HEALTH

A study conducted in 2020 has found that most of the antiretroviral therapy (ART) clinics in Kampala provide poor counseling services or provide inadequate factual information.

The research dubbed the Quality of Health Care Study was jointly conducted by the Kampala Capital City Authority (KCCA) and the National Forum of People Living with HIV and AIDS Network in Uganda (NAFOPHANU).

It was done in 15 Kampala-based ART clinics.

The consequence is that many men and youths are denied the chance to understand what HIV and AIDS treatments there are and how they work, or to make good use of treatment or even seeking treatment in the first place. 

Researchers established that more than eight in every 10 of Kampala’s ART clinics were not able to explain the difference between viral load and CD4 count, making it more difficult for people living with HIV to monitor their treatment. The situation becomes worse for those who wish to have an HIV test for the first time.

Kampala is among the regions with the highest percentage of people from the age of 15 to 65 living with HIV and AIDS, with 6.9%, according to the Uganda Demographic and Health Survey of 2019. Other regions are mid-north 7.2, central 8.1, south west 7.9. With 3.1%, West Nile has the lowest HIV prevalence.

Viral load and CD4 count

Someone who has received an HIV diagnosis will want to know two things: their CD4 count and viral load. These values give them and their healthcare provider important information about:

- The health of their immune system
- The progression of HIV in their body
- How their body responds to HIV therapy
- How the virus itself responds to HIV therapy

A CD4 count is a test that measures the number of CD4 cells in one’s blood. CD4 cells, also known as T cells, are a type of white blood cells that fight infection and play an important role in one’s immune system

Viral load describes the amount of HIV one has in his blood. The more HIV there is in one’s blood (and therefore the higher one’s viral load), the faster one’s CD4 cell count will fall, and the greater one’s risk of becoming ill because of HIV.

Science has proven that if there is so little HIV in one’s blood, making the viral load low and thus “undetectable”, one is 98% not able to infect another person, even if condoms are not used. A viral load can include millions of copies of HIV in blood, especially when the virus is first contracted.

It is the distribution of scarce, truthful information and failure to explain such important terms as CD4 count and viral load by ART clinics that has led to the intervention of a local organization.

Positive Men’s Union (POMU), a local organization for men living with HIV and AIDS partnered with Dr. Marilyn Crawshaw, an honorary fellow at the University of York in the UK and launched a free helpline to lessen existing barriers to healthcare, especially among men.

Dr. Marilyn Crawshaw and Richard Sserunkuuma (right) attending the launch of the helpline

So why men?

It is generally believed that participation of men in programmes aimed at mitigating the impact of HIV and AIDS is inadequate. It is difficult to see men outnumber women at a health facility meeting.

This even caught the attention of President Yoweri Museveni and he took action.

In June 2017 when he was launching the Presidential Fast-track Initiative on ending HIV and AIDS in Uganda by 2030 (the first such initiative in Africa and the entire world), one of the plans he highlighted to tackle the pandemic was to engage men in HIV prevention and close the tap on new infections, particularly among adolescent girls and young women.

The initiative followed concerns by the President about the increasing prevalence of the killer disease in the last few years, despite tremendous achievements in the past. In the early 2000s, Uganda was among the world’s top champions of the fight against HIV, having brought down its prevalence to about 5%.

Meanwhile, during the launch last Friday in Kampala, Dr. Marilyn expressed satisfaction that the helpline had finally been unveiled. The hope is that it will help alleviate healthcare access barriers among men and their loved ones.

“Unless men take an active lead, they stand to lose not only their own lives, but their entire lineage. I am happy to support this indispensable development and looking forward to its progress,” she said.

Members of POMU dialoging during the launch of the helpline

POMU executive director, Richard Sserunkuuma, said by using the helpline, men particularly will feel more confident about using services to help with HIV and AIDS, tuberculosis, sexual and reproductive health, COVID-19 and other related menaces, including gender-based violence services.

He said the helpline will help Ugandans who have difficulties in identifying where to go for assistance and how to make the first step, since to them, some procedures they have to undertake are so frightening that they choose to give up until they are too ill. 

“Men who are mainly new to having an HIV test also think HIV care facilities such as TASO, Mildmay and IDI charge a fee, which discourages many men who might otherwise get help, and they are left frustrated, uninformed and therefore failing to protect others from possible infections,” said Sserunkuuma.

The helpline will also be an avenue for users to provide feedback on the services they receive at their health facilities, and in turn, POMU will on a regular basis share this feedback (without naming any individuals) with the relevant partners as a way of either correcting any shortcomings or building on the successes in service delivery.

NAFOPHANU executive director Stella Kentutsi underlined that the problem of male participation has emerged as a constraint in AIDS prevention and mitigation efforts not only in Uganda, but also in many African countries.

Not too much has been done to approach this, yet the trend can make things worse because women cannot do it alone, she said.

Stella Kentutsi, the executive director of NAFOPHANU

“Very few men want to know if they are HIV positive. They don’t want to know they are going to die. But even if one comes to know one is HIV positive, today there are treatments and ARVs which can make you live a normal life and even have children without infecting them despite your HIV status,” said Kentutsi.

Mary Gorret Arielo, one of the helpline advice workers or counselors, said she and her colleagues are on standby 24 hours to provide information, advice, counseling, support and referrals to anyone contacting the helpline. 

The helpline is 0393194799/0200904090. They are also reachable on WhatsApp (+256757849849) and through text message (SMS).

 “We may not have the answers immediately, but we will definitely know someone who has and we shall certainly ensure to give you accurate information and any possible assistance,” said Arielo.

Callers can express themselves and be attended to in English, Luganda, Atesot, Runyankole, Rukiga, Rutooro and Runyoro and Luo. Users are at liberty to use a language of their choice to encourage openness and freeness, he said.