An estimated six million HIV-positive Africans are receiving life-prolonging antiretroviral treatment - a critical component in the management and control of HIV infection - but new studies show that resistance to the drugs is growing, especially in sub-Saharan Africa.
Resistance to first-line regimens means switching to much more expensive second- and third-line therapy, with patients progressively running out of treatment options at each stage. The authors of the study noted the need for enhanced surveillance and drug-resistance prevention efforts by national HIV treatment programmes.
Leah*, 45, a mother of four who was diagnosed with HIV 15 years ago, has since become resistant to first-line drugs. She shared her story with IRIN/PlusNews.
"At the time [I was diagnosed], it was common to hear people describe you as a walking corpse. I started taking antiretroviral [ARV] drugs when they were not very easy to come by, and when most people didn't really understand what they were or didn't believe they could help.
"When I realized I was HIV-positive, I lived in Nyanza [province in western Kenya] - not many health facilities had antiretroviral drugs in their stores, nor could they even handle HIV patients. I used to take a matatu [minibus-taxi] and travel 45 kilometres to get the drugs. My health started being robust again - I looked like a healthy person.
"I took the drugs for ten years. When my condition improved and I started feeling well, I decided to go slow on my treatment. I thought I had regained full life. I was now taking my drugs when I liked, and not as I had been advised at the hospital.
"When my employer, the Teachers' Service Commission, realized I was HV-positive, I was transferred to Nairobi. It was a tactical move to get me away from pupils.
"When I got here [Nairobi], I stopped taking the drugs completely. My condition started to deteriorate just seven months after I stopped. I was bedridden again and I knew I would die. I didn't realize my condition was worsening because I was not taking the drugs.
"When I was taken to the hospital, I was put on ARVs again after my condition stabilized, but I was not responding well. I was later diagnosed with drug resistance and I was started on second-line treatment, but it was not easy because the bureaucracy then of switching a patient to another line of treatment was slow. The drugs were not easily available and only certain people at the Ministry [of Health] could authorize [them].
"I was lucky because my employer was more proactive in ensuring that I get back on treatment again. Not many people are as lucky, and resistance leads to many people dying. Monitoring people more often will ensure they do not develop resistance.
"If you pass a drug-resistant strain of HIV to another person and the cycle continues, we will have many deaths. We must always guard against resistance because the success of treatment programmes relies on the positive outcomes of first-line treatment.
"Many health professionals, I can tell you, still do not have the knowledge to diagnose resistance to HIV.
"Now, I take my drugs more religiously... I don't want to get to third-line ARVs because I am not even sure they are found here."
ko/kr/he
*Name changed
Resistance to first-line regimens means switching to much more expensive second- and third-line therapy, with patients progressively running out of treatment options at each stage. The authors of the study noted the need for enhanced surveillance and drug-resistance prevention efforts by national HIV treatment programmes.
Leah*, 45, a mother of four who was diagnosed with HIV 15 years ago, has since become resistant to first-line drugs. She shared her story with IRIN/PlusNews.
"At the time [I was diagnosed], it was common to hear people describe you as a walking corpse. I started taking antiretroviral [ARV] drugs when they were not very easy to come by, and when most people didn't really understand what they were or didn't believe they could help.
"When I realized I was HIV-positive, I lived in Nyanza [province in western Kenya] - not many health facilities had antiretroviral drugs in their stores, nor could they even handle HIV patients. I used to take a matatu [minibus-taxi] and travel 45 kilometres to get the drugs. My health started being robust again - I looked like a healthy person.
"I took the drugs for ten years. When my condition improved and I started feeling well, I decided to go slow on my treatment. I thought I had regained full life. I was now taking my drugs when I liked, and not as I had been advised at the hospital.
"When my employer, the Teachers' Service Commission, realized I was HV-positive, I was transferred to Nairobi. It was a tactical move to get me away from pupils.
"When I got here [Nairobi], I stopped taking the drugs completely. My condition started to deteriorate just seven months after I stopped. I was bedridden again and I knew I would die. I didn't realize my condition was worsening because I was not taking the drugs.
"When I was taken to the hospital, I was put on ARVs again after my condition stabilized, but I was not responding well. I was later diagnosed with drug resistance and I was started on second-line treatment, but it was not easy because the bureaucracy then of switching a patient to another line of treatment was slow. The drugs were not easily available and only certain people at the Ministry [of Health] could authorize [them].
"I was lucky because my employer was more proactive in ensuring that I get back on treatment again. Not many people are as lucky, and resistance leads to many people dying. Monitoring people more often will ensure they do not develop resistance.
"If you pass a drug-resistant strain of HIV to another person and the cycle continues, we will have many deaths. We must always guard against resistance because the success of treatment programmes relies on the positive outcomes of first-line treatment.
"Many health professionals, I can tell you, still do not have the knowledge to diagnose resistance to HIV.
"Now, I take my drugs more religiously... I don't want to get to third-line ARVs because I am not even sure they are found here."
ko/kr/he
*Name changed
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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