Fighting HIV/AIDS

Jorge, al igual que en México, Colombia presente un gran reto en la detección oportuna de personas que que son VIH positivos. Me parece que una de las causantes es que hay acceso limitado y oportuno a la información sobre métodos de prevención o detección de esta enfermedad; pues la población que no presenta algún síntoma desconoce que es portador del virus y tiene mucho más riesgo de propagarlo. Si bien los sistemas de salud promueven campañas para la detección, un actor fundamental en esta labor son las organizaciones que pudieran tener más movilidad para alcanzar zonas aisladas de los servicios o a la población que no tiene acceso a los sistemas de salud, como ha sido el convenio con la Liga Colombiana de Lucha contra el Sida. La sinergia entre las organizaciones y el sector público es la suma de los recursos públicos y la innovación de la sociedad civil dando como resultado soluciones más eficientes.

Ruvani, I was wondering if the BISAP initiatives you describe are having some continuity. One of the problems detected in Europe and the USA is that younger generations tend to ignore basic precautions and engage in high risk behavior. This might be due, in part, to the fact that the massive awareness campaigns undertaken a few years ago, were victims of their own success and their intensity has substantially decreased with time. Experts fear that the infections rate might skyrocket again in the not so distant future.
Olatawura’s take on Lagos is completely in tune with the situation in Bogotá: it takes significant effort to get people tested, due to lack of information on the part of citizens and health practitioners alike. Of course prejudice and fear of stigma still play a considerable barrier. However, the availability of treatment and the need to prevent transmission make testing a priority. The approach described by Fernanda, mobile units that combine information with testing, allows for reaching to populations that donot have easy access to health car. But, as the Bogotá case illustrates, some times even in the health systems we can find unexpected barriers to widespread testing.

I completely agree with Jorge. Testing is the first step to preventing the spread of HIV, should one know they are infected it makes it possible for them to get treatment and take precautions to avoid transmitting it to others. While testing is priority information about prevention is also important to prevent spread.

Its obvious getting the word out on importance of getting tested, treatment options and care is a challenge for most cities and various organisations have found innovative ways of accomplishing this task. I find the mobile test and information center program in mexico city very appealing as it take the information and testing to he masses, in areas which might otherwise miss such information. A lot of effort needs to be re-invested in anti-stigma campaigns and circulating information.

I wonder if the invention if a home test kit could help with the frequency of testing. A program that provides this coupled with advocacy against stigmatization and next steps after results might be an innovative solution and one way to encourage people to get tested and subsequently treated.

Hi Wura, here in Kenya it has become very common to see billboards exhorting people to go and get tested. A recent one shows a husband in bed with his wife looking over him and the caption runs something like "you don't know where he's been, maybe you should get tested"
Testing in Kenya is free although like in Nigeria, the government does not pay for the drugs once people have been tested positively. There are however insurance companies that have begun to target HIV positive people, although I am not sure exactly how that works.
I was wondering how religious leaders tackle the issue? Is this something that is spoken about and what kind of line do the devout take on the use of contraception?

Katy Fentress
URB.IM - Nairobi Community Manager
@whatktdoes

Wura, I agree that reducing the stigma against HIV/AIDS is one of the most important barriers to overcome in getting people tested. People don't want to admit they are at risk or conducting in at risk behaviors. For example, in Indian cities, many of the migrant many who are in the cities on their own working go to prostitutes and would never admit this to their families at home. What has happened as a result is that large pockets of HIV positive patients have popped up in certain rural areas, where the men return to and pass it on, unknowingly, to their wives. Promoting safe sex and condom use among sex workers is another important aspect in the prevention of HIV.

I was very interested to read all articles this week and some reflections came to mind.

First, there seems to be few reliable and available sources of HIV data at the city level. Most countries manage data at the national level. International reports and case studies are mostly focused on countries and little is known specifically on the city level situation and how cities manage their HIV prevention, treatment and support interventions. This is really important as it not only affects planning effective responses, but also affects monitoring and reporting of such efforts.

Second, I agree with most of you who have highlighted the importance about testing. It is definitely a very important step in fighting HIV. But efforts should not stop there, as testing isn’t enough. There needs to be SIGNIFICANT improvements in providing infected people with adequate and affordable antiretroviral treatment. Lets take the case of Lagos for illustrative purposes. The city has an estimate of 600 thousand people who are already HIV positive and only very few receive proper treatment. With all recent advances in antiretroviral medicine many of these people could be living a fairly normal and active life. Also, with proper treatment, pregnant women will be able to prevent mother-to child transmission of HIV. So availability of treatment is in many ways part of the prevention strategy…

Last but not least, I was wondering about the picture showed in our platform’s page showing people with vests that read “HIV POSITIVE”. I think it is from Lagos. What is it about? Are photographed people really HIV+? I am curious to understand the context of this picture as it is not common to see people being so open accepting their HIV status. Would be interesting to learn how this campaign or project was implemented and how local people perceived it.