“Learning that you are HIV positive can be one of the most difficult experiences you go through in life. You may feel scared, sad or even angry after knowing that this is going to completely change your life forever.”
These were the words of 45-year-old Eric Amankwah, a person living with HIV (PLHIV). On December 20, 2014, Eric was diagnosed with HIV at the Korle-Bu Polyclinic.
Recounting the events that happened afterwards, Eric said he fell into a deep state of depression as he blames himself for the condition.
“I started attending church, thinking that I will be miraculously healed one day but that did not happen,” he says.
He confided in a friend and told her of his HIV status and within some days, the news about his status had spread like wild fire.
Eric then resigned from work since he was not feeling comfortable anytime he was with his colleagues.
“The decision to quit my job was the hardest decision for me to make, since I was scared that I would be judged and felt embarrassed,” he indicates.
After he decided to accept his fate, and got over his fears, and then started his treatment.
He went back to the Korle-Bu Polyclinic to see a specialist and after telling him his story, they quickly decided to put him on the anti-retroviral treatment.
Initially, he did not know the importance of taking the drugs on regular basis and often escaped taking it until he was introduced to a volunteer from Model of Hope.
The volunteers were also PLHIV and using themselves as examples, they offered counselling services to new persons diagnosed with the disease.
Richard Dongyong was the leader of the group.
“We became friends and exchanged contacts and he taught me the importance of regularly taking the medication,” he adds.
HIV PREVALENCE IN GHANA
For nearly four decades, human immunodeficiency virus (HIV) has been a global public health, as well as development challenge.
The Joint United Nations Programme on HlV/AIDS (UNAIDS) report has revealed that about 36.9 million people are estimated to be living with HIV globally in 2017, most were in sub-Saharan Africa.
In Ghana, the reports shows that HIV prevalence among antenatal clients for 2017 was 2.1 per cent, that is a decrease from the 2016 prevalence of 2.4 per cent.
The 2017 HIV Sentinel Surveillance carried out by the Ghana AIDS Commission saw four regions recording prevalence above the national median prevalence of 2.1 per cent.
Greater Accra and Ashanti regions (2017 prevalence of 3.2 per cent) have, thus, overtaken the Volta and Brong-Ahafo regions as the regions with the highest HIV prevalence rate.
The Northern Region characteristically recorded the lowest prevalence below one per cent while the Brong-Ahafo Region has a current prevalence of two per cent, and Central Region, 1.8 per cent.
For three conservative years, according to the report, there have been major swings in prevalence in all regions except the Northern, Upper East, Western and Central regions. Only two sites, namely Salaga (rural/Northern Region) and Agormanya (urban/ Eastern Region) have experienced a consistent decline since 2013.
“Thus between 2007 and 2017, Ghana has worked, and continue to work hard to halt the rise in HIV prevalence and to increase access to treatment for persons living with HIV,” the report reveals.
It indicated that the median HIV prevalence among antenatal clients reduced from 2.1 per cent in 2012 to 1.6 per cent in 2014, but then increased to 2.4 per cent in 2016 and then fell to 2.1 per cent in 2017.
The ART
The anti-retroviral (ART) drugs itself, according to Emmanuel Beluzebr Suurkure, president of the Ghana Network of Persons Living With HIV & AIDS (NAP+ Ghana), cannot cure HIV, but it can reduce the amount of HIV in one’s blood (viral load) and prevent it from reproducing in one’s body, and this allows the immune system to stay strong and fight off infections and other illnesses.
However, Eric discovered a problem taking the drug and when he discussed it with Richard Dongyong, he was told that “adherence is the most important factor in taking this drug and this is the success of my HIV treatment.”
“Not taking your HIV treatment properly can mean that the levels of the drugs in your blood are not high enough to properly fight HIV. If this happens, your HIV will be able to reproduce. The strains of HIV that reproduce when you’re taking HIV treatment can develop resistance to the drugs you are taking. Resistance can mean that your HIV treatment won’t work effectively,” Dongyong explains to Eric during one of their meetings.
Eric then continued to take seriousness in taking his drugs on a regular basis just like diabetic patients.
However, Eric realised that anytime he takes the anti-retroviral drug, he often gets very hungry within the shortest possible time.
“The drug increases my appetite and makes me go hungry within the shortest possible time,” Eric added.
Getting the right food was a problem for him after quitting his job.
He often depended on relatives for his daily needs, and this affected his way of living, including the choices of balanced food he must take to help boost his immune system.
HIV & Food Insecurity
In spite of the successes pertaining to access to treatment commodities that has reduced the number of AIDS-related deaths, a major challenge many HIV Affected households in sub-Saharan Africa grapple with is food insecurity.
A research carried out by Ghana AIDS Commission on the assessment of food security and vulnerability of HIV Affected households in selected regions in Ghana have revealed that HIV exacerbates the vulnerability of affected families of food insecurity, leading to hunger and malnutrition.
The research carried out by Dr. Amos Laar, a consultant, and with support from Prof. S.O Kwankye of University of Ghana revealed that severe food insecurity was associated with worsened quality of life among HIV infected individuals.
He says scholars had provided elucidation on the relationship between HIV and food insecurity.
“The relationship is complex and intertwined in a vicious cycle, with each worsening vulnerability and thus exacerbating the severity of the other,” Prof. Kwankye points out.
He says food insecurity heightens susceptibility to HIV exposure and infection; HIV on the other hand increases vulnerability to food insecurity and this relationship is often compounded by low income, resulting in profound consequences on health and nutritional status.
Dr. Laar reveals that households that suffer from food insecurity due to poverty are malnourished prior to infection.
“The research indicated that HIV has disrupted livelihoods as infected persons often lost the ability to work and generate income,” he states.
For instance, it is reported that caring for an individual with HIV in Ghana can deplete as much as one third of a family’s monthly income.
Dr. Laar adds that food insecurity negatively impacts anti-retroviral treatment adherence, leading to adverse health incomes in PLHIV.
He indicates that HIV has profound consequences on nutrition status.
He says the disease has become a cause of malnutrition in its own right through its effect on the infected individual’s metabolism, hampering their ability to ingest food and digest.
“HIV leads to increased energy requirements PLHIVs in low-resource settings are frequently malnourished prior to HIV infection,” Dr. Laar highlights.
In addition, he mentions that HIV virus puts them at high risk of disease induced weight loss and wasting.
“Once infected with HIV, the body mounts an immune response that requires energy above and beyond the usual needs, beginning with 10 per cent at the asymptomatic stage and increasing to 30 percent for adults at later stages of the disease,” he adds.
Atuahene Kyeremeh
Government’s Intervention
The Director General of the Ghana AIDS Commission, Atuahene Kyeremeh, has promised to take the matter up for government to, if possible, consider enrolling all PLHIV on the livelihood empowerment programme.
He says efforts were previously made to put them on leap but it was unsuccessful.
Mr. Suurkuri believes the World Food Programme (WFP) will also consider bringing back the module where food items were distributed to PLHIV within the northern sector irrespective of the challenges it caused previously.
lindatenyah@gmail.com
By Linda Tenyah Ayettey