Without attitude change, we won’t combat Aids
Their noise is deafening; the phrases are catchy: The 90:90:90 campaign and the Getting to Zero motif are just two among the many sweet sounding HIV targets and catchphrases.
But the trajectory we are on shows Malawi is not going to shake off HIV anytime soon this century.
The 90:90:90 is a target chasing the diagnosing of HIV in 90 percent of all people living with HIV in Malawi, to put 90 percent of those people on treatment and achievement of viral suppression in 90 percent of those on treatment by the year 2030.
The ‘Getting to Zero’ slogan is about achieving the utopian zero new infections, completely ending discrimination and also obliterating all Aids related deaths.
All good to the ear and to hear, but in Malawi, like many other places, this will remain but a dream as people are not getting tested enough – HIV Testing and Counselling (HTC) being an integral part of attaining the said targets as echoed in the National HIV and Aids Strategic Plan.
About a million Malawians live with HIV and about half of these are on ART but as the World Health Organisation reports, 46 percent of those that have HIV do not know it.
In Malawi, just over 2 million people got themselves tested in the period between 2012 and 2013. It sounds huge but as the Ministry of Health’s Malawi Progress Report for 2013 concedes, there were fewer new people coming forward to get tested than in the previous years.
This is despite the presence of static, mobile and home-based HTC services in addition to national HTC events.
Many people are said to fear getting tested. The simple theory would be that they know they have been careless but it is deeper than just this accusation.
According to the same progress report, many fear the idea of testing HIV positive, which as for long been portrayed by popular culture and tradition as the defacto end of life. Some t h ink they already have it and see no point in making it official; others cannot get tested for religious reasons.
Even more are blinded by illusions of invulnerability and think they don’t or cannot have the virus.
Social Psychologist Chiwoza Bandawe weighs in on this fear and says many people would rather not know their status because they fear change and the stigma that might come if they tested positive.
A story is told of one Chrissy Phiri from Mzimba who was being locked in her house by her husband who did not want her t o go to get HTC because he feared knowing the results.
Malawi has introduced what is termed the Option B+ where all women diagnosed with HIV are put on ART at once regardless of their CD4 count.
Option B + is known to drastically reduce the number of babies born with the virus and is just one of the things people who are untested miss out on.
Being untested is like being unvaccinated. While the nation makes strides in combating the pandemic, untested HIV carriers continue to spread the virus and their health continues to degenerate when lifesaving drugs are available. They probably are still eating badly and engaging in habits such as alcoholism that doesn’t augur well with the virus.
For those untested but negative, they live with unnecessary anxiety, they are not motivated enough to protect themselves and others and might also be under bad habits and life choices that might get them infected. HTC is known to make people live responsibly.
“Everyone needs to play a role in the awareness. Focus should be on letting people know that there is peace of mind in knowing their status – if they do not know there will always be lingering anxiety. People also need to know that testing positive is not a death sentence,” says Bandawe.
And if people do not step forward to get tested, the songs will keep playing and new targets and catchphrases will be coined beyond 2030.
Every untested person is an accomplice in this immoral duty of delivering HIV to future generation and to borrow from another sweet HIV catch phrase, an HIV- free generation is impossible because of you.
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