IPPMedia, 12 April 2014

Halima and her friend Agnes are HIV-positive. Both stay at one locality, but not one of them has conferred to the other about their status, although they are great friends. Each felt individually that concealing the status was the safest way of suppressing any spread of their HIV position.

Ironically, each suspected the other was infected. They could discuss any issue openly, except HIV. To them such a discussion could invite personal exposure, tantamount to attracting gossip likely to stretch like bushfire.

It is this fear that inhibits them from attending the nearby care and treatment clinic with the wrong perception that everybody at that locality might gossip over them.

In efforts to make the Three Zeros Initiative (a joint programme with concrete goals marking milestones on the path to achieving Zero new HIV infections, Zero discrimination as well as Zero AIDS-related deaths) successful, HIV positives should stop self-stigma.

Changes on controlling stigma must start with the victims, so says the UN Aids body UNAIDS. But the head of Tanzania Aids Prevention Programme (TAPP), Salama Lembariti, believes that some of them do stigmatize themselves to the extent that they stop attending at Care and Treatment Clinics (CTCs) on that wrong footing that such attendance would expose them to gossip by the society around them.

Salama acknowledges that there are many clients at a TAPP centre located at the Muhimbili National Hospital's premises but once they are advised and allocated to their nearby CTCs, they no longer heed.

"We frequently make follow-ups to make sure our clients do attend clinics, but most times the number of referred clients to CTCs has been decreasing significantly.

After interviewing some of them who come back to us after some time, they reveal that attending the near-by clinics might make them exposed and be laughed at, subsequently being discriminated," said Salama.

The patients' intentions are in contrast with those of TAPP. While its MNH located centre refers them to their near-by clinics as a move to ease financial constraints such as on transport costs and the like, patients want the far-way clinics in the name of self-stigma.

Stigma among victims is at high level as TAPP's statistics shows that last month alone the centre received 87 patients but only 11 reported at the CTCs, in February there were only 14 at the CTCs against 36 patients, and in January there were 10 out of 23 clients.

Together with other efforts by the government and various stakeholders in preventing mother-to-child transmission, TAPP also advised victim mothers to bear few children, if possible a single kid as an HIV victim needs much time to rest.

"Pregnancy in its nature has many complications, and some women experience those complications soon after getting pregnant wherein regular fatigue continues like that until delivery time, which does not match with the disease characteristics that need patients to have much resting time," said the TAPP's boss.

Not only that, but APP insisted on very minimal sexual activities among victims for the same intention - avoiding fatigue.

Controlling mother-to-child transmission means Tanzania without HVV/AIDS is possible from 2018 onwards, that all new babies will be free from the disease, according to Tanzania Commission for AIDS (TACAIDS).

Speaking recently during a journalists' orientation workshop on media engagement focusing Three Zeros, TACAIDS's Advocacy Officer, Simon Keraryo said in reinforcing the initiative plans in the country, the government has already completed its third strategy which defines national plans and strategies for the next four years.

In the workshop that was organized by the Association of Journalists Against AIDS (AJAAT), Keraryo clarified that the government's strategy, which is the guide to all stakeholders towards the control of HIV infection in different sectors, aims to encourage the target of achieving the initiative in various areas according to each stakeholder's willingness and commitments.

"To make it easy, the concentration areas as analyzed by the government are the availability of enough antiretroviral drugs, testing and counseling, eradication of HIV infection from mother to child, sexual education and health care, and provision of condoms, to mention but a few.

TACAIDS is therefore on progress to seek enough resources and allocate them in those areas, together with encouraging the establishment of AIDS trust fund, he confirmed.

Not only that, he went on, but also the Commission provides further impetus to10 regions with high rate of HIV infections as well as giving priorities to 15 to 24 youths within and outside of schools.

From TAPP's point of view, it seems as further education on the importance of clinic attending is needed to HIV victims, the government's efforts in supplying ARVs and condoms will prove a failure.

This is because CTCs are the only comfortable places for both victims and health service providers, added Salama.

Another challenge facing Three zeros implementation is the use of condoms as it is believed that despite availability, many people do ignore them.

In an exclusive interview with this paper, Adelina Mwilafi, a sex worker and at the same time a hair women's salon tender at Temeke Pile area in Dar es Salaam, said that the bigger the number of people refraining condoms uses, the bigger the amount of money she earns in her night business (sex activities).

She conformed that the amount given by those who refuse condoms is twice more to the condom users, something that gives her up-keeps to herself and her six-year-old kid whose father ran away soon after she got pregnant.

Her statement therefore proves poverty to be a big challenge against three zeros implementation as it promotes new infections.

"Obeying condom rejection is unavoidable especially when I hook foreign clients because they give affordable payments. But I'm ready to stop the business once I acquire capital for my profession because the salon I work at is not mine and my salary is very minimal," clarified Adelina.

The sex worker confirmed a huge disparity between local people and new comers as she sometimes earns up to Sh200, 000 from a single foreign client, an amount that she seeks for the whole week once dealing with local customers.

On the other side, faking on Tanzanian cultures' compliance have been much contributing in HIV infections as partners of young females have been strictly forbidden to show up in front of the girls' families.

AJAAT's facilitator Charles Kayoka told the workshop participants that many Tanzanians, especially female students in colleges, have used that opportunity to catch up different partners under the pretence that they are in normal relationships.

"In some countries, once a girl feels to fall in love with a boy, she is free to introduce him to her family in which everybody in and outside the family knows about their relationship.

The same might be useful to Tanzanians as in such a way, the partners' behaviors are easy to monitor," opined the facilitator.

To make voluntary testing successful, TAPP urged the government to encourage HIV mobile clinics as in it its research, clients are many once the services find them around their residences.

Responding on how the health situation is despite many voluntarily testing clients, the TAPP leader replied: "Many of them are HIV negative compared to those who come at our facility."

Halima and Agnes are not sex workers. Their fear of gossip is only far from being real.

Source: IPPMedia