ZNNP+ Position on mandatory testing

April 9, 2014

The 33rd SADC Heads of State and Government Summit was held on 17 and 18 August 2013 in Lilongwe Malawi. On the sidelines of this meeting, AIDS Watch Africa held a meeting with the Heads of State and Government to discuss progress and challenges in regards to the HIV epidemic in the region. Following this meeting, it was reported that several SADC leaders lauded mandatory HIV testing as a viable strategy to curb the spread of HIV.

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In response, the Director of ARASA, Michaela Clayton, highlighted that mandatory HIV testing is a gross violation of the human rights to dignity and autonomy, which will hinder the achievement of public health goals and negate the gains made in the AIDS response over the past decade in a press statement released on 22 August. “Instead, we should look critically at the underlying causes of the low levels of HIV testing and uptake of prevention and other HIV related services,” she explained.

The Zimbabwe National Network of People Living with HIV (ZNNP+), an ARASA partner since 2012, also clarified their position on the call for mandatory testing. They point out that international standards require HIV testing to be confidential and accompanied by counselling as well as be conducted with voluntary and informed consent.

The organisation which represents people living with HIV further argues that mandatory testing would discourage people from seeking treatment and care. Mandatory testing and disclosure obligations run the risk of deterring people, especially women, from getting tested. Where due caution is not exercised, informing a woman’s partner of her HIV status may expose her to the risk of violence, eviction, disinheritance and severe abuses. “If Zimbabwe is to adopt the mandatory testing, the health system will have to be equipped with a comprehensive HIV management programme including CD4+ counts, Viral load testing machines and liver function testing. Health-care services will have to become capable of absorbing higher patient case-loads,” they said.

At the moment it’s not possible to have mandatory HIV testing because once people are tested they will need to be initiated on treatment and yet the country is unable to clear the waiting list which grew due to the introduction of the new guidelines. Only about half the people who need ARVs are currently accessing them, therefore this will be a tall order for the nation,” explained Sebastian Chinhaire, ZNNP+ Chairperson. The organisation further argued that the country is relying on foreign donors to sustain people on treatment.  Until the Zimbabwean government can fund HIV management programmes, only then can they introduce mandatory testing. However, ZNNP+ highlights that regular HIV testing is important because it might encourage people to modify the behaviours that cause the spread of the disease if they know they are infected. There is also a general agreement that it is in the interest of infected individuals to get tested, since early treatment has proven effective in slowing the progress of the disease.

Editors Note: This article was originally published in AIDS and Rights Alliance for Southern Africa (ARASA) Quarterly Newsletter Issue 14

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Nastia: A HIV advocate living life in her hands

March 25, 2014

A young woman named Anastasia talks of what helps her to live with HIV. “Diagnosis of HIV is not a sentence, not a terrible word. Everything is in your hands only, and each one of you can change this world a little for the better,” – she says.

How did you learn about their HIV-positive status? What was your first reaction? How did your relatives/friends react?

I was told of my positive HIV status in the hospital. I had several operations, and was given a HIV test. Before being discharged, the doctor called me and said that I was diagnosed with HIV infection. I was shocked. By that time I was living for three years with my common-law husband. I knew what this disease is, but I also believed that it could not affect me. I do not use drugs, I live with one man. For me it was a 100% guarantee. But it turned out to be not enough protection.

Do you face stigma because of your status from the part of physicians, friends or others?

At first I decided that I will not tell anyone. That it is a shameful disease that should be hidden. Later I studied the information, went to the support group and understood that I can tell my loved ones about my diagnosis. The first one to know about it was my mother. She was very scared and sad. But I told her more information about this disease, and now she no longer sees it as deadly.

Besides, I told my close friends about the diagnosis, and they, in turn, shared this information with their husbands. One of them, a woman with medical education, accepted the information steadfastly, but another’s husband called me and said that we shall no longer communicate. Basically, this is the only negative experience in my life associated with the diagnosis. Later on I was telling my friends; they were telling their friends and acquaintances. And no one condemned me. On the contrary, people were approaching me, asking about my health and HIV, how it is to live with it, what one can do in such situation. By that time I could already speak about it, I knew a lot of information. And I conducted a kind of prevention among my friends.

What helped you to accept the diagnosis at the beginning?

