In Kenya, the fight against HIV-AIDS has developed a strong new weapon: State run and private health clinics have begun offering voluntary counseling and testing.
VCT centers, as they are known, serve two key purposes: to test a person's blood for the HIV virus; then educate that person on the virus and how to stop its spread.
The United Nations has backed VCT centers in the global fight against the virus and is calling on member countries to expand access to testing services by 2005. Uganda, for example, has already proven VCT centers a successful part of its national AIDS program. President Bush and others have praised the program for reversing the spread of the epidemic in Uganda.
So far, nearly 150 VCT clinics have been created in Kenya at government hospitals and independent sites. Many more are on the way.
Dr. Miriam Taegtmeyer is the director of Liverpool VCT and Care in Kenya, a nonprofit group that is helping the Kenyan government to open more VCT clinics across the nation:
“The government of Kenya is, I think, completely unique in its commitment to VCT scale-up, because they've said they want to open up 350 sites in the next two years - five in each of 70 districts - so that there will be equitable access to VCT services. And I don't think any other country in the world has made that kind of commitment through its government health centers.”
This strong commitment, in part, has been possible through the use of rapid HIV tests. Kits like "Determine" from the U.S. laboratory Abbott take a few drops of blood from a finger prick and yield a result within 15 minutes. Ireland's Trinity Biotech makes a similar test called "Uni-gold." Dr. Taegtmeyer says the rapid tests have made Kenya's clinics much more effective. She says with traditional tests - which took several days to reach a result - less than half the people returned to the clinic to learn of their HIV status. Now, about 99% of people taking the test get their results.
Kenya has been among the countries hardest hit by the HIV epidemic. About 2.5 million Kenyans are living with the virus. The United Nations last year reported the virus has infected about 15 % of Kenyan adults, more than twice as high as in neighboring Uganda and Tanzania. Experts say prevention efforts like VCT services can cut the rate of infections and prevent the crisis from developing as it has in some South African countries where HIV has infected more than 20 % of adults.
Of course, the fear facing anyone who gets tested for HIV-AIDS is testing positive for the virus. Dr. Taegtmeyer, however, says the news doesn't mean a person should stop living a full life: “Rather it should open one's eyes to the many ways people are coping with HIV-AIDS and, in some cases, seeking treatment to prevent the illness from taking over. The benefits of a positive result are starting to get in the public mind, I think. It's good to know that I'm positive early enough so that I can take care of myself.”
Quick results can be especially important for pregnant mothers, who can then take steps to avoid passing on the virus to their children. Some private clinics are offering medical attention and a short-course of drug treatment which have proven to increase the chance a baby will be born HIV-free.
Still, the majority of people who come to VCT clinics test negative for HIV - confirming something they may have already believed. But the experience doesn't stop with the test. Counselors at VCT sites can provide a wealth of information on how to maintain a person's health.
“By pulling them into voluntary counseling and testing sites, they're able to have access to accurate information on HIV,” says Peter Mwarogo, Deputy Director at the IMPACT project, which has been helping to promote the use of VCT clinics through Kenya's media.
The project is a joint effort between the United States Agency for International Development and the nonprofit health organization Family Health International. Mr. Mwarogo says they have run a variety of messages on billboards, television and radio in the past year to help people understand more about the HIV virus and why they should get tested for it. He says a key goal of the program is to overcome people's stigma and fear, and he says the most effective way is through education and reliable information.
Mr. Mwarogo points to the success of a recent campaign targeting Kenyan youth, which showed teens that getting an HIV test is a normal thing to do: “The next campaign we're having is going to encourage people to go to VCT as couples, particularly young couples. As they're making their lifetime decision, dating, getting married, it's wise for them to go as couples for voluntary counseling and testing.” Campaigns like these have helped educate thousands of Kenyans on ways to control the spread of HIV and AIDS. In fact, they have generated so much interest in some areas that state-run hospitals are unable to keep up with the flood of patients seeking to be tested.
The interest is welcome news to the government, however, as it continues its plans to double the number of VCT sites in coming years. That comes in addition to non-governmental organizations, or NGO's, that are opening private testing clinics across the nation.
But, Dr. Taegtmeyer of Liverpool VCT and Care warns that all the attention could ironically threaten the success of the VCT program: “The mass media campaign has made VCT a fashion a trendy thing, and every private practitioner, and NGO, and small community based organization wants to open a site. And not all of them are registered. So the national AIDS control program is struggling to catch up with all the sites that call themselves VCT sites, and making sure that they're reaching the minimum national standard.”
Dr. Taegtmeyer says the government has implemented effective quality control measures to ensure that HIV tests are accurate. But patients in some areas have complained that counseling services have failed to meet their needs for information. And the need to train new counselors for the dozens of clinics scheduled to open in the future presents a major challenge to the program.
A strong boost may come from the United States, which has promised $15 billion to help African and Caribbean countries fight HIV-AIDS. During his July trip to Africa, President Bush reaffirmed his stated commitment to AIDS relief, which includes plans to fund VCT projects and other initiatives aimed at preventing millions of new infections.
More than anything else, the long-term success of Kenya's fight against AIDS will depend on the Kenyan people and their personal commitment to awareness. Programs like the VCT clinics are providing vital information on preventing infection and caring for those already infected.
However, AIDS remains an incurable disease and treatments are expensive and difficult to obtain. The best way to combat HIV-AIDS is by preventing infection and while this message may be simple, prevention still remains a complicated process, and requires exercising a lifetime of awareness. The lives of millions of Kenyan people are surely worth the effort.