 Mwadi maatwa kipini kwa iISWI in the morning my name is Ram Magukou yiferoju just joining us we're just in time for the next conversation of the day and it's all about HIV testing and counseling as you can see at the bottom of your screen there wana tha mitsa miskonseption wana tha mitsa miskonseption do you remember when HIV came in a play the stigmatization the fear the panic all that Do they still exist? Is HIV still a problem? Is it an issue in the society? How far are we in regards to preventing HIV in the society, and even to the point of trying to minimize its effect being felt on the ground? What are the myths and misconceptions about HIV counselors? Do you feel like you can trust that when you go for counseling, confidentiality is going to be maintained? Well, this morning, we shall talk about this and much more. I am joined by Albert Mwangi. He is a counseling psychologist who serves as a counselor at HIV test services. That is HTS, Karibusana. Thank you for finding time to join. How do you feel this morning? Feel so good. Remember to be part of this conversation. The hashtag as always is why in the morning at Ram Aguko, at Y254Channel is where you can find us, and at Michelle Ashera. Head over to Facebook and drop in your comments there. Head over to Twitter. Drop in your comments. Remember we are live also on our website at www.kbc.co.ke4slashy254. Let's keep the conversation going. Keep texting and keep tweeting. And also tell us where you're watching us from. Tell us how have you ever been stigmatized in regards to HIV? So, Wana Mwangi, Before we delve deep into the conversation, you are from HTS, which is HIV testing services. Let's first of all find out what is HTS all about? HTS means HIV testing services provider. It's a head worker who has been trained on testing HIV, and not only testing HIV but also counseling. The reason is, HIV when it came to be, it came without a stigma, because people were introduced to HIV with a lot of fear. Yes. And they also got a lot of fear going to the hospital. Why? Because HIV was introduced as a curse. It was seen as a death sentence. Yes, as a curse, death sentence, and also as something that is brought by sexual immorality. So if you have someone who has HIV, you would only conclude that it is connected to? Sexual immorality. Which is not the case? It's not the case. So, and this is the reason when the NASCOP came up with the idea of having people who are separate from the doctors and nurses who are called HIV testing services providers, so that they become independent. HIV disease has been treated independent from other diseases because of the stigma, the way it was brought. I remember when it came back in 1980s, it was given a lot of names, nicknames. In the central Kenya it was called Mukiigo. You know Mukiigo is somebody that has lost his weight, so that the neck becomes tall. You see how HIV was retaged to? It's a disease that can never be cured. You get that disease, you are cursed, you are rejected. It's because of the way the immune system works in the body back in the day. You would lose your weight. You would feel wasted. You get other diseases. HIV makes your body to be weak. It destroys your immune system. Your immune system is the one that fights the soldiers in your body. It's like when our KDF is no longer existing, you can imagine how the country would be. The rate of stigmatization currently in 2021, today, is it the same as it was back then? No, currently it's the same because of these people we are calling the providers, HIV providers. They are teaching people and trying to tell them HIV is not a dead sentence. It's a disease, it's a virus that you can live with. It's a virus that you can live with. It's not the way it was brought. Even the adjuvats that were made during those 1980s and 1990s, they were deadly adjuvats that is a deadly disease. Currently we are not having those diseases. Somebody you could advertise even through the radio, you are saying can you aboard a vehicle that is going to have an accident, no angry? You cannot. Knowing that you will get an accident. You cannot. So they were saying how can you have sex with somebody without the preventive measures. It was not taught in a way that is friendly to make people understand but they induce the fear. Even though the stigmatization is not the same even though the rate is not similar, is it still there? Is stigmatization still existing? It is still there. The stigmatization is still there because these things stigmatize stigmatization is the good response toward shame and disgrace that is brought by doing things that are relevant or good in the society. So stigmatization comes from the society that somebody has acquired HIV why? Because he was immoral. That's why the stigma comes in and that's why confidentiality when our patient comes to us we attain high levels of confidentiality because this patient whenever a patient gets what he does is to ask the patient whom we do like to disclose your status. Now let's talk about that because yes you've said that the rate of stigmatization nowadays is a bit lower but still there. It's still there because nowadays someone is looking healthy but is HIV positive. So we need to dispense of that particular myth but now clarify this what is the importance now of HIV testing and cancelling? Yes for treatment and prevention of HIV testing treatment and prevention testing is very important. We say that testing is the gate of prevention and curing of HIV because you can never cure HIV or treat HIV without knowing that you are HIV positive and you can