Uganda: Assuming serostatus undermining AIDS fight
HIV/AIDS and TB are synonymous - people with HIV are more likely to get infected with TB because their immunity is weakened
The tendency, common among Ugandans, to assume individuals are HIV-positive or negative without prior testing is undermining the positive results the country had registered in its initial fight against HIV/AIDS in the 1990s, a new study has shown.
The study, a collaboration of researchers from the University of California, San Francisco (US) and Makerere University, found out that many patients attending the National Tuberculosis (TB) clinic at Mulago Hospital, Kampala, grossly overestimated the likelihood that they had HIV.
Dr. Alphonse Okwera, the head of the TB unit at the hospital, and co-author of the research, says their five-year study, which started in February 2008 was carried out at the TB clinic and in the homes of relatives of patients.
The study shows that anticipated and actual HIV status are driven by anticipated stigma among individuals.
Many people were unwilling to test and to refer their family members for a test, and people who thought they were HIV positive were less likely to refer members of their household for HIV testing than those who did not think so.
Okwera says the study was carried out on Ugandans aged 18 years and above and residing within 20km of Kampala.
Purpose
Okwera says the aim of the study was to control the spread of HIV and TB by identifying infected patients or those with TB and at risk of HIV contraction and evaluate them for possible care.
Okwera says it is also in compliance with the World Health Organisation requirement that people with TB should be offered HIV counselling and testing.
"This is important because the HIV/AIDS and TB are synonymous. People with HIV are more likely to get infected with TB because their immunity is weakened," Okwera says.
The study which ends in 2013, released its preliminary findings of over 434 patients who have already been tested out of a targeted 1,200 people at a conference on retroviruses and opportunistic infections held in California, US.
Stigma still high
The first striking result is that 60% or 202 of the patients wrongly anticipated having HIV and of these 69% were less willing to refer their household members to test at the TB clinic. The actual HIV prevalence in the group was 19% (80 individuals).
Okwera says only 18% correctly assumed they were HIV-positive and 33% correctly assumed they were HIV-negative. He adds that only 1.4% of the group thought they were HIV-negative when they in fact had HIV. And 48% of the group thought they were HIV-positive when they did not have HIV.
"The perception among our people is that 'what will I do if I get to know I am HIV positive or what will the community think of me?' There is perceived or anticipated stigma and people fear to test," he says.
He adds that this is fuelling HIV spread.
Okwera blamed poor nationwide coverage of HIV/AIDS programmes. He says "as much as we have many HIV/AIDS programmes aimed at getting rid of the disease in the country, these services are lacking in the rural areas especially in nomadic regions.
By Frederick Womakuyu
allAfrica.com
