Barriers to HIV status disclosure

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe
[First published in Manica Post]
HIV testing and counselling emphasises the importance of status disclosure between sexual partners. This is to encourage partners to also get tested.  It helps prevent new infections. It increases opportunities for support and treatment for the one infected. But there are a number of reasons why one cannot not disclose his or her status after testing HIV positive.

Disclosing one’s status may be the most difficult thing to do in a serious relationship, but it sets one free and gives a chance to know each other better. While the infected partner has fears of rejection, the other partner may also fear getting infected. Both fears are real and need help if the two are to move on happily. I was somewhat stressed recently when I visited my local clinic to collect my supply of medication. This got me thinking. I ended up asking the receptionist for a chat with the nursing sister in charge of social psycho support who booked me for a discussion on my next visit. I found the bin in the ladies’ bathrooms full of boxes and containers that contain a special type of medication—anti retroviral tablets (ARVs). The tablets are enclosed in small sachets, which helps keep them in the best form as regards moisture content. The sachet is only to be discarded when the tablets are all used. But what I found disturbs me even now. The boxes, containers and the sachets were all in the bins. This could mean only one thing—the owners had removed the tablets from the sachets that maintain freshness and efficacy. It got me thinking whether the tablets were still effective. Were the ARVs now in a paracetamol package? Hey, why would one go to such lengths to change the correct packaging?

This was a serious issue that needs addressing.There is fear of being abandoned; fear of losing support from partner be it social or economic security;  fear of discrimination and even violence; fear of reaction from other family members; the greatest fear of accusations of infidelity. Fears, fears and fears! All these fears need support from a trained counsellor and for the two to understand each other’s needs. Gumisai Bonzo, an activist in the field, says that acceptance is the first issue to deal with before addressing disclosure. “For me acceptance of the new status is paramount. First deal with that; then moving on becomes less of a challenge,” said Bonzo. Bonzo said some people would discard the boxes because they are bulky. “In my case, I am open about my status to my family and friends However, I find the boxes bulky and so discard them and just carry the containers with me. I will fill my table with the boxes if I were to carry all,” Bonzo said.

Shingi Matogo a trained counsellor, said the motivating factors that help one to disclose were a feeling of responsibility and concern for the partner’s health. “One needs social support to cope with the HIV positive status.  One needs to reduce the stress associated with non- disclosure. The couple needs to use safe sex and prevent infecting the negative partner,” said Matogo. Another international activist, Tendai Westerhof, said the container was not marked with one’s status, so why the hullabaloo.“Medication must be kept in the original container from the clinic as the container is clearly labelled with accurate instructions on the dosage, and how and when to take the medicines, name of the client, source and date of expiry,” She further stated that it was easy to identify the medication in its original package. “The container from the clinic  makes it easy to store the medication and to carry in your handbag. There is no need to change the container as the container is not labelled HIV positive so there is no need to fear disclosure”. Westerhof brings up the important point of date of expiry. How then does one keep track of that if one changes the packaging? Food for thought, indeed.

Catherine Mwauyakufa, Citizen News Service - CNS
June 15, 2017

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