How can I save my mother's life?
Oct 24, 2012
The media portrays an ever-increasing number of people who need ARVs, and I am scared that in Uganda, we shall never get to a situation when all who need these wonder drugs can have them, considering the colossal sums of money involved.
QDear Doctor,
The media portrays an ever-increasing number of people who need ARVs, and I am scared that in Uganda, we shall never get to a situation when all who need these wonder drugs can have them, considering the colossal sums of money involved.
What advice do you give people living with HIV who cannot access ARVs?
Lynette
ADear Lynette,
Universal access to ARVs is achievable if we get orgainsed. The biggest problem is that many people who have HIV do not know it because many still fear to do the HIV test, or cannot easily access the services.
This means there are people living with HIV (PLHIV) who will keep showing up with very low CD4 counts, having lived with the disease for a long time. If such people were known early and registered for care and treatment, we would have enough time to plan for them.
Before the coming of programmes like PEPFAR and Global Fund, which offer free ARVs, in Uganda in 2004, we had between 5,000 and 10,000 PLHIV, who were on ARVs paid for from private sources, and yet the drugs were costing much higher than what they do today.
Many of the HIV and AIDS activists we have in Uganda today did not get ARVs from government or donor agencies at the beginning.
They had to pay for them. We commend the Government and other development partners for giving free ARVs to those who are accessing them, but since they are not covering all PLHIV who need them, we must mobilise ourselves once again using structures like churches and mosques, clan systems and families, plus workplaces so that no one dies of AIDS.
The cheapest regimen of ARVs costs as low as $15 (about sh45,000) a month, per person. This may be high and not sustainable for most people, but working together in an organised way, we can achieve it.
The greatest hindrance to this is stigma and fear of discrimination, which make many people fear to disclose they have HIV. So, we must work hard to eradicate stigma and discrimination in order to achieve universal access to ART.
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Can ARVs cause impotence?
Dear Phoebe,
ARVs are not known to cause impotence. In fact many men’s desire to have sex often increases once they are put on ARVs and their general health improves. You need couple counselling with an HIV competent counsellor so that you are able to talk about sex and reproductive health in general with your husband.
It is possible that each time your husband thinks of having sex with you when you are HIV-negative, he fears to infect you with HIV. Fear and anxiety among men often lead to sexual dysfunction.
If two people in a discordant relationship always use condoms correctly and the one who is HIV-positive takes ARVs with good adherence, the risk of transmitting HIV is greatly reduced. Lastly, your case underlines the importance of couples going for regular medical check-up, including testing for HIV together.
It is possible to look healthy, yet you are HIV-positive. Discordance is also fairly common among married or co-habiting couples who practise consensual sex. So, no one should base his or her HIV status on their spouse’s, because they could be discordant; meaning one is positive, while the other is negative or vice versa.
The writer is a medical officer at Mildmay Uganda