 Good morning. Welcome back to the why in the morning show. This is a Y254 channel. My name is Joy Mochache You can find me on Joy underscore Mochache only on Twitter But when you want to interact with this channel when you want to talk to us when you want to ask questions about this health show You can do so on Facebook and Twitter. That is Y254 channel on Instagram You can find us on Y254 underscore channel. Do remember that you can watch us. I repeat a 2 p.m That is on channel dstv 376 and today we're discussing a very important topic on health on Monday and Actually, I forgot to mention if you do want to discuss with us remember its hashtag health on Monday and hashtag why in the morning? And let me introduce our guest. We're discussing a very important topic today HIV-AIDS and we've been hearing the word being thrown around but today we have a specialist He's actually in the infectious diseases control sector So if there's someone who knows everything about this it is a man that we have on set today allow me to introduce Dr. Leon Ogotti Karibu Sanna Yes, Karibu Dr. Gotty Yes, yeah, I work in infectious diseases and I have also trained in infectious diseases. Okay. Yeah, okay What do people in infectious disease do exactly just briefly? people in infectious disease I Think the most interesting part is when you see Ebola in Congo and all these people running around those are infectious disease people but generally infectious disease people treats Every kind of disease that is contagious. I mean that can be passed from me to you so anything think of the flu think of Malaria think of HIV think of TB Anything any infection that's caused by something from outside to in that goes into your body Yeah, that's what infectious disease. So that's what you focus on a day-to-day basis. Okay, and today we're discussing in particular HIV AIDS and you know, we are on a youth channel. This is why 254 and you know, most of the time We'd like to angle our discussion into something or you can understand. So let's just jump right in let's start first of all by Maybe letting our youth know made those who don't know when it comes to HIV AIDS What is this virus exactly very briefly and what does it mean for somebody who may carry it? so HIV as you said is a virus and Having HIV means you've been infected by the virus. That's it. It doesn't mean anything else Doesn't mean you're sick. It just means you have the virus inside you with HIV has proven to be very difficult because of the rate at which it multiplies It multiplies very fast. Okay. Yeah, so it produces many many copies in a very short period of time after the virus the primary virus gets into your body and in addition to that Viruses are generally difficult to treat or Let's say impossible. There are usually no cures for viral infections Most of them. It's very hard to cure them. Yes. Yes. So you have a virus that's Multiplies very fast. Yes kills yourselves and kills the cells that Contribute to your immunity so you have a virus that multiplies very fast is difficult or currently impossible to treat and It kills of your immunity. So now you become susceptible to any other infection So you have this infection that has made you immune system so weak that now you can get any other infectious disease Yeah, so your chances are a lot higher. So that's what HIV is That's what it does and that's why it's such a big problem. Okay And before we go verifying the conversation Maybe I can point out that even though people may have HIV or AIDS that they are able to live a normal life through medication and Antiviral medication and all those things and counseling even and I hear actually that wonderfully and very Fortunately that there's even online websites that have come up to match HIV couples together. So there's there's hope when it comes to that but moving right along Maybe we can touch on a different issue Because for us we'd like to focus on statistics when it comes to youth Well, we hear that the people who do carry the HIV virus amongst all of them the percentage Who do carry the highest of it are the young people? Maybe age from the age of 15 up until 35. Yes Could you maybe speak a bit about this and maybe focus on Kenya as a whole or Africa? Okay? So in Kenya we have about 1.5 million people infected with HIV So 1.5 about 1.5 million people infected with HIV and as you said the biggest chunk Should be the youth actually the cohort that's going to see that most important is 15 to 24 15 to 24. Yeah, because Why is that because that's when people are oriented into sex, right? And you see at the age of 15, there's a lot of ignorance around sex at that time, right? So you're more likely to do things that you'd not want to do or to be forced into sex and get infected Subsequently, so it's because this is a very vulnerable age group Right and people are transitioning from childhood into adulthood and there's a lot of confusion at that time, so They can be confused with money. They can be tricked, you know So many things that are contributed to people getting HIV at that time as compared to all the people who make decisions Okay, we assume they make logical decisions It's not necessarily true, but there better place to make decisions around that So Yes, so we we do have a big chunk of the youth infected, but the biggest problem we have