A 43-year-old woman, currently nursing a healthy 7-month-old baby, has been on Septrin for five years on the presumption that she was HIV positive. But she has now been tested two times and found to be ‘HIV negative’.
The mother of nine says: “After the father of my seven-year-old child died, I went and tested for HIV at Kiwoko hospital, and they told me that I was HIV positive. I started taking medicine called Septrin, and recently when they tested my blood again they told me that I did not have HIV.
“My current husband, the father of my seven-months-old baby, is HIV positive but he refuses to go on ARVs and he is very stubborn. At one time he had been started on Septrin then ARVs but he later stopped and refused to respond to any HCT [HIV counselling and testing] activities.”
The woman, who hails from Kibosa parish in Nakaseke district, talked to this reporter at the end of last month (24 August) at Kamuli primary school during a voluntary counselling and testing and PMTCT session organised by the International HIV/AIDS Alliance under the ViiV HealthCare’s Positive Action for children’s PMTCT fund project.
The International HIV/AIDS Alliance in Uganda receives funding from ViiV HealthCare’s Positive Action for children’s fund to implement a three year PMTCT community referral strengthening project that started in January, 2012. This project is implemented in partnerships with community based networks/groups of persons Living with HIV (PLHIV), district based health facilities, and in partnerships with various NGOs and CBOs. The four districts covered in this arrangement are Luwero, Nakaseke, Mukono and Iganga.
Responding to her second test, which diagnosed again that she is HIV negative, and asked about her future plans in relation to her HIV status, the woman said: “Today I have again taken the test and look, [brandishing her test results] they say that I am HIV negative and I do not have AIDS, the sickness that is associated with that virus. I also have a child who goes to school, his father died of AIDS, when I took him for testing, they said he did not have the virus. They instead told me to feed him well. But the teachers were complaining that he was always falling sick. This baby I am carrying…was also tested and he is HIV negative.”
Asked about her relationship with her husband whom she believes to be HIV positive, she says: “I love the father of my child very much, and he is a stubborn man. He cannot accept anything less and I have to please him. All counsellors have failed to convince him to start going for ARVs or to have another test.”
However, the woman still complains of other ailments like dizziness and constant headache. Sometimes she gets fits of epilepsy, known locally as Ensimbu.
But according to Dr. Stephen Ian Walimbwa, head of the Discordant Couple Clinic at the Infectious Disease Institute (IDI) at Mulago hospital, the woman’s assertions as to her HIV status can only be taken as speculation until the sample taken in 2007 when she was found to be HIV positive is retested.
He said: “It is possible that she was never HIV positive when she tested then. I am not convinced that was HIV positive when she tested the first time and I highly doubt what they are saying.
“Even what she says – that her husband is HIV positive – remains speculation until he has been tested and followed up with a confirmatory test. It would be better if we tested her from here [at IDI] where we are privileged to have standard tests, even using DNA-PCR which is very reliable.”
Another HIV laboratory expert at IDI, Emmanuel Asule says: “The problem, which other tests like Determine have, is that they can pick other antibodies even in cases that are not HIV related. This could have been the case of the woman the first time she had her test. But it is crucial to make the second confirmatory test, and we normally use Stat Pak, sometimes we even go for the third option using Unigold when the results are contradictory. Other times the inconsistencies could be caused by defects or a manufacturing error or a problem with the process of testing.”