Two women's resolve to live positively with HIV, get children

The day was cool and the sky was like a dome of plasma blue as we made our way to Kasule village in Kisumu Central Sub-County to meet with a group of persons living with HIV.

Atieno (real name withheld) received a standing ovation from fellow HIV and Aids survivors when she took to the podium to tell her experiences and struggles.

Atieno, the fifth-born daughter in a family of six children, was born positive as a result of mother-to-child transmission (MTCT).

Her parents succumbed to the virus when she was barely four years old and was left under the care of her grandmother.

"I was always in and out of the hospital with recurrent herpes infection," said Atieno, adding while in Class Two, she tested positive for the virus.

Herpes sores usually appear as one or more blisters on or around the genitals, rectum, or mouth and HIV patients are susceptible to it (herpes) since their immune system has been compromised.

Atieno said that her grandmother was made aware of her status by the doctors but she contested the results "as my younger sister (sixth born) was HIV negative."

"Community Health Volunteers (CHVs) would pick antiretroviral (ARV) drugs and bring them at home but my grandmother would throw them away," said Atieno.

She became critically sick and when the CHVs learned of the situation, they would bring the drugs in the morning and evening and ensure she took them.

"My grandmother went to the school and told the teachers and fellow pupils of my HIV status. Everyone abandoned me. Due to stigma and discrimination, the CHVs took me to a children's home where I was brought up," said Atieno.

When she turned 18, she left the children's home but was told to always reveal her HIV status to any man who approached her and wanted an intimate relationship.

This was to ensure she did not infect people as she looked healthy and beautiful.

"I fell in love with a young man from Bungoma who showed me the true definition of love but didn't disclose my status to him for I feared losing him," said Atieno.

"For three months, we always used a condom whenever we had sex. He asked why I was always against having unprotected sex. That is when I took his phone and typed the word 'HIV positive'. I told him everything about how I got infected with the virus."

The two would then go to voluntary counseling and testing (VCT) at Moi Teaching and Referral Hospital (MTRH) - Eldoret.

After the tests were conducted, Atieno again tested positive but the boyfriend tested negative and the two were found to be a 'discordant' couplE.

They would later get married but Atieno would always get her ARV drugs in Bondo and not Bungoma where they lived as a way of keeping their HIV status secret.

They birthed a baby after two years who was HIV-negative. Atieno avers that she always took her ARV drugs without missing them so as to lower her viral load in order to give birth to a healthy baby.

The husband used to take Pre-exposure prophylaxis (PrEP) whenever they had sex and whenever her viral load was high they used a condom.

According to the Centre for Disease Control and Prevention, PrEP is taken to prevent HIV infection and reduces the risk of getting HIV from an infected person by about 99 per cent.

"Before going into labour, I told the midwives of my HIV status and they were able to save my baby at birth. My baby was put on medication within an hour before breastfeeding her," said Atieno.

After six weeks, she discontinued Zidovudine which she was given at birth for Nevirapine and Septrine until she stopped breastfeeding.

Atieno said when the baby was a year old, the husband told her that he wanted to reveal her HIV status to his parents, a suggestion she vehemently opposed but after consulting with her family members, she consented.

"He had become a bother to me. I told him (husband) to go and tell them the truth about my status. My father-in-law had no problem with that but my mother-in-law forced a separation," said Atieno.

"I looked for a partner who was HIV+ to avoid more stigma and discrimination and together, we have two more children who are all HIV negative."

Today, Atieno together with other HIV warriors in Nyanza and the Western regions are leading advocacy campaigns aimed at ending new HIV infections by 2030. They include ensuring that HIV patients get access to ARV drugs by picking them up from the hospitals and taking them to their doorsteps, advocacy against adolescent pregnancies and sexual and gender-based violence (SGBV) in Kenya (The Triple Threat), which are key contributors to new HIV infections.

On December 1, Kenya will join the rest of the world to celebrate World Aids Day 2023 under the theme 'Let communities lead'.

The focus is on prevention, care and treatment, prevention and response to SGBV and stigma, and multi-sectoral engagement to reduce new HIV infections and related deaths by ensuring the victims are on medication and ensuring there are zero HIV infections by 2030.

Merab Oguna (who consented her name to be used) is among a group of people living with HIV who have been educating communities about the dangers of the virus and ways of protecting themselves.

Despite living with the virus for two decades, she has managed to conquer all infections that are common among people living with HIV.

Under an umbrella body called, Network of People Living with HIV, Ms Oguna says she has reached out to thousands of people in the war against the virus. Among the people she has helped not to contract the virus are her husband and children.

"My husband is not living with HIV and the two children we gave birth to after knowing our status. This is a testimony that people living with the disease should not be sidelined," said Oguna.

Statistics show Kenya has the seventh highest number (1.4 million) of people living with HIV in Africa. This is according to the National Syndemic Diseases Control Council (NSDCC).

According to NSDCC, the country has made key milestones within the HIV programme in reducing new infections between 2010-2023.

In 2010, there were 71,000 new infections which shot to 77,647 in 2015 with the figures dropping to 41,416 in 2019. In 2020, the number of infections dropped further to 32,027, however, the figure increased slightly to 34,540 in 2021, and in 2022, new HIV infections dropped to 22,154.

"Our key objectives is to reduce new HIV infections by 75 percent by 2025, reduce Aids related mortality by 50 per cent, eliminate viral hepatitis, and reduce incidences of sexually transmitted infections," said Dr Peter Arimi, who heads the Technical Support Unit at NSDCC. He went on: "We want to ensure we reduce HIV-related stigma and discrimination by 25 per cent and increase domestic financing to HIV response by 50 per cent."

Dr Arimi said that the counties of Mombasa, Taita Taveta, Lamu, and Kilifi sustained efforts to combat the deadly virus have seen them record a decline of more than 50 per cent in new HIV infections between 2021 and 2022.

According to the Kenya National Bureau of Statistics 2019 census, at least 59 per cent of the country's population are young people below 24 years of age.

"Majority of HIV new infections is among the youth, people who can't feed themselves. They worry too much about pregnancy and not getting infected with HIV," said Dr Arimi, adding that "those born in the 2000s and beyond have little information about HIV' because they haven't seen the changing faces of the epidemic."