in Africa is Data we don't have a lot of data. We don't do enough studies. We don't have enough information and Now we also have a lot of Undiagnosed patients a lot of people are diagnosed and diagnosed Okay, so we have a lot of people working around with HIV, but they don't know and Our surveillance surveillance is actively seeking cases May not be the best Because we mostly rely on a hospital surveillance, which is you come to the hospital then maybe we test you But if you don't fall sick Then how no one will ever know we don't do much community outreaches to go and test Yeah, and self-sustaining kids have just been introduced But we are not we can't really say that we know how many people Have HIV estimates can be given, but they're also given by outsiders, but in ourselves We haven't done enough studies. We don't do enough outreach to actually identify all the cases that we have Yeah, and before we move into how the youth may Contract the virus. Maybe we can touch on something that you have said a lot of people walking around with This and it's not diagnosed. They're walking around with HIV Maybe it's even become AIDS at some point and they're walking that have no idea. It's not been diagnosed They've not gone for testing. Yeah, might you have any idea why as a doctor? It's because and like Most other infections the incubation period can be a long time. What is a good period? The period between when you get infected that when you start seeing your symptoms, right? So it can be a very very long time ears. Okay, so you see unlike the flu where if I Come into contact with you and you sneeze in my face and I pick up the virus in three four days I'll be sneezing. I'll have a sore throat But now you see if you're talking about a disease that takes years that means I get infected today There's nothing to show me that I'm sick and because I am not thinking that I might be sick I won't go and test because there's also a lot of stigma people are even more afraid to test than if If you know people are now more afraid to test for HIV because I'm afraid they might have it Yeah, so because it takes such a long time for you to have any kind of symptoms It might take it takes different duration, but it can take a long time So that makes it very difficult because if you're not exhibiting symptoms, then how do you know that you you're sick? you have to take the initiative of going to the hospital and Asking for the test to be done such you can know now many people are not willing to do that That means they wait until they get sick or they wait until a partner gets sick then tells them a I've been found with this you might want to go and get tested Yeah, so that's how we end up having so people who are out there, and they're really normal very healthy They look very normal, right? I have you brought up something very interesting and I think we'll touch very at the very end Maybe you can be thinking about it Maybe we'll touch on why some countries have decided to put a Death penalty on somebody who does not disclose the fact that they have HIV But that we shall leave for the end now We need to go forward and talk about exactly why our youth because they don't know that they have it Yeah, which means their ways that they're contracting it and Maybe they know they're getting it or they don't know they're getting it Yes, can we talk about the ways our youth are contracting HIV AIDS because yes There's the normal intercourse way, but I believe that they're more Avenues our youths are able unfortunately to contract this virus. Okay, so So HIV transmission is mainly it's Is transmitted through body fluids? So when you say body fluids are talking about blood You're talking about semen. You're talking about vaginal blades and also leads and talking about breast milk So mainly those five yes, so because you're not yet to talk about Mother-to-child transmission. We want to talk about the youth. Yes, and as you see I said blood Vaginal anal and semen. Yes, so three out of those for our life Not saliva. Okay, three out of those four assets related. Yes One is blood and now blood we look at mostly people who use injectable drugs And people who use injectable drugs tend to share needles because expensive the drugs are expensive But then you want to burden them with the cost of buying a new series in each time They want to shoot up. Maybe I don't know many times they shoot up three or four times a day And you want them to buy different series in each time. They'd rather spend the money on the drugs So they share needles most junkies are sharing needles and sharing needles blood is contaminated So you end up having HIV and also other Blood-borne diseases you could have hepatitis being transmitted in the same form So when we're looking at transmission, it's either drag users who are sharing needles That's a main one-way and sex. So for sex is heterosexual sex and Homosexual sex so for heterosexual sex It's I Mean it's pretty much the same as it's always been It's just that I think of late we're seeing a lot more It's become very mainstream sex is being is very mainstream when Media it's like a way to yes It's become very kind even the kind of songs people are singing about the things that have been shown So sex is has become very mainstream heterosexual sex, but in the background you also have men