Give me an H, give me an I, give me a V, HIV

The issue of HIV/AIDS has been on my mind lately because of a few incidents that occurred in January. In early January, two friends of mine took a long distance bus to another part of Tanzania. The bus left later than scheduled and they ended up traveling after dark. The bus ran into a timber-filled truck that was stopped in the middle of their traveling lane and was not marked with any reflectors. 30 people died. My friends were very lucky to walk away with cuts and bruises. However, there was a lot of blood. My friends are now taking anti-retroviral prophylaxis. Similarly, someone was carjacked and was cut with a knife that had blood on it. He too is now taking anti-retroviral prophylaxis. Both sets of people are taking ARVs out of an abundance of caution, but it reminds me that HIV/AIDS is something that needs to be taken into consideration.

In Tanzania, the prevalence of HIV/AIDS is estimated to be 6.2% or, differently stated, 1.4 million people. This prevalence rate is relatively low in comparison to countries like Botswana, which has a prevalence rate of 23.9%, and Swaziland, which has a prevalence rate of 25.9%. However, it is high enough to make it an issue that is fairly high up on the agendas of the government, donors and non-governmental organizations.

There is also a caveat to the statistic regarding the HIV prevalence in Tanzania. It only represents those people who have been tested for HIV/AIDS. In 2007, the Tanzanian government launched of year long voluntary testing and counseling program. It was fairly successful, as 4 million people were tested. However, there are approximately 40 million people in Tanzania. People are reluctant to be tested as there is a significant amount of social stigma associated with a positive result and, from what I’ve heard, the confidentiality of results is not always guaranteed. I think reluctance to get tested is a natural response. In November 2008, I had the opportunity to be tested for HIV. Even though the chances of me being HIV-positive are incredibly slim, I had to take a couple of minutes to think about whether it was something I wanted to do. The testing itself was incredible simply. One pin prick and 20 long, anticipation-filled minutes later, I had my result. As expected, it was negative. For me, getting tested was fairly nerve-wracking and slightly scary. I can’t imagine what it is like for people who run a real risk of being HIV-positive.

In an effort to control and address HIV/AIDS in Tanzania, the government passed the HIV and AIDS (Prevention and Control) Act, 2008 in August 2008. This Act addresses matters such as discrimination, treatment of HIV-positive people, and AIDS orphans. It is a fairly comprehensive act. However, I take issue with some of its provisions, like the provisions that puts a positive obligation on an individual who tests positive for HIV to inform their partner. In addition, a health care provider may disclose an individual's results to that the individual's partner. I get the rationale behind these provisions. However, given the social stigma associated with a positive result, the risk of violence against an HIV-positive person and the power imbalance between men and women, I wonder if this provision will act as a disincentive to being tested. After all, if you don’t know your status, then you don’t have the obligation to disclose anything. Of course, you also don't get treatment and may not take any steps to prevent the transmission of HIV.