Mabelle Kpawilina, 22, is the only HIV-positive patient known to be taking antiretroviral (ARV) medication in Sam Ouandja, a mining town in the northeast of the Central African Republic, where the prevalence rate is 7.4 percent. She told her story to IRIN/PlusNews.
"I was born in Bangui [the capital] and lived there throughout my childhood, firstly with my parents, then alone with my father, who was in the military, after my mother died in 2001.
"I studied in Bangui. I messed about [had sexual relations] a lot with boys too. At college there were information campaigns about AIDS and I started to wonder: 'maybe I've already got HIV'?
"Thanks to the advice given in these campaigns, in 2006 I found the courage to go and get tested. I was positive. I was really sad and I thought about it all the time.
"I was in my second [year] when my dad died [in 2007]. I was all alone in Bangui, with no family and no support, and I couldn't continue with my studies. The only family I had left was my grandmother in Sam Ouandja.
"I'd heard that the IMC [the International Medical Corps, the organisation that runs the hospital] was giving free care there [in Sam Ouandja], so in January 2008 I decided to go and join my grandmother.
"When I arrived, I went to the hospital and explained my situation. There are lots of HIV cases in the region, but there is no [HIV/AIDS] service in Sam Ouandja - no testing and no treatment - but IMC helped me get medication from Bangui. Thanks to them, I have been taking ARVs here for a few months.
"In Bangui there are lots of organisations working with AIDS. There are awareness campaigns everywhere: in colleges, on the road, in bars, at the market. But there's nothing here - there isn't even an organisation [for people living with HIV].
"At least if there were an organisation for young people, we could talk about AIDS. I've tried to start talking about it in conversation with people around me, but some say that AIDS doesn't exist.
"But people are dying, and when they get sick, people say that they were poisoned by their neighbours. I want to raise awareness; I can talk to boys just as easily as girls.
"In Bangui people are starting to change their behaviour, but in Sam Ouandja AIDS is worse than in Bangui - here the problem is money [from the diamond mines].
"People want lots of money, and those that have it, pay to get it [unprotected sexual relations]. There are more men than women because of the mines; there are also armed men [military and ex-rebels] who look for girls in the town - it's a risk.
"For the moment, I'm selling peanuts near the market. [The head of the town's Health Management Committee] is supporting me; he helped me to get this small business going. Sometimes I also help my grandfather in the fields.
"But I'm not doing anything else - I'm not even doing any awareness raising. I'd prefer to go back to Bangui and start my studies again. [ARVs] can help me for a few years, but there isn't anything here. I cannot stay.
"I haven't told my grandmother that I'm HIV-positive yet. She is old, and if people in the neighbourhood find out she will be humiliated. As I've got high blood pressure, I've told that is why I take medication.
"But I want to start talking about it and hold meetings to speak to people about HIV, which is why I am talking openly about it today."
ail/lc/kn/he
"I was born in Bangui [the capital] and lived there throughout my childhood, firstly with my parents, then alone with my father, who was in the military, after my mother died in 2001.
"I studied in Bangui. I messed about [had sexual relations] a lot with boys too. At college there were information campaigns about AIDS and I started to wonder: 'maybe I've already got HIV'?
"Thanks to the advice given in these campaigns, in 2006 I found the courage to go and get tested. I was positive. I was really sad and I thought about it all the time.
"I was in my second [year] when my dad died [in 2007]. I was all alone in Bangui, with no family and no support, and I couldn't continue with my studies. The only family I had left was my grandmother in Sam Ouandja.
"I'd heard that the IMC [the International Medical Corps, the organisation that runs the hospital] was giving free care there [in Sam Ouandja], so in January 2008 I decided to go and join my grandmother.
"When I arrived, I went to the hospital and explained my situation. There are lots of HIV cases in the region, but there is no [HIV/AIDS] service in Sam Ouandja - no testing and no treatment - but IMC helped me get medication from Bangui. Thanks to them, I have been taking ARVs here for a few months.
"In Bangui there are lots of organisations working with AIDS. There are awareness campaigns everywhere: in colleges, on the road, in bars, at the market. But there's nothing here - there isn't even an organisation [for people living with HIV].
"At least if there were an organisation for young people, we could talk about AIDS. I've tried to start talking about it in conversation with people around me, but some say that AIDS doesn't exist.
"But people are dying, and when they get sick, people say that they were poisoned by their neighbours. I want to raise awareness; I can talk to boys just as easily as girls.
"In Bangui people are starting to change their behaviour, but in Sam Ouandja AIDS is worse than in Bangui - here the problem is money [from the diamond mines].
"People want lots of money, and those that have it, pay to get it [unprotected sexual relations]. There are more men than women because of the mines; there are also armed men [military and ex-rebels] who look for girls in the town - it's a risk.
"For the moment, I'm selling peanuts near the market. [The head of the town's Health Management Committee] is supporting me; he helped me to get this small business going. Sometimes I also help my grandfather in the fields.
"But I'm not doing anything else - I'm not even doing any awareness raising. I'd prefer to go back to Bangui and start my studies again. [ARVs] can help me for a few years, but there isn't anything here. I cannot stay.
"I haven't told my grandmother that I'm HIV-positive yet. She is old, and if people in the neighbourhood find out she will be humiliated. As I've got high blood pressure, I've told that is why I take medication.
"But I want to start talking about it and hold meetings to speak to people about HIV, which is why I am talking openly about it today."
ail/lc/kn/he
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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