who have sex with men and that's contributing a lot to HIV cases in the West Like in the States we have Majority of the men who are getting infected with HIV are having sex with our men In the US majority of them who are infecting other people are homosexuals Not necessarily Homosexuals, I don't know if they are or they are not because they might be having homosexuals and heterosexuals But yeah, but at least they're having sex with men. So that's a major way of contracting the risk of contracting HIV if you have Among men who have sex with men is higher much higher than Man, I mean a regular heterosexual sex. So it's a increased the higher chance of getting HIV through that Form so it's basically about just if you look at how it changes that have been made The changes that are happening in sex Yeah, so it's become very rampant. It's a lot more reckless. I don't have people are having Three psalms and orgies all these things I've recently I learned and I was so surprised and I swear I would pinch my children if I had children When I get them I am learning that the things like sex parties Parties solely dedicated for intercourse of all kinds and I'm thinking to myself really how you're gonna walk out of there without infection Yeah, how you're definitely walking out with an infection of some sort But back to the conversation at hand Maybe we cannot touch on what our country is trying to do because I feel like we've Exhausted our measures if we have advocated we have advocated if we have gone online We've gone online if we have advertised and held up placards if we have marched to the streets We have done everything we can to Express and to show the problem that there is in HIV AIDS and the spread but still it continues to spread and not even that It's even rising. Yeah. Yeah, it's like getting worse and not only that it's getting worse amongst our youth What are we doing wrong? What what do you think we're doing wrong as as an expert when it comes to infectious disease control? so It's true that the incidence of HIV is rising I think in a study a global study done in 2015 by international health metric evaluation showed that Cases of HIV are the new cases of HIV have actually increased Okay, they're measured in as a decrease So it's if it's decreasing by 2% every year then this year decreases by 1% we can see that there are more people who are getting HIV, right? so and Kenya was one of the countries so the 74 countries that were listed as having increasing cases of HIV in Kenya was one of the 74 When you see we've exhausted our measures We haven't because The measures that are in place. It's not that they are not working Because you see for example if I give you drug X to treat disease A Then you take it and you don't get better. Then you say it's not working But if you take it and you get better then you someone else doesn't take it and doesn't get better You don't say it's not working. You find ways to improve because this measures work and if they were Used a hundred percent they work. They actually do work abstinence works Abstinence does work abstinence does work. It does work. Wow. So that's a one measure. We've not exhausted We've not exhausted that people can abstain it was staying Yeah, because even if you walk into workplaces work areas in the toilets everywhere. They're condoms everywhere with yes But that's the one thing abstinence is the one thing we've not tried to Push for and once I think when you speak it you either look like a religious fanatic or something Yeah, but it works. It's I mean I Don't know what people's perceptions of abstinence are but if you can abstain Abstain at least for people who are under the age of eating because we're talking about 15 to 24 years So at least before you feel like you're at the age where you can make Logical decisions sensible decisions are able to live with the consequences of your decisions. You can abstain. That's the best option Okay We are talking about Because we still work with ABC the government as well as talking about ABC Abstinence be faithful and use condoms People can be faithful. It works. It's a strategy that works if the man and the woman in a marriage are both faithful And why is the HIV going to come from if they're not using it? It doesn't come into the picture Yes, but if you're not faithful or you you're not abstaining, that's fine Then if you're in a relationship, you're not abstaining. That's fine But if you're not being faithful then now you've complicated the matter because we always know that You're not faithful. You're not faithful. This is not faithful And I mean it's a long long chain of a lot of unfaithful people at some point if HIV comes into the picture It comes into the picture the whole picture Okay, so we have kind of you know come to the conclusion that Abstinence I think is the best thing and being faithful and you know using contraceptives and condoms So I feel as if maybe we can move on to that one question. I said that we're going to touch on we're leaving Kenya now We're going overseas There are measures that people are taking overseas to curb HIV AIDS Since we have talked about the measures we've taken here in Kenya and what we have done and how it's going Maybe we can talk about how do you feel as a doctor when it comes to The countries where for example if you somebody