The fight against HIV/AIDS is far from won in Kenya despite numerous efforts and the huge amounts of money pumped into the related programs.
However, we all acknowledge that a lot has been done and strides have been made so far.
In fact, to begin with, some of the great steps made so far include interventions like the Home Based Counselling and Testing (HBCT), the existence of Patients Support Centres (PSC) in most public and private health facilities, just to mention but a few. Today when one talks about HIV/AIDS, it is not as scary as it used to be. Remember the days when getting infected with the AIDS causing virus HIV would be a quick and direct ticket to the grave? This is no longer the case. So dreaded was the disease that the Luos even gave it a “death name”- Ayaki Matieka. This can be loosely translated as the “brutal killer”. It is therefore good news that HIV/AIDS no longer kills so brutally.
With the above brief intro, I would like us to take a keen look at one particular intervention, the uptake of Antiretroviral Therapy (ART). The uptake of ART has equally been largely successful. Truth be told, ART has prevented hundreds of deaths of HIV infected people. But is ART uptake satisfactory around the country? Are there cases of drop outs? The answer to the first question is no, and the next is yes. I will explain why I think so.
Rapid urbanization and the ever increasing slum populations within rural-urban Kenya portend certain challenges for faithfully sustaining HIV-infected patients on ART. As ART is being scaled-up, its success will largely depend on high adherence. Most Kenyans who live within the informal settlements, whether in Nairobi, Kisumu, Mombasa, Nakuru or Eldoret have certain economic challenges that would affect ART uptake in case one is HIV infected. Yes, granted, the PSCs are in plenty, but what happens when a patient steps out of the center and walks into his/her house in Kibera, Mathare, Manyatta, Kongowea or Langas?
One key aspect of the ART uptake is proper diet. The drugs that are taken must be done so accompanied by a proper, nutritious meal! Some have very clear warnings of “do not take before eating”. Certain studies have found out that the main reason for some people not accepting ART was the fear of taking medication on an empty stomach due to lack of food. Sad, but true. This begs the question, should the government consider food aid for HIV/AIDS patients who are unable to sustain the required diet?
The other areas of concern and that have been a hindrance to ART uptake is traditional religious beliefs. Again, this is very common and prevalent within the slum settings. Several patients are known to have dropped-out of ART to seek alternative cure based on their religious beliefs. Some of these patients firmly believe that traditional medicine is more effective compared to the more conventional treatment methods.
In general most people living below the poverty line remain at a risk of dropping out of ART uptake for reasons ranging from food and nutrition to backward religious beliefs. Sustaining HIV patients on ART in such settings will remain a challenge. The high proportion of drop outs must be addressed. It may as well be important to invest more in poverty reduction strategies in general even as ART uptake is scaled up across the country.
The writer is the Assistant Communications Officer at KEMRI/CDC. Views expressed here are personal and not the position of KEMRI/CDC