Night: perfect cover for AIDS testing in Zimbabwe

by Jeffrey Moyo | @moyojeffrey | Thomson Reuters Foundation
Monday, 16 October 2017 01:00 GMT

FILE PHOTO - A Kenyan woman prepares ribbons ahead of World Aids Day at Beacon of Hope centre, a non-government organization formed to address women's problem of HIV/AIDS in Nairobi, November 25, 2004. REUTERS/Antony Njuguna/Files

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"I was so filled with fear and shame to get tested for HIV/AIDS during the day because I just felt I could bump into some people who know me"

By Jeffrey Moyo

HARARE, Oct 16 (Thomson Reuters Foundation) - Denigrated by friends and lampooned at work, Jimson Hove had a reputation as a ruthless womaniser who would die of AIDS.

The 24-year-old walked tall but was racked with worry and consumed by guilt - what on earth would people would think if they saw him checking out his HIV status at a downtown clinic?

Night testing was made for people like him.

"I was so filled with fear and shame to get tested for HIV/AIDS during the day because I just felt I could bump into some people who know me and they would start questioning my being at an HIV testing place," Hove told the Thomson Reuters Foundation.

So when Zimbabwe launched a night testing service in August, Hove steeled for the worst and walked nervously into the medical tent pitched at the heart of the Zimbabwean capital, Harare.

About 10 minutes later, his world had changed.

Hove emerged jumping, clapping, screaming and singing at the top of his voice.

He had tested negative for HIV.

"I'm without AIDS!" Hove shouted jubilantly as his colleagues grouped outside the tent at Harare's popular Copacabana bus terminus, thick with vendors and taxi marshals.

MOST AT RISK

Zimbabwe's National Aids Council (NAC), an organisation that co-ordinates the country's response to HIV and AIDS, launched night testing on August 18, reaching out to sex workers and their clients in a conservative nation that has struggled to be open about the health risks of unprotected sex.

According to UNAIDS, Zimbabwe has the fifth highest HIV prevalence in sub-Saharan Africa, at 14.7 percent, with 1.4 million people living with the virus, 77,000 of them children.

NAC says Zimbabwe's deaths from AIDS-related illnesses are falling, from 61,000 in 2013 to 31,000 two years ago, while the number of children orphaned by AIDS also dropped from 810,000 to 524,000 over the same period.

The new government testing aims to bring rates lower still.

Of the 18,000 people so far tested for HIV in Harare's night clinics, 36 percent have proved HIV-positive, NAC said.

The ratio is higher than the number who test positive in day clinics. The Ministry of Health and Child Care puts the number of people who test for HIV during daylight in local clinics at 380 every month, with 6 percent found to be HIV-positive.

"Through this programme we call moonlight testing, it has since been established that there are more HIV-positive cases at night, because more people who come to get tested at these times are mostly sex workers and their clients, who are the high risk groups," said Adonijah Muzondiona, provincial manager for the National Aids Council in Harare.

One such client is 29-year-old Ratidzo Chiutsi, who lives in the Avenues area, a red-light district in Harare.

"It's only at night that we get the chance to do brisk business and therefore the right time to get tested for HIV, plus again nobody notices us in the dark," Chiutsi told the Thomson Reuters Foundation.

Chiutsi said she tested HIV positive last month, and was immediately put on anti-retroviral treatment to protect her.

Groups that represent the rights of sex workers back the initiative as convenient, discreet and medically important.

"It has reduced the burden of having to travel to testing centres, which costs money and time, as queues are often very long. Besides, some women in commercial sex work don't want to be seen to be frequently visiting testing centres for fear of being judged," said Talent Jumo, director of Katswe Sisterhood.

Katswe Sisterhood fights for sex workers to gain sexual and reproductive health and rights.

Along with testing, Jumo said the sex workers were also given free condoms in the night tents, another incentive for those at risk of infection from unprotected sex to stop by.

NOBODY IS SAFE

But the perceived protection that comes with testing under darkness has drawn in less likely clients, too.

The Ministry of Health and Child Care said 17,000 teenagers had signed up for night tests at posts around the country.

The results make for grim reading.

The ministry said 37 percent of teens tested at night were found to be HIV-positive; all were given anti-retroviral treatment to slow the growth of the virus.

Teens are worse hit for two distinct reasons, experts say.

"Owing to the failing economy, many teenage girls are into sex work and they often have unprotected sex with much older clients, who have HIV, while other teens are also born infected with the disease," said Heather Mutambu, an HIV/AIDS counselling official based at a private clinic in Harare.

Gays and lesbians, marginalised minorities that face deep prejudice, are also taking advantage of the night testing.

"First came self-testing for HIV, which also became the way to go for sexual minorities to discover their HIV status; now in, is night testing for the disease, which gives sexual minorities another way to get to know their status despite the laws here that criminalise gay relations," said Edward Hombarume of GALZ, an LGBTI rights organisation.

For GALZ director Chesterfield Samba, the moonlight tents must be actively promoted if the disease is ever to be defeated.

"Night testing - as one of the approaches to reaching communities - needs to be promoted as one of a comprehensive package of services," Samba told the Thomson Reuters Foundation. "We need to tackle stigma associated with HIV ... to dispel myths about HIV transmission and treatment."

(Editing by Lyndsay Griffiths. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's rights, trafficking, property rights, climate change and resilience. Visit news.trust.org to see more stories.)

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