Holistic approach to combating HIV/AIDS

An HIV/AIDS testing and counselling centre that will be the template for other such facilities in Swaziland's urban areas opened this week in the centrally located town of Manzini. "This is a holistic centre offering many services - that reflects the holistic approach needed for living with HIV-AIDS: counselling, blood testing, nutrition, exercise and all-round physical and mental health, with the added expertise of legal and other kinds," said Rudolph Maziya, national director of the Alliance of Mayors Initiative to Combat AIDS at the Local Level (AMICAALL). The mayors and municipal authorities of the country's nine towns coordinate their activities through AMICAALL, which has a local representative in each town. King Mswati dedicated the facility last week, naming it 'Lamvelase Help Centre' in remembrance of his great-grandmother. Swaziland has the highest prevalence rate of HIV in the world, with nearly 40 percent of adults infected by the virus. Although a recent survey showed a decline in HIV infections among teenagers, the health ministry's latest sero-surveillance study showed that Manzini has the worst AIDS problem in the country. "This is the 'Hub of Swaziland', where all the roads and bus routes convene, so there is a lot of people movement and spread of HIV - the Matsapha Industrial Estate is just west of town, and you find there workers' compounds and temporary workers, who are at risk of contracting AIDS. Sex workers are also here," said Pholile Dlamini, who is employed by Manzini City Council as a consultant on AIDS programmes. Health workers are watching closely to see if Swazis will overcome their fear of being identified as being HIV positive in a country where stigma runs high. "People want to be tested to see if they are HIV positive or negative and get over that anxiety, but they won't go to AIDS centres because others will see them go in and the gossip will spread that they have AIDS," said Hannie Dlamini, president of the Swaziland AIDS Support Centre in Mbabane. "This has inhibited the wider use of anti-retroviral drugs, because a blood test is required to get them. Some people who suspect they have HIV are purchasing ARVs on the black market rather than get them for free at AIDS centres, because they fear someone might recognise them," Dlamini said. The Manzini coordinator of AMICAALL, Gugu Dlamini agreed: "For you to achieve good health, you have to deal with the stigma. That is easier said than done, but people are realising that. Already, people are coming here before the doors are officially open."