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Paidamoyo Chipunza Senior Health Reporter

Born HIV-positive 22 years ago to an under-age mother, Brian Mandizadza (not his real name) of Chinyudze in Gutu District has defaulted on his treatment multiple times.

This has seen him relapsing to advanced HIV.

Denial, coupled with stigma and discrimination from his relatives, as well as at his workplace has contributed to non-adherence to his medication.

This is despite that he is fully aware that he needs to take his medication religiously for it to be effective.

“When I was growing up, I was very sickly,” said Brian as he struggled to hold back tears that were already running down his cheeks. I was battling recurrent multiple ulcers all over my head and body, but being told that I was HIV positive broke my heart.

“My maternal grandmother played a huge role in counselling and encouraging me to adhere to the medication.”

His divorced under age mother passed on in 2002 while still in her teens.

Brian said although his grandmother encouraged and supported him to religiously take his medication since 2007 when he tested HIV positive, in 2013 he travelled to Harare hoping to get assistance from his paternal relatives in getting a birth certificate.

“Initially, it was a big struggle for me to get the tablets from the nearest clinic in Warren Park as they demanded a transfer letter from Chinyudze Clinic in Gutu where I had come from,” he said. “Eventually, they gave me the tablets, but I had already defaulted for some days.

“Following an altercation with my aunt, I left her house unceremoniously for my maternal relatives in Chitungwiza and in the process, I left my medication at her house.”

Brian said while in Chitungwiza, the issue of a transfer letter from the nearest health facility also came up and he could not produce it, again forcing him to stop taking his tablets.

He said since then, until 2018, he had not been taking any medication.

“In between, I have been looking for menial jobs for survival,” said Brian. “At some point, I looked for employment at a mine in Chegutu where I had to pay one of the foremen to submit a favourable report about my health condition.

“It was really a traumatising period because being seen taking any medication would be taken to mean that I was not fit for the heavy work done there. Hence I did not even bother to collect my supplies because I wanted to appear fit.”

All hell broke loose this year in September when Brian lost consciousness while in Chivhu where he had begun moulding bricks for sale.

“I received a phone call in the evening from one of his friends in Chivhu advising me that Brian had fallen sick and had been taken to Chivhu General Hospital,” said Brian’s grandmother who sat by his side throughout the interview.

Brian’s grandmother said when she eventually managed to bring her grandson back home, he was wasted, could not speak properly and had advanced HIV.

She said she took Brian to the nearest clinic where he was immediately put on HIV treatment.

Authorities at the clinic said Brian had to be commenced on first line treatment because the condition he was in could have claimed his life if he had been put on second line treatment immediately. Brian is now recovering well under the care of his grandmother.

He represents the remaining few people living with HIV throughout the country defaulting treatment for a number of reasons and proceed to relapse to advanced HIV.

According to the first Zimbabwe Population Based HIV Impact Assessment (2015-2016), an estimated 1,3 million people are living with HIV and Aids from which 74 percent know their status.

From the 74 percent who know their status, 87 percent are on treatment and have their viral load suppressed to undetectable levels.

As the country joined the rest of the world in commemorating the World Aids Day at Mucheke Stadium, Masvingo on Sunday, Government and its partners were urged to intensify targeted HIV testing approaches to ensure that no one is left behind.

Medicines Sans Frontiers (MSF) nurse mentor in Gutu Mr Tinashe Mbirimi said while Gutu was one of the first districts to achieve the United Nations 90-90-90 targets, a lot still needed to be done to ensure the remaining 10 percent was also covered.

According to the targets, 90 percent of all people living with HIV should know their status, while 90 percent of those who know their status should be on sustained antiretroviral treatment (ART).

In addition, 90 percent of those on sustained ART must have an undetectable viral load. “If the remaining 10 percent are not managed well, they can re-infect others, hence reverse the gains already made in combating HIV,” said Mr Mbirimi.

He said MSF was assisting Government to identify and put these individuals in the remaining 10 percent on sustainable treatment.

Gutu district nursing officer Mr Shephard Kachidza said communities have a critical role in advancing HIV interventions.

He said issues of stigma and discrimination were all centred on communities and could only be addressed from a community perspective.

“We need to continue educating our communities, to fight stigma and discrimination so that we successfully address issues of treatment defaulting,” said Mr Kachidza.

This year’s World Aids Day ran under the theme: “Communities make the                                             difference”.