#WorldAIDSDay
There is a largely ignored reality in Homa Bay, Kenya: 30 percent of the population is HIV positive. While advancements in HIV treatment have changed the prognosis of living with the disease…
AIDS
Continues
To
Kill.
Not only in Kenya, but around the world. One million people died from AIDS last year.
Antiretroviral drugs, known as ARVs, have been found to be effective in keeping the virus at bay since the late 1980s. For many years, these drugs were not available in Africa due to their prohibitive cost. Now, in Kenya, “ARV drugs are available. Diagnostics are available,” explains Dr. Berna Gurer, a physician with MSF in Homa Bay.
“So the question is: why are HIV patients still dying?”
The answer is a complex mix of stigma and access to care. Many patients do not know they are living with the disease since they have never been tested. When they start their treatment at a late stage, the virus is much harder to manage. Others interrupt their treatment at some point and become resistant to standard drugs. These people will need a different type—called second-line—for care. As nations decrease their funding for HIV treatment around the world, it will only become more difficult to get reliable access to care. It does not have to be this way.
In 2011, 39 year old Prisca enrolled as a patient in the MSF HIV/AIDS project in Zimbabwe. She was diagnosed with HIV in 2008 and became pregnant by her second husband in 2010, whom she had met at the project. She named her daughter, Shamiso and gave birth in January of 2011. In Shona, one of the widest spoken languages in Zimbabwe, Shamiso means ‘miracle’. And a miracle she was. When tested, Shamiso’s tests came back with a result that truly shocked Prisca – HIV negative. Because of that, Prisca even thought of having a second child with her husband.

Now Shamiso is 5 years old and is a fully healthy and functioning child, even attending school.
“I had not known about MSF’s HIV program before I went and got tested but when I tested positive, I followed all the instructions I was given, but I still thought my child would be HIV positive. I had lost all hope but I got assistance and through that, I was able to give birth to an HIV negative child.”
How to get ahead of the HIV epidemic?
It’s a community-driven approach: If implemented more widely, these strategies could significantly reduce the rate of HIV/AIDS.
Patient care works like dominoes - with an entire community involved in testing people where they live and work, and ensuring someone who tests positive is initiated on treatment, and supported to stay adherent to lifelong treatment with suppressed levels of the virus. The lay workers in communities and facilities are the glue holding everything together—improving both quality of care and access.“
“We have created the impression that we don’t care about the young people who are sick and dying…This is a war. It means that all of us should stand on our feet and mobilise the community” - Nelson Mandela, during a visit to one of the AIDS clinics in Khayelitsha. He expressed support for the treatment initiative, coupled with prevention programs, to protect the lives of people infected with HIV and to curb the impact of the virus.

It’s the international day in honor of Nelson Mandela. It’s also AIDS2016 - where Doctors Without Borders will share operational research related to simplified patient-focused differentiated models of care, community-based testing, linkage and retention in care, human resources for health as well as scale up of routine viral load monitoring.
In 1994, as South Africa celebrated its hard-won freedom from apartheid, the country descended into a chilling new crisis. An incurable disease called HIV – which destroys the body’s immune system - was sweeping across the country like wildfire.

By 2000, an estimated 4.2 million South Africans were infected by HIV. Nearly a thousand people were dying a day.

Stigma was powerful and dangerous. Aside from the few who were privately insured, treatment was completely out of reach: A year’s worth of branded antiretrovirals cost $10,000 to $12,000. Pharmaceutical companies refused to lower the price.

Here’s the story of how activists and people dying from AIDS started the biggest health revolution South Africa has ever seen: free HIV treatment for all.
Looking forward to a bright year ahead, we release our access to medicines Wishlist for 2016 www.msfaccess.org/wishlist2016
It’s World Aids Day, and it’s time to prove HIV is in no way an automatic death sentence. The people of Khayelitsha in Cape Town, in creative collaboration with MSF, activists, artists and musicians, came together to urge young people to stand strong against the virus. (via https://www.youtube.com/watch?v=HeS9YPkdVhI)
Get your questions ready! Dr. Helen Bygrave is holding a Reddit AMA on Women and HIV around the world TODAY at 12pm ET: https://www.reddit.com/r/TwoXChromosomes/comments/3lfm24/im_dr_helen_bygrave_hiv_advisor_for_doctors/
Edna’s HIV support group in Malawi has helped her through some very difficult times. By enrolling in MSF’s prevention of mother-to-child transmission of HIV program (PMTCT), she successfully kept her baby HIV-free.
Jennipher, a young HIV-positive mother in Malawi, washes her child’s hands after a meal. While she was pregnant, she managed to keep her babies from becoming infected, and since her husband left them, she is raising their four children alone.
MSF reacts to recent results of the Strategic Timing of Antiretroviral Treatment (START) study.“We should no longer squander an opportunity to offer treatment to a person living with HIV who is not yet seriously ill, because our experience shows that a third of these people will never come back to get treatment.” -Dr. Helen Bygrave, HIV medical advisor in MSF Southern Africa Medical Unit. http://bit.ly/1VAylCu
In 2015, we’re asking for wider access to routine viral load monitoring with the goal of having 72% of people living with HIV with an undetectable viral load. http://ow.ly/G38a8
Photo by Libuseng Marekimane/MSF
“I have fun during our monthly meetings because we share ideas on how to stay healthy and eat right together with taking our ARVs correctly.”
Name: Mampolai Ntsoha
Location: Lesotho
For HIV patients like Mampolai, above, being part of a Community Antiretroviral Treatment Group (CAG) means she has a safe place to meet other people who also live with HIV and to find support from peers. In meetings, members make sure everyone has been taking their drugs by counting each other’s remaining pills. They also share troubles they have encountered. CAG members rely on each other to take turns traveling often long distances to the clinic to pick up everyone’s treatment. Patients having trouble with their treatment are referred back to the normal procedure of coming to the clinic once a month, so they can be monitored by a health professional. They can rejoin the CAG once treatment is working well again. On World AIDS Day, Dec. 1, MSF is calling for health providers to adapt treatment to realities of patients’ lives: https://www.doctorswithoutborders.org/article/world-aids-day-portraits-my-life-my-hands
Photo by Kate Ribet/MSF
“In clubs, we talk one language. It makes everything easier. Why don’t we have clubs everywhere?”
Name: Zithulele Khanyile
Location: South Africa
Zithulele was diagnosed with HIV in 2002 and found that not only was it difficult to deal with the stigma associated with the disease, but also to access his ARV treatments. In 2007, he joined an MSF-supported NGO, “SHINE”, a club where people with HIV can be together and create a system that streamlines treatment access. “It made living with HIV much easier!” Zithulele says. “I can take care of myself really well now. People can talk to each other, they know each other, we talk one language, we discuss our problems, the side effects we were having. In the hospital, people are still scared to disclose. In clubs, you’ve already disclosed!” On World AIDS Day, Dec. 1, MSF is calling for health providers to adapt treatment to realities of patients’ lives: https://www.doctorswithoutborders.org/article/world-aids-day-portraits-my-life-my-hands