For nine-months, 27-year-old Lydia Kamati was knowingly in a relationship with an HIV-positive man. She knew about his HIV-positive status long before they formally started courting.
“I knew him before we even got into the relationship. I knew his HIV-status. However, when he asked me to be his partner he also disclosed his status to me,” said Kamati.
Although she and the man are no longer romantically involved, Kamati says she fell in love with his personality. “One doesn’t date someone because of his or her HIV-status,” she said as she laughed when asked what attracted her to her former lover who is HIV-positive and considering the stigma still attached to HIV.
She also highlighted that they did not part ways because of his HIV-positive status, but rather due to “personal” reasons.
Kamati, who has worked as a counselor and HIV-tester, says she knew exactly what she was getting into when she agreed last year to be romantically involved with an HIV-positive man.
Being in a discordant relationship – where one partner is HIV-positive and the other partner is not, meant they had to use protection every time they engaged in sexual intimacy. “There was a time the condom burst,” she says.
Being fairly knowledgeable on the subject of HIV/AIDS Kamati and her partner knew exactly what to do when the condom burst. They rushed to a health facility to get the Post-exposure prophylaxis, an emergency HIV-treatment known as Pep.
Pep is not a cure for HIV; rather it is a form of HIV-prevention. It is a short course of antiretroviral (ARVs) drugs that stop exposure to HIV from becoming a life-long infection and should be taken within 72 hours of exposure to the virus.
Kamati explained that the treatment was not easy for her, as she was required to take the tablets for 36 days. She experienced side-effects, which included dizziness, diarrhea and nausea.
In addition, at the time of the exposure her partner’s viral load was undetectable, which further minimised her chances of acquiring the virus – for which there is no known cure.
Although, the couple was tested when they agreed to be in a relationship, it was crucial for them to get tested again after the incident with the condom burst. Luckily, her result was still HIV- negative.
Kamati emphasises the importance of both partners knowing their HIV-status when agreeing to a romantic relationship.
In a country where the HIV/AIDS infection rate is relatively high, with a prevalence rate of 16.9 among pregnant women, according to the 2014 sentinel survey, Kamati feels strongly about regular testing for HIV. She also stresses on the importance of disclosure between partners.
“It’s very important that couples get tested first, otherwise you’ll just keep going for PEP. One should also not take the risk of being romantically involved with a person whose status they do not know, because there are side effects to taking the drugs, should they decide to go for PEP,” Kamati explained.
She says initially PEP was meant for rape victims and health professionals in case of an emergency, such as a needle prick.
Dr Tafadzwa Chakare, a medical practitioner specialising in the treatment of HIV, explained that ARVs (antiretroviral drugs) may cause nausea, vomiting and poor appetite during the first few days.
“PEP is supposed to be taken for four weeks following HIV-exposure, but some people have stopped taking the medication, because of these side-effects. Other side effects are less common and depend on the particular medicine used,” Chakare explained.
Kamati feels that more awareness should be created on PEP, as not many people know about it or where to access it should they be exposed to HIV.
“Some people know about PEP, but they don’t know if they can use it. It’s very important that it’s out there. We have a lot of discordant couples and if they have that information it may save the negative person’s life,” said Kamati.
Meanwhile, Chakare also said PEP is not a routine method of HIV-prevention. “It is a method to be used after accidental exposure,” he told New Era. PEP is not a widely applied method for HIV-prevention in Namibia, added Chakare.
More emphasis is placed on methods such as abstinence, being faithful, using condoms and medical male circumcision. PEP works by attacking and killing HIV early, before the infection has a chance to multiply and establish itself permanently in the body, Chakare emphasised.
He also confirmed that PEP may be used by an HIV-negative person, who has been accidently exposed to the virus. “It may be used more than once, but frequent use suggests a risky lifestyle and such individuals would benefit better from PEP (Pre-Exposure Prophylaxis), Chakare explained.
He said PEP is designed for high-risk individuals with frequent HIV-exposure and the individual is asked to take a daily pill for as long as the elevated risk is present. “It may even be lifelong, but this is a relatively new intervention and is yet to be rolled out in Namibia,” Chakare explained.
PEP is available at all State hospitals, health centres and clinics that offer HIV-treatment, said Chakare. However, it is not offered after hours, because State facilities that offer ARVs operate only during regular working hours, he added.
Asked how effective PEP is, Chakare said he is not aware of any hard data on this, but it is widely accepted that PEP is not 100 percent effective.
“Some people have been infected with HIV after taking it,” said Chakare, explaining that any intervention has a failure rate, despite its known successes.