HIV Disclosure:Challenges Faced By Women

Everyone who tests  for HIV is usually advised to share  his/her results with their partners.

This is so because there are those who believe that there is no need for two  people who are in a relationship to get tested.There is usually this assumption that the  two people could also be HIV concordant.

This is not usually the case.

HIV and Disclosure

It is recommended that every one takes the initiative of disclosing his/her HIV positive status to their partners. However, literature shows that disclosure is influenced by gender power relations.

It is not strange for a man who tests HIV positive to disclose his status to a woman. This is so because most women will not take any drastic measures upon receipt of such life changing news.

The opposite is true, in cases where it’s the woman or female partner who is HIV positive. Women are more likely than men to experience discrimination, violence, abandonment or ostracism when their HIV status becomes known.

Most of the HIV positive women who access care always express their difficulty on how to disclose their HIV status to their partners. This in a way hinders access of women to HIV care related services.

 HIV Testing and Human Rights

HIV testing violates important human rights concerns at health facilities and for women.This is so because there are health care workers on Kenyan public health facilities who never seek consent  from pregnant women before subjecting them to an HIV test.

Few women who have declined to undertake an HIV test,are known to have been denied ante natal service.Reason being that the health care workers don’t want to risk their own health by attending to people whose HIV status is unknown

Gender Based Violence  and HIV:Experience of Most HIV Positive Women

As a result of disclosing their HIV positive status, many women have reported subjection to various gender based violence related acts like:

  • Physical: their sexual partners have inflicted bodily harm on them
  • Emotional: where women tested HIV positive have been labelled “prostitute” by the partners
  • Sexual: some women have been denied this  right as a result of being HIV positive
  • Financial: Given that in most households men are the breadwinners, women who turn HIV positive  have limited control over family resources and hence at times not able to access timely and quality medical care. Violence in itself reduces a HIV positive woman’s ability to  participate in budgetary decisions within the household

  Winnie’s Experience: HIV Infection and Disclosure

This is a case of one woman out there for whom disclosure of her HIV status saw her start living positively with HIV.

Winnie knew her HIV status in 2005. By then she was expectant and married. In 2005 after she conceived, Winnie went to the clinic as it is a normal procedure for expectant mothers, but was afraid. This first time she went to the clinic, she was scared about testing, but was told it was mandatory for every pregnant mother to be tested for HIV among other routine tests.

The counselor just asked questions such as if she knew what he was doing when he drew blood. Winnie told him he was testing the blood for HIV since this was the only thing they tested for in this City Council clinic.   The counselor then  asked Winnie what she would do if she found out that she was HIV positive? Winnie responded by telling him that she didn’t know how she would react

The counselor asked Winnie not worry as he had counseled her. This assurance was based on the fact that Winnie had started getting scared.

After 15 minutes, Winnie and the counselor went to HIV testing area to see what the results were. The counselor reminded Winnie that One strip on the HIV testing kit, stood for a HIV negative result; while two stripes stood for a HIV positive test result. A HIV positive result meant that one was infected with the HIV virus, and vice versa if HIV negative.

When Winnie saw two stripes her legs grew weak, but the counselor held onto her. He counseled her again and enquired if she was married. When she said “yes”, Winnie was asked to bring along her husband so that the both of them could be offered joint counseling. He told her not to fear because many women were HIV positive

Winnie however got harsh with him and waked away from the clinic.

Given that she was in shock, Winnie went home telling herself that she was going to die, and as such there was no need for her to disclose her status to any one, not even her husband

She even stopped visiting people and even taking baths. Winnie would at times  sit back and look at her daughter and ask herself  questions like, ”f I died today who would take care of my child?”. She would at the same time remind herself that she had heard of HIV drugs I but wasn’t sure where to get them.

Due to the fear of disclosing her status to her husband, Winnie happened to conceive her second child.5 months into her pregnancy; Winnie contemplated aborting the child, but couldn’t bring herself to do it.

This time round Winnie did not go to the antenatal clinic. She did not even tell her husband that she was pregnant, as they were not planning to have another baby soon.

Upon noticing how frightened Winnie always was, her husband started questioning her strange behavior.

After a while, Winnie decided to disclose her HIV positive status to her husband who beat her and deserted her

Her husband’s reaction left her confused; because she thought that her husband would support her, but instead told her that she was the only one who knew where she got the HIV virus from

Due to fear of being stigmatized further, Winnie did not go to the hospital to deliver her child. She instead opted for home delivery, after which never took her child to the hospital for examination.

One day, Winnie’s friend visited her and she contemplated on whether to disclose her status or not. She decided not to, but  kept noticing her child’s health was deteriorating. Due to her ignorance, she decided to breastfeed her child so people would not suspect anything. When her child was 9 months old, she died due to HI V related opportunistic infections.

HIV related rashHer child’s death really scared Winnie. It was during this period that she noticed ring worms had appeared on her neck.  To conceal this skin condition, Winnie could not put on a dress that   did not expose her neck as people would ask her what I was suffering from.

She further got scared because she had heard that skin infections were a sign of HIV. At that point she decided to find out where to seek treatment. The same friend whom she was debating whether to tell or not to tell her HIV status was the one she disclosed to.

Her friend told her that her roommate uses drugs and that she was going to ask her to take Winnie  to the hospital. The two took Winnie to a VCT site in Kariobangi, Nairobi.  Winnie was still not receptive to the information given to me by the counselor. She was however counseled, tested again, and eventually accepted her HIV status.

Winnie was given Septrin which she decided to keep hidden and not even her mother or sister or anyone in my family knew about her HIV status.

One day Winnie met a certain lady whom people said was HIV positive. She told Winnie that use to attend group therapy and Winnie decided to join her. This was her first time to attend group therapy.

There Winnie met women who were like her and got to learn so much on how to live with HIV.

While at the support group, Winnie met another man during her visit to the support groups. The two of them moved in together as husband and wife.

She conceived his child.  This time round Winnie was no longer scared. She then asked her husband to accompany her to the antenatal clinic. He declined as he did not think he was HIV positive.

Winnie enrolled into a PMTCT program in addition to heeding to the doctor’s instructions. She even thought that if only she had this information she would not have lost her first child.

After delivery, Winnie took her child for a  PCR test and the child was found HIV negative. The next HIV test will be undertaken in the next 6 months.

In Closing:

How would you handle this situation if your partner informed you that they were not only pregnant with your child, but also HIV positive?

 

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