Whilst on the field with my team providing free HIV Testing and Counseling (HTC) services to the public, we counseled and tested *Mr. Jones for HIV (not his real name). Mr. Jones got his test results and he was HIV negative. Mr. Jones was happy to know his HIV status and seeing this advantage, he took us to his house had his entire family tested. He brought out his wife, who was very sick and reportedly hypertensive, and their three daughters. We commenced routine testing which includes checking the BP and HIV status for all the individuals. We started with the wife, who even though was HIV negative, her Blood Pressure (BP) check on the spot was very high. The family explained that the high BP was normal as it runs in their family. The daughters who were barely out of their teens and the breadwinners of the family refused to get tested for HIV – they were aged between 19 and 25.
After the counseling session, the youngest eventually agreed to get tested. When her result came back negative, her sister who is the middle child agreed to have herself tested and her result also came back negative. Meanwhile, their eldest sister, *Jane just refused to get tested for HIV. So I encouraged her to at least check her BP even if she did not want to have the HIV testing. She agreed and I checked her BP and it read 220 over 120! Alarmed, I strongly advised her to go to the hospital for further medical examination and care.
I left *Jones’ household and continued with my work, providing HTC services in the community from house to house. After about 2 hours, *Jane came to me asking if she could confide in me and I answered in the affirmative. Explaining to her, that I was there, to counsel the community members concerning their HIV status. So she took me aside and began to tell me her Story. She said some time ago, some people had come to her workplace to test her for HIV and she was told that she had primary HIV. So she wanted to know if there was any such thing. I told her that the only way I will know is if she was tested but because she didn’t want to get tested there was no way of knowing. She said she will only agree to get tested on the condition that I keep her test result a secret. I gave her my word. Also, she asked me if I will take her for treatment and I said I would – explaining to her that most part of her treatment will come at no cost to her.
I then ensured that she had audiovisual privacy for the HIV testing and counselling. I used the first line rapid test kit (RTK), Determine and it showed she was negative. I used the second line RTK, Unigold as confirmation and it also showed negative. When she got the results, she was ecstatic. Part of the story she left out is that the people who had tested her and told her she had primary HIV had asked her to bring Twenty Thousand Naira (₦20,000.00) as cost of treatment.
With proper counseling, she understood that even if her test were positive, it would not have meant a death sentence. Of course, she was made to understand the concept of window period in the use of RTKs for antibody screening of HIV. She also learnt not to engage in risky behaviours even though her result was negative at that moment.
So the lesson learnt is that during the HIV Testing Services (HTS), the people who appear very aggressive and decline the HTS offered them may have a number of reasons for their action/inactions:
- It might be that they already know their HIV status and are already on drugs
- They know they are at high risk of being infected by HIV and are afraid that if they test they might be positive and
- It might just be because of the story of Mr. Jones daughter, Jane who frightened and needed extra efforts and assurance of confidentiality to accept the service.
Counseling is a key part of this exercise because this young girl had the opportunity to get retested and know her true HIV status at the time.
-by Adaeze Obison (Project Officer, CFHI-CCFN SUSTAIN project)