Testing positive

It’s Friday night and it’s the start of a long weekend for most Mozambicans. Monday 25 June is Independence Day and a public holiday. “Mozambicans love to party,” Rosalina, a young Mozambican woman in her mid-twenties says. “We like good music and we love good food,” she adds laughing. Pointing a finger at a group of young women in the corner of the crowded bar, Rosalina adds: “Look at them falling over those men. I used to be like that. Talking to any guy, taking drinks from them and sometimes going home with them. But that’s all changed now ...” Rosalina, a receptionist for a South African company in the capital Maputo, was diagnosed HIV-positive early last year. “At first I could not believe it. I also did not want to believe it and for a little while I just forgot about it. But it’s not something that you can forget. There is always something in your mind,” Rosalina says above the music, but not without checking first that no one is listening. “I decided that I needed to take the test. There was this guy and well ... we were more than just friends and I heard from someone that he had died. Some said it was tuberculosis. Others said it was AIDS. So I decided that I needed to know and went to the hospital and took the test,” Rosalina told IRIN. According to Rosalina there was no pre-test counselling or anyone to tell her what being positive would actually mean. “But I was lucky I knew about AIDS, not much but something.” she said. “When the nurse told me I was positive. There was no kindness or anything in her voice. It was like she didn’t even want to look at me. I walked in the room and she said that it was positive and that was it.” According to Fernanda Teixeira, secretary general of the Mozambican Red Cross, cases like Rosalina’s are not unique. “The problem we have at the moment is that all the efforts are being thrown into prevention. Everybody is trying so hard and doing everything they can to prevent new infections, and I agree we should be doing that, but what about those people who are already living with HIV/AIDS,” Teixeira told IRIN. “We need to start thinking about these people, about how we are going to care for them and also what the effects are going to be on the communities that they live in.” “I think that we need to start looking at these kind of issues very seriously. For example, we know - and the statistics show - that women are more vulnerable than men. Strategies and programmes have to be devised to look at how we are going to not only help the women but those they leave behind as well. In Mozambican society, as in most African countries, women are the primary caregivers.” Last year, according to the UN, Mozambique had an adult HIV prevalence rate of 16 percent – reaching about 20 percent along some transport corridors. In its Mozambique National Human Development Report 2000, the UNDP said the prevalence rate among women was on average 1.6 percent higher than men. According to the UN there are going to be over 800,000 HIV/AIDS orphans by 2006. Teixeira told IRIN that some kind of “hope” needed to be created for those already living with HIV/AIDS. “We have to let these people know that they have not been forgotten. Mozambique might not have the drugs, right now, to care for them but that doesn’t mean that we can’t help them at all,” she added. She noted that part of caring for people living with HIV/AIDS involved developing strategies to cope with the millions of people who are going to start presenting themselves at clinics and health posts around the country with infections such as tuberculosis. “But nobody, or rather very few, are thinking like that,” she said. An aid worker with an international organisation in Maputo told IRIN there were no initiatives to help and care for those living with HIV/AIDS. “We (local and international organisations working with HIV/AIDS) have not yet seen any initiatives that talk about caring for those who have AIDS. Everything is focused on prevention. Prevention is great and I believe that is the key to stopping this disease. But what about those who are trying to live with HIV/AIDS,” he said. “We need to take a long term view because only by looking at those already living with HIV/AIDS will Mozambique really be able to gage the kind of impact that the disease is going to have. It’s going to affect education as more teachers start living with HIV/AIDS. The health sector is going to come under increasing pressure as so many more people need help, but this kind of thinking will only start happening when we take a more holistic approach that involves, education, prevention and care.” In its report the UNDP noted: “In Mozambique there is a tendency to view the HIV/AIDS epidemic as less serious than that facing the neighbouring countries. Unfortunately this is not the case. Despite the fragility of the data arising from the methods and the small number of sentinel sites, the available estimates indicate that the levels of infection in Mozambique are at best, only a few years behind the most severely affected countries in the region.” Teixeira added that apart from caring for those living with HIV/AIDS, an environment needed to be created which encouraged people to have themselves tested. “We need to try and ensure confidentiality. People need to know that if they get tested and whatever that result is, it will be kept between the health care worker and the patient. At the moment that is not happening. It is improving in some areas ...” she noted. “I also feel that people doing the testing need to be trained and educated on the fact that they need to be a bit more empathetic towards their patients and not simply dismiss them as is currently happening in many parts - not in all but in most. We might not have all the great technology that some have, but at least we can try and listen and treat people with dignity,” Teixeira said. “Sometimes I feel that maybe it was better not to know. That when I died I died and that was it. But I know and I am learning more all the time and I ask myself why can’t the government do more to help. I don’t understand everything about all these drugs they talk about in the newspaper. They say it’s very expensive. Okay but that doesn’t mean that they must forget about us,” added Rosalina. For information from the UN Special Session on HIV/AIDS and a selection of IRIN features on how Africa is fighting the pandemic, please see: http://www.reliefweb.int/IRIN/webspecials/hiv_aids/index.phtml