be healthy for a long time without knowing that you are HIV positive for months and you are spreading the disease. So it is very important to go and be tested so that you help the community because when you realize you are positive you will be given the measures on how to use the drugs because the drugs are there giving you viral roads zero to zero in the sense that it is not the rate of infection will go down you will not be able to infect others when your viral road is low the rate of infection is also low so when somebody takes drugs the rate of infection is low so when testing is very important so that you know your status then you might be positive a husband might be positive and the wife is negative to live together with a positive husband or a positive wife because we have this we have the drugs that are going to prevent infection but there is one more important thing that unless you are tested and the most thing that people fear being tested is because of the stigma they don't want to know their status because they associate HIV with the death sentence so it is better to live without knowing to know and die this is not the case because some believe that if I go for HIV testing and I am found to be positive they will contemplate suicide some they do that some they think of that and in fact during the testing there are procedures that we do for there is pre-tests cancelling where the package for the client you assess the client your patient does he know more about HIV so pre-test is before testing you carry out your client very well in this cancelling so how do you go through it the first thing you understand does the client understand about HIV how does he take HIV to be you assess the stigma you assess the stigma but they believe they believe that he has about HIV then from there you understand the client does the client in any point had unprotected his ex how are you establishing how they made contracts HIV so you must ask the mother assessing the risk factors that the client had gone through so if someone is asked that question he does not mean that they should feel like their privacy has been infringed you will frame it in a very bright way in a way that he will not feel that he has been attacked in an only judgment way sometimes you ask somebody in a way have you ever you can't do that you use your that is too direct you get the procedures where get your language because the moment you don't get your language at the beginning you don't create a rapport with your client so the client will broke you and even if you are going to test that client he will go unbaked so that is pretesting any other thing that you do you establish the risk factors then there is another thing that nowadays we call it apns apns means assisted partner notification assisted partner notification is whereby this client you try to probe more of his sexual partners his friends so that in case this partner this client is going to be positive you are going to get the other partners on board through the consent of your client so he gives you the the consent ya i can give you the names or the client himself can go and contact his friends until the friends how he has found his status so that they can come to the facility for testing if the client wants to be positive why you saying friends friends because you may not be having one partner one partner multiple sexual partners yes you may be having many we are trying to break the cycle of infection we break the cycle of infection you remember sometimes back when somebody was found by a doctor having STI you want to be treated unless you bring your partner so that the partner on board you are both treated alright now that is pretesting pretesting when there is pre there has to be post so what is post testing post testing after testing now after taking the sample of the brada you put it for 15 minutes for 15 minutes before you get you give the results so during this time post testing is now the time you are preparing the client to receive the results because the result of HIV testing the client himself should lead for himself you advise or you teach the clients how to interpret the results pretesting I did not tell you that you teach how to interpret the results then after getting the results then you take the the client or the patient to lead his only results then he tells you the result then you assess the response of the results by observing the client you see the response if the response comes to be positive so this is the whole process of cancelling you see the response how does it respond to these results if the results is positive obvious it is very normal for the patient to respond without offshock now we have had cases of wrong test results being administered and it has caused a lot of problems in the past for so many people people have made even bad decisions after getting wrong results how should you know all of the measures that are done or how should we ensure that we have correct test results yes during the sample correcting that's where some cancer goes AY you correct the correct sample it is two drops of blood because you have a capillary that measures amounts and the quality you need for the blood then there is the buffer that you determine then after using these items you have to wait for 15 minutes before you read the results sometime some cancer don't wait for 15 minutes to read results because maybe the queue is wrong I want to clear the queue I want to clear the queue no give the quality service that's what I can tell my fellow cancerers outside there give the quality service