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Battling HIV and AIDS in the Era of Covid

By Vanesa Mhizha

A DARK and somber atmosphere engulfed the room as Agness Zinhu (48), from Highfield in Harare recounted how she lost her only daughter to COVID-19.

Agnes, 19, was also HIV positive. The tragedy happened in April 2020, at the height of the COVID-19 pandemic.

Before the pandemic, her daughter was not always feeling well and her viral load was very high.

However, with the coming in of strict lockdown restrictions that disrupted health services and travel, she struggled to access facilities to collect her medication.

“It was hard for us to get a steady supply of antiretroviral drugs at the peak of covid-19 back in 2020, combined with travel restrictions this meant that we could not access medication at all,” said Agness, with tears running down her cheeks.

“My daughter ended up defaulting her medication and it’s very unfortunate that she succumbed to covid-19 as well, but I believe that she was going to have a chance if she had access to antiretroviral, her immune system would have been stable enough to fight Covid-19.”

Most people living with HIV especially young people had a difficult time accessing services during the COVID-19.

For Takudzwa (24) who stays in Cannan, Highfields, 2020 was the worst year and passing through police and military manned roadblocks was his worst nightmare as he had to involuntarily disclose his HIV positive status to security officials whenever he went for a refill.

Takudzwa has been on second line Antiretroviral Therapy (ART) for three years now. However, in 2020, during lockdown period when Zimbabwe faced unavailability of second line treatment drugs and this almost forced to defer taking his medications.

“I am on second line ARV treatment; I was switched to the second line regimen last year after it was discovered that I was not responding well to the first line. However, we are currently experiencing a shortage of second line ARVs in the country especially under the lockdown period.

“At times you are referred from your clinic to go and collect at a public health institution but on arrival, you will be told that they don’t have the drugs in stock and they only have stock for young people and children who are registered to collect from that institution. Once you talk to the nurses and other health staff, they tell you to pay a sum of US$1 just to get the drug through the backdoor,” said Takudzwa

In private pharmacies, second line ARVs then were going from US$25 and above, a sum which is way above the reach of many young people living with HIV in Zimbabwe since majority of them are unemployed and survives on hand to mouth ventures.

In an interview with this publication, Director for the Network of Zimbabwe Positive Women (NZPW), Evellyn Chamisa, said the reason why some HIV patients went into default during the peak of Covid-19 was due to a sudden lockdown which caught many people especially PLHIV unprepared.

“Well, some HIV patients saw themselves going into involuntary defaults because some of them were not able to collect refills that would see them through the lockdown, after all the lockdown came as a surprise nobody was prepared for it” she said. In the interview, she said people feared exposure to COVID -19 hence were reluctant to go for refills and some of the PLHIV at the beginning of COVID -19 had no travelling letters to go for their refills.

“When the first lockdown was imposed, we all feared exposure, we were yet to understand the virus and so was everybody else, moreover the issue of travel restrictions made it even worse because people had no traveling letters to allow them travel, so it was hard to travel around without those letters,” said Chamisa.

She also added that they received reports of human rights violations towards PLHIV where they learnt that patients were being harassed at police roadblocks in the Masvingo province when going for refills.

However, to address the challenges that PLHIV faced during the COVID-19 pandemic, NZPW together with the Zimbabwe Network for people living with HIV advocated for multi-month prescriptions and managing the supply chain of medicines effectively to avoid stock-outs as well as to limit frequent visits to health facilities to reduce exposure to spaces that might be infected with covid-19.

They also arranged worked with community art refill groups where by one person went to collect the drugs from the health facility for other members. However, she said the outreach programs did not cater for everyone on HIV medication as they were reports of shortages of the second line drugs drug which forced patients to do personal collections at health care facilities.

Meanwhile, Population service international (PSI) also played a crucial role during covid-19 in ensuring service delivery towards HIV patients. PSI monitoring, evaluation and learning advisor, Noah Taruberekera said t when the first wave of the pandemic hit, the PSI began to work in September 2020 with the government’s Aids and TB units to ensure that the Last mile initiatives delivers services towards HIV Prevention.

“Through the Last mile programme, 50% of New Start Center clients received a three to six months supply of Art, Prep and contraceptives which sustained them during the first lockdown many clients from New Start Center received notifications telling them to come and collect their refills as the institutions would be decongesting their working space following the World Health Organisation’s covid-19 guidelines” said Taruberekera.

According to the Zimbabwe Rapid Assessment for covid-19 impact on HIV service provision statistics done by the ministry of Health and child care for the period of April to June 2020, there was a reduction in the number of clients who tested for HIV and receiving results, a 15% reduction in the distribution of HIV self-test kits, 99% reduction in voluntary medication male circumcisions performed, 49% in sexually transmitted infection (STI) clients tested for syphilis, 95% reduction in patients newly diagnosed with HIV initiative on antiretroviral therapy and a 29% decline in viral load sample collection.

#A Dark and Somber