Lusaka, told IRIN/PlusNews.

"As far as I am concerned, it is better to remain ignorant of your status. We have seen so many people dying quickly upon knowing their HIV [positive] status. I know what I have done, and I also know what I haven't done, but believe me, having an HIV test is the last thing on my mind ... not even on my death bed."

Mwewa is not alone. The government estimates that almost two million of the country's 11.7 million people have been tested for HIV, but Zambia's prevalence rate of 15 percent puts it among the world's highest.

Although the government recently announced a slight decline in HIV prevalence to 14 percent, the rate in some urban areas, including Lusaka, is still as high as 21 percent.

"The uptake of VCT services is still unacceptably low in Zambia ... despite government and non-governmental organisations' efforts to make VCT as widely available as possible," said Brian Chituwo, Zambia's health minister.

Drugs become more widely available

About 170,000 people are accessing antiretroviral (ARV) drugs from various government clinics and hospitals, according to the ministry of health, but the number of HIV-positive people needing medication is estimated at nearly 300,000.

"Comprehensive antiretroviral therapy services are now available in all [73 of] our districts. This is as opposed to the situation that existed only five years ago, when we only had two such sites," Chituwo noted.

Frederick Mulenga, a peer educator working at a VCT centre in Lusaka, said most people shunned the services because of the myths associated with HIV. In the minds of many, HIV/AIDS is linked with promiscuity, and this misperception is reflected onto HIV-positive people, who are often scorned and suffer discrimination, especially in rural areas.

"The thing is: there is a very big misconception that catching HIV is a form of punishment from God for one's sins or promiscuous life. Just the other day, I had a case of a lady - I think in her late 20s - who wept uncontrollably after her results came out [HIV] positive. She said, 'God has betrayed me; I have lived a sinless life and I am still a virgin, why should I be HIV positive?'."

God has betrayed me; I have lived a sinless life and I am still a virgin, why should I be HIV positive?

Even if we encourage them to know [their HIV status] so that they can seek medication earlier, many people still look at HIV/AIDS as a killer and an incurable disease – this is really undermining our efforts," Mulenga said.

HIV/AIDS consultant and former health minister Nkandu Luo believes VCT services are still not widely accessible. "VCT hasn't attracted a lot of people because we are not looking at access to facilities ... people have to travel [from the townships] ... into town [to be tested], which costs money," she pointed out.

"And, obviously, when it comes to competing with finding food, no one would give preference to going for VCT. Services must be taken to the people. As it is, we don't have enough structures to support the level of intervention operations that we would like to see."

Luo suggested that another reason for people's reluctance to be tested was because for a long time there was nothing in it for them; there was no incentive. Even though ARVs were more widely available and people knew about this service, there was still no nutritional support.

"The programme should have been comprehensive; there must be drugs, there must be food, and there must be facilities all over," she said.

The UN Population Fund [UNFPA] has supported the Zambian government's prevention and education efforts for the past five years by providing condoms, prevention of mother-to-child transmission of the virus, and focusing on the human rights of HIV-infected people.

"VCT promotes early knowledge of HIV status, which is now recognised as a critical component in controlling the spread of new HIV infections," said Deji Popoola, country director for UNFPA in Zambia, who also noted that people would not change their behaviour if they did not know their status.

"It is hoped that if individuals know their HIV status, they would adopt behaviours that would either reduce their risk of infection if they were HIV negative, or reduce the risk that they would transmit the virus to others or get re-infected if they were HIV positive."

nm/kn/he

Theme (s): Care/Treatment - PlusNews, HIV/AIDS (PlusNews), Prevention - PlusNews,

[This report does not necessarily reflect the views of the United Nations]