DESIRE FOR CHILDREN CONTRIBUTES TO HIV INFECTIONS
BY MAURICE ALAL ( Kisumu Kenya)

The desire to have children could be fuelling the spread of of HIV in marriages in Gwassi Division, Suba district of Nyanza region,health expert warn.

They note that the persistent cultural perception held by many communities in Kenya especially Nyanza who see children as the epitome of a successful and fulfilling factor to spread of the deadly virus among couples who could otherwise have been discordant.

Medaically speaking,discordant couples are those living together as a husbands and wife or sexual partners who whereas one is free from HIV,the other party in the relationship is infected with the lot who are more prone to infection if having children is their biggest desire.

Medics are of the view that whereas there was nothing wrong in couples wanting children, if became a health concern when the desire pushes them- including those who would otherwise have been discordant to engage in unprotected sexual activities.

As such, they say, the possibility of the negative partner getting vinfected at some point is high.The Nyanza Provincial Aids and STIs Control Coordinator Dr Charles Okal says provinding services for the discordant couples is curtailed by the fact testing is the only suret way to find them,yet couples rarely turn up for testing together.

“We are constantly passing the message forward that couples should get tested together so that those who are discordant can be singled out and ways to stop the infection of the negative partner put in place,” he says.

Dr Okal observes that many marriages continue to be at risks because people do not know their partner’s status, added to the fact that it is in such institutions where the use of condoms as an HIV preventive measure is at its lowest.

“Even those partner who already know their status would rather resort to keeping mum about iot becausebthey do not know how other partner will react on kwowing their sero-positive status,” he says.

An estimated 6% of couples in the country that is about 344,000 are HIV discordant while a further 22% of couples know their sexual partners HIV status.
According to the Kenya AIDS indicator survey of 2007, 45% of all new HIV infections occur in marriages.

The survey astated that the fear of disclosure of the status remained a major problem in the war against the disease.The recent study shows that more couples in sexual relationships across Nyanza are turning out discordant to HIV tests.

The research which has been conducted by the Kenya Medical bResearch Institute and the America’s Centre for Disease and Control (KEMRI/CDC) in Kisumu since November 2009 has shown that over the last three years, there has been an increase in such cases in the region.

This is the group the study has concentrated on in Nyanza for the purposes of research trials.The findings show that among these discordant couples who have already been infected but have their CD4 count at 350 and above if put to ARVs at the initial stage can greately help reduce chances of their spouses contracting the virus by the said percentage.

KEMRI/CDC study cordinator for the project Arthur Ogendo says the study findings are indeed a breakthrough in the fight against HIV and AIDS in Nyanza region.

“These study findings are exciting because tthey prove that HIV infections can be managed by prevention. We now know that this is true for the discordant couple. Our next step should be on how to explore this within the local communities across Nyanza,”Ogendo says.

The medics says the study findings will be shared with the World Health Organization (WHO) so as to make a policy on HIV that can be shared by a number of nations worldwide.

However, Dr Victor Akelo, medical Officer for the study notes that whereas findings were impressive, its important that the couples exercused care so as not to infect the other even if they are not on treatment.

“The best preventions is to use all the available prevention tools and I recommend that all get testyed, if found to be negative then get linked to care and treatment services,” Dr Akelo says.

The results of the trilas which was also conducted in other 12 countries is the first one from a randomized clinical trial to show that testing HIV infected persons can greately help in reducing vthe risks of sexual transmission of the virus to vtheir uninfecvted partners.

The study known as HIV prevention Trials study began in Botswana,India,South Africa,Brazil,Thailand and unikted states in 2005. In Kenya it started in 2009 with some 1,763 discordant couples.

The Kenya AIDS strategic plan of 2009 to 2013 shows that the higher levels of HIV testing among women are 43% as compared to men which is only 25%.This attribute to testing of the pregnant women who visists clinics for the Ante Natal services where HIV testing is crucil for the prevention of mother to child transmission.

The up take of the prevention of the mother to child transmission programs at the hospitals for expectant women is also said tpo have contributed to high rate of HIV testing among women in marriage.
END