The cost of defaulting on medication

The writer, Cynthia Dzilla. Photo/ Courtesy

Recently, a court in Kirinyaga County sent a man to prison for defaulting on his Tuberculosis treatment.

It is now emerging that this trend of defaulting on medication has been happening in the country especially among HIV patients, with far reaching consequences. This writer spoke to two such cases, where patients admitted defaulting on their medication.

Akinyi*, who tested positive for the HIV virus, is one of the many patients who have been forced, time and again by circumstances, to default.
 
The mother of three, who is now breast feeding her one and half year old lastborn, has been facing a lot of hostility from her husband as a result of her status.

“After disclosing my status to my husband, he accused me of lying to him and that the news about my status was all lies,” Akinyi told this writer.
 
Akinyi’s husband insists that the doctors lied to her and due to that, adhering to medication has turned out to be an extremely difficult exercise.
 
“My husband denies me food that I have prepared and he even throws away my ARVs medication arguing that a positive person is meant to die,” she tearfully narrated.

Her sentiments are similar to those by Rosemary*, a tailor living with the virus, who admits that she has at times failed to adhere to her ARVs prescription.
 
“What people don’t know about these medications is that they are strong and need one to eat properly,” says Rosemary. She holds that with the nature of her job it has been hard for her to follow the prescription as recommended.
 
“At times I need to finish a cloth for a customer at a certain duration and if I am to take my medication then that means I will have to rest for a while before I continue with my duties hence my customers will be angry and they would not understand the situation,” she says.
 
Dr. Francis Nyamiobo, a research physician with Kenya Aids Control Project says that the reason why most HIV patients default their treatment is because they experience fatigue from the medication.

Others patients, he adds, feel the burden of being under so many drugs, due to opportunistic disease which they experience along the way hence they opt to stop the ARVs and take medication that will tackle the disease they have at the moment.
 
“Once a patient has started ARVs treatment, they should take the medication for life because once they default for a long period, a different type of drug, which is more expensive and more toxic to the body than the previous one, may have to be prescribed,” he says.
 
He says that patients are required to take 95 percent and above of the prescribed medication, that is; if a patient is taking medication twice a day then he/she should not miss more than three doses. 

Dr. Nyamiobo further urges all HIV patients who are on ARVs to continue taking their medication regardless of the side effects since the medication helps in lowering the viral in their body.

Ms Dzilla is a journalist.

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About meshakenya

Media for Environment, Science, Health and Agriculture in Kenya (MESHA) is an association of communicators who are specialized in science, environment, agriculture, health, technology and development reporting.
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9 Responses to The cost of defaulting on medication

  1. martha says:

    Taking any type of medication is usually nauseating for most people, I can imagine taking all these prescriptions at once. I think they should develop a single drug for HIV it will make things a lot easier.

  2. John Riaga says:

    I hear you Dzilla. This happens all over. The fact is that ARVs are taken for life and those who are HIV positive must be encouraged to dutifully take their doses. We have good examples of people who have been living positively for years, the only short cut is an early date with the maker-death.

  3. Linda Keya says:

    sad but so true of what is happening to people, many of whom we know. Maybe she can make it her top secret to take the ARV’s, she can trust a friend to keep for her and to ensure she swallows them religiously. Although this could pass as dishonesty to the husband, it is also self love. That way she will be sure to prolong her life and take care of her 3 children. One concern though Dzilla, why is she breastfeeding? first because she is positive and secondly she is not eating properly. I think medically HIV mothers are not allowed to breastfeed, or what do other readers think?

    • Dzilla says:

      Linda, mothers who HIV positive can breastfed too only that the nipple should not be cracked and as long as the doctor gives a green light to the mother, they too are advised too breastfed.

  4. Dr. Sikolia W says:

    Linda’s concerns about breastfeeding and HIV are true. Ideally an HIV positive mother should not breastfeed at all! This greatly reduces the chances of the baby being infected. This explains the low rates (almost zero) of mother to child transmission in the developed world. There are, however, some studies done in the developing world including Kenya like the Kesho Bora study which found that women can still breastfeed as long as they adhere to ARVs and have low viral loads (<1000) and the baby also receives ARVs. This reduces risk of transmission to baby. Note that these studies are designed to address the issues concerning affordability of formula feeds and food insecurity in poor nations and the recommendations are targeting those who can't afford to formula feed. Remember in Africa it is not AIDS that kills HIV patients, it is poverty. Bottomline, if one can afford formula feeds then they should not breastfeed their baby if HIV positive, thats what I recommend to my mothers. Period!
    There are, however, cultural issues to content with in Africa, the story of Akinyi is just one such example. Besides poverty we need to liberate our women. Would the story be the same if Akinyi's husband was the first to discover his status? Food for thought.

    • Dzilla says:

      Dr. Sikolia i would like to discuss this issue with you. kindly get back to me on my email so that we can arrange for a meeting “dzillac@gmail.com”
      thnx so much for the comments. Hope to hear from you soon.
      Regards
      Dzilla

  5. magak says:

    its an impressive piece and educating what l am sure of women who are HIV positive should not be breast feeding without following the doctor prescriptions because failure to that, the baby could get infected .

  6. Thindisa says:

    my brother is having purstules sores in whole body now he is very sick, d u think he had defaulted

  7. puns says:

    This was too bad to hear 😦
    “My husband denies me food that I have prepared and he even throws away my ARVs medication arguing that a positive person is meant to die,” http://airplasma.com

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