HIV testing and treatment in the time of COVID-19

HIV testing and treatment in the time of COVID-19

Date: May 4, 2020
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Matiisetso Mosala

Maseru, 5 May: As the world battles the novel Corona virus the challenge in Lesotho has not only been trying to keep the virus out but strengthening healthcare services and ensuring safety as the nationwide lock down came into effect.

Lesotho has one of the highest HIV prevalence rates in the world. It has been an even bigger challenge for HIV positive people to get their antiretroviral (ARVs) given that some health care facilities experienced go slows from health practioners.

According to the Lesotho Population- based HIV Impact Assessment (LePHIA) survey that was conducted by the Ministry of Health from November 2016 to May 2017 Lesotho was well on meeting the global 90-90-90 targets by 2020.

The UNAIDS 90-90-90 goal challenges each country to meet three objectives by 2020. The first 90 percent target sought to ensure that by 2020 90 percent of all people living with HIV know their status. The second target strive to ensure that 90 percent of all people diagnosed with HIV receive sustained antiretroviral Therapy and the third target was to ensure that 90 percent of all people receiving ARVs will have viral suppression by 2020.

The report stated that the country had already met one of the three global HIV targets set by the joint United Nations Programme on HIV and AIDS (UNAIDS) of having at least 90 percent of all HIV positive people on Anti-Retroviral Treatment (ART) by 2020, with 92 percent of its HIV-positive people on ART by 2017, years ahead of the 2020 target.

The COVID-19 pandemic outbreak seems to be threatening this progress as the virus seemingly affects those with compromised immune systems with much greater intensity.

Two days after the announcement of a 21 days nationwide lockdown by the Prime Minister Thomas Thabane effective from March 29 2020, doctors, nurses and other health workers went on strike in different healthcare facilities around the country demanding protective clothing and risk allowance amidst the pandemic. As frontline workers, they felt they needed to be protected against the virus and have surety should anything happen, although Lesotho had still not recorded any positive Covid-19 cases.

This allegedly resulted in some people being turned away at clinics by nurses who told them they could not risk assisting them without Personal Protective Equipment (PPE) which the government failed to provide. One woman from Maseru who opted for anonymity said on her last two pills, she went to her usual clinic but was turned away.

She says she questioned what would become of her health being off treatment but they looked at her helplessly indicating they can only attend to emergencies.

The Ministry of Health Public Relations Officer ‘Mateboho Mosebekoa however said no one has complained to the ministry that they are unable to access their medication at respective clinics. She said the only calls she received were those people Basotho who are stuck in South Africa who stated they were left supply enough for two days and required assistance on how to go about getting assistance from the nearest clinic in SA.

On the other hand Queen ‘Mamohato Memorial Hospital better known as Tšepong says its patients have successfully been receiving their ARV treatment during this time because the doctors and nurses at the referral hospital were not on strike.

Tšepong Public Relations Officer Mothepane Thahane said although their patients are safe, it is a sad reality that some people are without their treatment as that could have negative ramifications on their health.

“Without their treatment, their CD4 count is bound to decrease which may lead to drug resistance and perhaps treatment failure,” Thahane explained.

The doctors and nurses are reported to be back at work after the government gave into their demands on risk allowances and provision of protective gear.

The Deputy Minister of Health ‘Manthabiseng Phohleli confirmed that they received reports in the last weeks that people were being turned away at some clinics, especially the Christian health clinics therefore not able to receive their respective medication.

Phohleli admitted that although she has not been able to take visits to these clinics personally due to other commitments, she is reliably told that the situation is back to normal and that people are being assisted accordingly.

Meanwhile, the Ministry of Health and Population Services International (PSI) Lesotho is strongly urging Basotho to make use of the HIV Self-Test product, so that if need be, they get initiated on treatment as soon as possible and bolster their immune systems to give themselves a fighting chance against the opportunistic pandemic.

The HIV Self-Test kit, is explained as a screening tool, and it is advised that after each test, if it comes out positive (result with two lines), individuals continue on to a health facility to take a follow up confirmatory test and to get started on treatment.

PSI explained that the HIV-Self Test kits are distributed in partnership with the Ministry of Health and can be accessed free of charge at all major government health facilities, as well as PSI’s New Start sites across various districts in the country.

PSI Lesotho’s Program Director, Dr. Cyril Nkomo states “In this day of COVID-19, it is even more so important for people to make use of this Self-Test tool, as we are all encouraged to maintain stringent levels of Physical Distancing”.

He explained that their work as PSI in the communities of testing people in mobile sites in attempts to bring services closer to people has stopped for the time being. Dr Nkomo however said it remains imperative that people get to find out their status, and immediately get on treatment if they need to.

The HIV Self-Testing program has been running in Lesotho since December 2017, distributing HIV Self-Testing kits to more than 200,000 Basotho across the country to date.

Southern African Development Community (SADC) recognises that, in the midst of combating this unprecedented COVID-19 pandemic, it is easy to overlook the abuses that women and girls encounter during this crisis.

SADC Executive Secretary, H.E. Dr Stergomena Lawrence Tax in a statement published in April 2020 on Covid-19 and Gender Based Violence and Domestic Violence said under lockdown, domestic violence cases tend to increase as security, health, and finance concerns heighten socio-economical tensions.

She says it is important to work together during the COVID-19 crisis, while considering the differential impact of the crisis on women and men, boys and girls to avoid double crisis.

“Women that have been in abusive relationships are now forced to be at home with their abusers for a prolonged period, making it difficult for them to reach out for help due to the presence of the abusive partner at home”.

Furthermore, Dr Tax observes that social distancing in itself makes it difficult for women victims to reach out to their usual support systems.

Police Spokesperson Superintendent Mpiti Mopeli when contacted said it was hard to give a clear picture of cases of domestic violence because there is no direct bill on domestic violence, rather different offenses such as assault and sexual offenses which come consolidated making it difficult to tell whether they occurred as cases of domestic violence or otherwise.

Mopeli stated also that unless people are not reporting, crime seems to have generally slowed down during the lockdown citing there were 40 cases of sexual offences in March, while as of April 23rd only 12 cases had been reported. Assault cases were 9 in March and nothing has been recorded in April, while no abductions (Chobeliso) were reported this month, except for one in the month of March.

He said it was a matter of reiterating as the police to the public that just because the country is in the middle of a lockdown does not mean police stations are closed.

“People should feel free to report cases of such nature, they should not have to suffer alone at home”, Supt Mopeli stated.

Tšepong PRO admitted they have had patients portraying domestic violence; however that she could not say the numbers have increased due to the lockdown.

“We have had people come in here but the numbers are not unusually high, only that because some clinics were not fully operational in the last weeks we had more numbers coming here”, Thahane says.

Tax emphasised that it is important for the member states to provide flexible and innovative tools for reporting, counseling services, and support to domestic violence and that they must be clearly communicated to enable those affected to access and utilize them.

*Picture from Lesotho Times

Matiisetso Mosala is a journalist from Lesotho. This article is part of the GL News Service Gender and COVID 19 news series.


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