even if you are going to test 3 people for a day and you give the correct results that's the best then giving a lot of people and give the wrong results because we have had cases where somebody have been taking drugs for a long time and he was negative I feel I've seen such cases and I really felt for them all that money spent all that time spent and the stigmatization and the idea that I'm having a terminal disease that will never be cured and this is an error made by the cancerer now you've said they should correct they should collect the correct sample and what about the person who is going to be given to be taking the test should they seek a second opinion once you've acquired results from a particular source from a cancerer is it advisable that you get a second opinion from a different cancerer absolutely yes and that's what happens suppose it's alba to have tested and I have found kamao or jaraga is positive I'll give the results then I'll call the second cancerer to come and repeat exact what I have done a different test and not using my items the determine and the buffer he is going to use his own because I'll come to tell you about that so that he is going to confirm that everything is true positive after also using the determine there is another confirmatory test that's done using first response then it is done first response will tell you this type of HIV is HIV1 or HIV type 2 because it is very responsive it gives specific but the determine is we call it it is reactive so the different apparatus for HIV testing 2 different wants to confirm and wants to specify because of the interest of time I want us to wrap this conversation up but before we do let's talk about the cancerers themselves because now that you mentioned that sometimes some cancerers want to just hurry things up to just maybe because there is a long queue to ensure that he reduces on the time spent delivering services maybe they want to just go home maybe they just want to head over for lunch or that particular plan that they had set for themselves what are the qualities of a good cancerer that clients should be looking out for Yes, number one the good cancer should be one who has confidentiality confidentiality is number one Yes when you come to the facility everybody should have confidence in you that whatever you are going to discuss with your client the result of your client are not going to be disclosed to anyone else without permission client it is a client who should permit the disclosure of his so a good cancer should not disclose any of those number two maybe just a few more the other thing should be honest the honest is very important that all the the algorithm that you are given by the NASCOP do that work you should follow it be honest let the test learn for 15 minutes as it is curated by the law then let everything be done according to the procedures we have the procedures that are done let not do things on a hurry take your time take your time then the other thing for a good proper documentation of what you have done because that is the one that is going to rescue you after anything the documentation of your work should be clean because of time we will not mention all of them but I want you to have a final word talk to Kenyans there about HIV testing and cancer what should be our take home that thing that we feel like that youth that Kenyan who is watching you ought not to forget number one HIV is not a dead sentence that is number one that Kenyans should understand number two no one should stigmatize you or discriminate you because of your status let embrace those people outside there who are HIV positive and those people who are HIV positive it's a high time not to keep on hiding because the more you hide them let people know that you are HIV positive and try to educate others so that they come on board so that everybody is going to see that HIV is not a big deal it's now with some medication that is making you healthy and helping you move on your life because many people are now surviving on drugs and they are doing well because of their virus operation has been brought down but sometimes we fear the fear is the greatest enemy so let's not fear don't fear walk in that facility that is near you go there then the last thing to the youth and this practical to the youth let abstain from sexual from all sexual activities and if you are going to have sex have a sex by using condoms or preventive measures so that you don't have this disease spreading because if you look at our statistics currently the youth are the one who are reading they are the one who are at a high peak now with HIV and we want by 2030 to have zero infection of HIV but if you are not going to use preventive measures and you are not coming up in numbers to be tested then we are not going to achieve our targets we want to have zero infection the way you have kicked out we are going to kick out HIV wonderful that is Albert Mwangi counselling psychologist counsellor at the HIV test services that is HTS Wara Mwangi Nashi Kudusana thank you for finding time to talk to the youths about HIV testing it is quite informative and to the youth outside there prevention is better than cure youth cannot lead in infecting it is not good I am not happy with that thanks before marriage to prevent but remember there are also many other ways that you can get HIV that was to the end of this conversation on this particular Tuesday morning but we still have more coming up in the bid keep it while in the morning this is why 2-5-4 thank you very much for being part of this conversation