How would you react if you discovered your doctor or nurse is HIV positive?

Today we celebrate the 32nd World AIDS Day in the most ironic manner, in the middle of another pandemic!

Despite both pandemics causing wanton destruction of lives, there are marked disparities between them. The current Covid-19 pandemic did not give us time. It has swept through the entire world like a typhoon, leaving destruction in its wake. Whereas HIV infection may give patients years before claiming their lives, Covid-19 takes days.

Health Workers

The high transmissibility of Covid-19 puts our healthcare workers in the direct line of fire in their efforts to save lives. In July 2020, The Lancet (www.thelancet.com) published a study showing that health care workers were at least three times more likely to contract Covid-19 than the general population. In Kenya, we have lost dozens of health workers while hundreds are in various stages of dealing with the infection.

Amid the bleakness, I choose to focus on hope, embodied in the theme for this year, “Ending the HIV/AIDS Epidemic: Resilience and Impact”. To me the message speaks to a special category of HIV positive people rocking the world in their little spaces. These are our HIV-positive healthcare workers.

Carren* is one such person. She is bubbly and full of life and she could easily fool you into thinking that she has absolutely no worries in this world. This is further enhanced by the fact that she spends her days working with children who desperately need her skills for their future.

Confinement

Yet despite finding so much joy and fulfillment in her work, Carren is forced to face up to the fact that she lives part of her life in almost solitary confinement. For many years, Carren has known that she is HIV positive, having been tested during a routine wellness check. She has moved past the surprise of it all but she still lives with the acute isolation of the disease.

We have invested enormously in trying to eliminate HIV stigma but Carren’s story paints a totally different picture. As a doctor, I have the unenviable task of encouraging my patients to disclose their status to their loved ones as one of the ways of dealing with the news. It is even more important in the obstetric setting where the diagnosis clouds the otherwise exciting news of a baby on the way.

Carren is in the business of caring for the sick. Her loved ones would never imagine she could be in need of care herself. She can only share about her condition with her husband because she must protect him but not her mother or sister with whom she shares everything else.

It is tough for Carren to not be able to seek medical care at her place of work because of the need to maintain her own confidentiality. The journey to finding a colleague to care for her, with whom she feels safe, is not easy. A hospital admission means any number of nurses could know about her status and spread it along the professional grapevine, leaving her feeling even more vulnerable.

Medical Care

Carren fully understands why colleagues will travel for miles, seeking medical care for their own peace of mind or those who will not allow any other doctor to touch them until their personal doctor arrives. As mothers, their parenting journey is even harder as they strive to ensure their babies are protected alongside their confidentiality. These moms are tough as nails!

I cringe every time I hear conversations among women regarding the HIV status of their nannies. How they will readily fire their domestic managers in the event they turned out to be HIV positive. I ask myself how many of these women would agree to HIV testing by their employers as a pre-requisite for employment. Yet every single time they are in the employer pedestal, they throw the rights of HIV positive people out of the window.

The existence of our HIV positive persons in the society is still riddled with unacceptably high levels of stigma. Despite this barrier, healthcare workers like Carren continues to abide by their oath and serve with dedication and empathy. They surmount the stigma to provide impartial care to their patients while always being mindful of how important it is to protect them from themselves. If this isn’t love for humanity, I do not know what is!

Yet, despite this level of dedication, they live every single day wondering how their own patients would react to the knowledge that their care provider is HIV positive. Carren is under no illusion that she will be readily accepted by her patients, should they know of her status. It is the embodiment of how deeply rooted the stigma runs.

As we close the decade, could we make it count? Let us genuinely bring an end to HIV stigma.

Dr Bosire is Obstetrician gynecologist