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Women with HIV in Cameroon still stigmatised
By Liza Fabbian
Yaounde (AFP) July 24, 2017

Love hotels targeted to fight HIV among Cameroon's teens
Guider, Cameroon (AFP) July 25, 2017 - The two big maps show the districts of the northern Cameroonian town of Guider along with its brothels, nightclubs and other seedy spots to identify places from where AIDS could spread among adolescents.

Cameroon, a country of 23 million that hugs Africa's Gulf of Guinea, has one of the highest HIV/AIDS prevalence rates in the world.

"The maps highlight the high-risk zones for transmission," said Boris Mbaho Tchaptchet, 21, speaking at a local youth club.

"We located the love hotels, the video clubs, the cabarets, the underground meeting places before putting into place an action and prevention plan in our community," he said.

The club in Guider was one of those selected for the "All In! End Aids among Adolescents" project launched in August 2015 with the backing of the UN children's agency UNICEF.

According to official figures, 79,771 children and adolescents are HIV-positive, but experts say it is much higher.

"This platform brings together all the interventions fighting HIV in the country targeting young people," said Jules Ngwa Edielle, who runs the HIV prevention in Cameroon's youth and civic education ministry.

It ropes in local administrative, political and religious authorities to fight the disease.

- 'You think I'm sick? -

With his colleagues, 21-year-old Bouba Saliou was trained as a peer-group educator in his neighbourhood.

"My role is to talk with other young people, ask them questions to understand their situation and to encourage them to get tested," he explained.

But broaching the delicate issue is not without its pitfalls.

"Some people react saying, 'You think I'm sick? Have you ever seen me having sexual relations?'

"Other simply refuse, saying that they are confident about their status. But I try to convince anyway," he added with smile.

Saliou cites the case of a 17-year-old who found out he was HIV-positive because of his intervention.

"He was very angry at me when he got the results," he recalled. "But today we talk regularly and he tells he is following his treatment regularly."

This community-based approach is essential if Cameroon is to attain the 90-90-90 target set by the UNAIDS, which Cameroon signed up to back in 2015.

The aim is to get to the point where 90 percent of those who are HIV-positive know about their condition; where 90 percent of those who know are on retroviral treatment; and where 90 percent of those receiving that treatment achieve viral suppression.

The hope is to be able to wipe out the virus by 2030.

Therese Nduwimana, who runs UNICEF Cameroon's HIV unit, said the programme had proved its worth in the north of the country with the No Limit for Women Project (Nolfowop).

"With a budget of just $40,000 a year the results have been spectacular," she said.

"In just months, the number of HIV-positive children identified has been multiplied by four," she said.

However, one of the problems is an acute shortage of medical staff. The hospital in Garoua, which serves an area with 2.7 million people, only has one paediatrist and one gynaecologist.

- Door-to-door campaigns -

A group of around 30 women were gathered at one of the town's health centres, waiting to be tested about their HIV status. The result is announced almost immediately.

"Our volunteers have gone door to door to encourage every pregnant woman to get tested," said Odette Etame, who heads the Nolfowop project.

Other mothers acting as mentors then made home visits to physically accompany HIV-positive women and their children for anti-retroviral treatment, she added.

This was one way to reach people who would other wise be lost from view, she said.

Blandine, a 28-year-old mother of a baby girl, sits restlessly on a chair in a women's health centre in Cameroon's capital, not knowing how or what to feel as she waits for an HIV test.

Blandine is HIV positive.

But the waiting is not for her -- it is to find out whether her one-year-old girl also has the human immunodeficiency virus.

A few minutes later, she has her answer.

"I am so relieved," Blandine said upon learning that her baby's blood tests came back negative for HIV. "I feel like I've won a battle with my child, a battle I was unable to win for myself."

In Cameroon, more women are living with HIV than any other group, and they are also more stigmatised than their male counterparts.

Blandine, a teacher, was willing to share her story but preferred to use an alias to protect her identity and her family, including her husband, who has public responsibilities.

"I have a life to build," she said.

"There is progress but we cannot say that the stigma has disappeared. When you have a certain role in society, you have to defend your husband and your in-laws.

"You have to protect your children."

Blandine discovered she was HIV positive nearly two years ago, after a long illness. Her husband was the one who broke the bad news to her, as she was too weak to speak to the doctor herself.

She is still not sure how she came to contract the virus. Her husband, like their daughter, does not have it.

"It is really due to my husband's love that I was able to live through that situation," she said.

Blandine said many HIV positive women are rejected by their husbands and families and then isolated from society as a whole.

"Some women don't even dare talk about their status for fear of being abandoned," she said. "They deal with it on their own, without even opening up to their husbands."

- 'Afraid' of sex -

Serodiscordant couples -- where one partner is HIV positive -- face an extra set of hurdles in a relationship, especially as it relates to personal hygiene and sexual relations.

For Blandine and her husband, adjusting to her status meant regular visits to health professionals and a sex education course at the hospital.

"When you get the results, it's not obvious you can go back to a normal sex life," she said. "You are always afraid at the beginning."

At the hospital, the couple was taught the best way to continue having safe sex, but the most important thing was to remain faithful to each other.

"Fidelity is essential, for him but also for me, because we don't know the (HIV) status of people outside our relationship".

Blandine, whose HIV positive status is "nearly undetectable" because of her continued treatment, never thought she would be able to live such a happy, normal life -- with healthy children.

"I was always told that I could be a mother like any other, in spite of the HIV, and I am now just understanding that it is not a dream," she said.

"You can give birth to your child and breastfeed them like the other children. I am really happy."

As soon as she was born, Blandine's daughter benefited from immediate HIV treatment, and her first test at six weeks showed she had no HIV antibodies.

The baby will have to undergo her final test when she turns 18 months.

- 'We see progress' -

In the cheerful waiting room of the women's health centre of the Chantal Biya Foundation, Blandine sits surrounded by other HIV positive mothers and their babies.

Cameroon, a country of 23 million that hugs Africa's Gulf of Guinea, had a 5.75-percent HIV prevalence rate for pregnant women in 2016, making it one of the 10 countries responsible for 75 percent of new paediatric infections worldwide.

"We see progress in the prevention of the transmission (of HIV) from mother to child," said Therese Nduwimana, director of the HIV and AIDS section at the UN's children agency, UNICEF, in Cameroon.

In its efforts to lower the prevalence rate, the country has launched programmes where pregnant women can get tested for HIV during prenatal visits.

According to Nduwimana, "79 percent of those who find out they are positive are immediately started on treatment" and their children also receive treatment as soon as they are born.

Still, 17 percent of pregnant women skip their prenatal visits and about 12 percent refuse the test.

Cameroon has also invested in rapid HIV testing, which delivers results within the hour as opposed to a month.

When Blandine first tested her daughter at six months, the month of waiting was not easy.

"For weeks, you have a feeling of guilt, you cannot stop thinking that maybe you've passed a virus to your child that they'll have to fight for the rest of their lives."

In her work as a teacher, Blandine has been able to advise younger women living with HIV, without revealing her status.

But she hopes one day to be able to live openly with HIV.

Headway on AIDS threatened by funding slowdown
Paris (AFP) July 23, 2017
Progress in beating back the AIDS epidemic risks being eroded by a funding shortfall set to grow under Donald Trump's proposed cuts to global health projects, experts and campaigners warned ahead of a major HIV conference. If adopted by Congress, the 2018 Trump budget could deprive some 830,000 people, mostly in Africa, from life-saving anti-AIDS drugs, according to calculations by the Kaise ... read more

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