I got a lot of help from support group and from communication with my peer counselor. Once I was registered in the AIDS Center, I immediately called the peer counselor, and she invited me to the group. I had a lot of fears, but the cozy and relaxed atmosphere helped me overcome them. I studied the information, took brochures at group meetings and in the center, was searching through the Internet – and at some point I realized that I could give information too. So I began to lead the group myself and became a volunteer for primary prevention among youth. It really helps me accept the diagnosis, and understand all its nuances. Speaking about it, you learn to accept yourself with such a diagnosis.

What can you wish to the readers of this material?

First and foremost, I wish all male and female readers to love themselves. HIV diagnosis is not a sentence, not a terrible word. Is a disease, with which can and should learn to live. It is not an obstacle for education, work or relationships. Everything is in your hands only, and each one of you can change this world a little for the better.
For more women’s stories and further information on the work of E.V.A visit their website: or join their Facebook or Twitter
Editor’s Note: This story was originally published on the E.V.A (Equity. Verity. Activity) website. E.V.A is a network which aims to improve the quality of life for women and families affected by HIV, drug use, TB, and hepatitis in Russia

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New UK Health Guidelines signal progress for PLHIV and community.

September 30, 2013

In August this year, the UK National Health Service (NHS) announced that it would lift a 20 year ban on HIV positive healthcare workers, such as surgeons, dentists and midwives from practicing in their field. The policy comes into effect in April 2014. The decision was welcomed by scientists, advocates and civil society actors, such as the National AIDS Trust (NAT) many of whom had been actively campaigning on this issue for years. It is also welcomed by the estimated 110 HIV positive healthcare workers in the NHS.


Health care workers are required to be on combination Anti-Retroviral Therapy (ART), have an undetectable viral load, and be regularly tested and monitored.

 

Due to the to roll out of Anti-Retroviral Therapy the risk of transmission of a person living with HIV who has an undetectable viral load is extremely low. The government says that patients will have more chance of being struck by lightning than being infected with HIV by a health worker who is on ART . There have only been four cases worldwide of HIV being transmitted in a healthcare setting, and these cases were before the availability of ART.

 

A sure sign of progress is when decision-making by policy makers is based on scientific evidence, rather than outdated rules and attitudes. Many HIV-related policies were designed during the 1980’s, before progress was made in both education and treatment. Deborah Jack, Chief Executive of National AIDS Trust welcomed the policy for being “based on scientific evidence and not on fear, stigma, or outdated information”.

 

With increased awareness of HIV and treatment, we now know that discriminatory guidelines in today’s context do not protect patients, but instead keep qualified people from moving ahead in their chosen field.  The NHS changes will also encourage more people to get tested, with less fear about what the outcome will mean for their lives and careers.

 

As the NAT statement outlines, “It also sends an important message to young people growing up with HIV telling them they don’t have limitations set upon what they can achieve and become”.

 

Policy change plays an important part in changing public attitudes. We all have our part to play in working together to improve public understanding and encourage policy makers to support those living with HIV.

 

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Scientists urge us to ‘Go with your gut’ in HIV treatment.

August 27, 2013

A breakthrough study published by medical researchers from the University of California may throw new light on reversing the progression to AIDS in People Living with HIV. Body wide inflammation, which is thought to be one of the factors leading to progression to AIDS in PLHIV could be prevented by changing the composition of bacteria in the gut. Could this be a first step towards developing a new form of treatment for PLHIV? Scientists involved in the study believe that these findings could mean that PLHIV can live longer lives without daily antiretroviral treatment.

                   

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Professor McCune says ‘Our dream is to be able to make the virus go away allowing HIV-infected people to lead longer lives without the need for lifelong therapy. Perhaps restoring the microbiome to normal will be one strategy to make that happen.”

We all have different types of bacteria residing in our gut. Within our bodies, our intestinal wall acts as an immune barrier preventing harmful bacteria from entering the bloodstream. However upon HIV infection this barrier is weakened, with harmful substances entering the blood, which then travel throughout the body and cause body wide inflammation.

The study ‘Dysbiosis of the Gut Microbiota is associated with HIV disease progression and Tryptophan Catabolism’ studied the differences between gut bacteria of PLHIV and those who were not living with HIV. Overall the gut bacteria of PLHIV was found to contain many bacteria which can cause disease on their own.

What are the implications of these findings? If the composition of the gut microbiome is linked to disease progression of HIV, then theoretically doctors could slow the development of AIDS by changing the composition of bacteria in the gut. This is a tantalizing thought, and perhaps is a preliminary step towards finding alternative treatment for PLHIV.

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