Engages in intercourse and they have HIV and they don't tell that person that they have HIV That person can take that person to court on charges of murder because essentially you're killing them And essentially you are taking and they will die at some point. Yeah, and I hear that Yeah, this does come because people taking it seriously like if you don't tell me I'm taking you to court and if I do find out that you had it I will Make sure you get a life of the death penalty or something. How do you feel about this? And do you think that it's too extreme or do you think it's a measure we can take here in Africa? I Yes, what you've said is true. It is Technically it is reckless in the instrument Because you're putting someone at risk of something and you're aware you see if you don't know then it's different Yes, but if you know then you're intentionally infecting someone. Yes, whether you Intend to do it or not if you do it, then you are intentionally putting them at risk. So In that case you could look at it like that. I Really don't have an opinion on What should happen under the law and I don't know what happens because I mean, you know There's really no way of saying I knew unless maybe you know, they are taking drugs, but most people don't even know so I Think I would leave out a pin there. I mean if you would not be an opinion if I wouldn't like to give an opinion but if the people who make laws Find Because it is a big problem. It's costing the government a lot of money and is costing And we also losing a lot of economic output from people being sick Don't you think for such an extreme problem that maybe extreme measures Yes, if you're an extreme thank you for answering the question You were saying yeah, so Yeah, I mean if lawmakers choose to go that way then maybe Maybe yeah, because we also have a similar problem with this is like TB There are people who are sick and you know TB is very easy to transmit because you're seated in a matter to I have TB when we leave I've Given it to all of you. So it just depends on how you get sick or not and you have this person not taking their medication So you see them that means they're putting our people at risk and they're doing it intentionally because They might not want you to get sick But the fact that I'm not taking my drugs means you're going to get sick if I stay around you long enough That's a problem. That is a problem. Yeah, so maybe it after measures are required I don't know how that would be done. Okay. Yeah, well, I would give a direct answer But I'll say for you know for extreme cases Let's have extreme measures and we need to conclude our segment I'd like for us to now talk about when it comes to our young people in stigma Because lastly the thing that bothers people the most is if I have HIV first of all I can't tell anybody and it's embarrassing like even going to get medication is a problem Not even that Just going for testing is an issue Maybe you can try and tell our youth Through the words of an expert of infectious disease control and through being the experience of a doctor how you could Assist our youth in maybe taking this as a serious problem Do get tested every six months, especially if you're if you know, you're sexually active Make sure you're getting tested a couple times a year not just once a year And yes, I'd like for you to give those details through on how someone can carry the measures through because at the end of the day We're not going to stop by young people from having sex. We can't do that But we need to give measures on how they can protect themselves So in HIV can treatment we there's something called the 1990 90 rule. So that's in 90 so the UN AIDS and the WHO and CDC trying to have 90% of people Diagnosed 90% of people the HIV diagnosed 90% of the people who are diagnosed on treatment 90% of those on treatment having their viral load suppressed Which means it's all low that It won't have any factor in your immunity So you'll live very normally and secondly you will chances of you transmitting it to anyone else Very slim because if you're working with numbers of the virus being transmitted They're so low in your system that you can even pass it to anyone else So there's that but you see the first 90 years test So that's the biggest problem that we have because people are not testing when you speak about stigma It's a biggest reason why people are not testing because when I go test first of all, what is your pain? What is the how does a person who's testing me look look at me? That's what I think The people are trained and their counselors and they've seen a lot of these cases and they take it just as any other disease But what is their perception that you think they have of you once you test in your positive? It's a problem. And once you're positive what you do, would you tell you can tell anyone you feel isolated? So I find that even where I work People will come from very far to come and pick their drugs from there because they don't people that they have a place Where they live to know so they go very far to be seen somewhere else where nobody knows them Yeah, even the pharmacist doesn't know them Yeah, nobody knows them the community doesn't know them. So it's so stigma is a very big problem It's stopping people from getting from getting tested now if we can't test then we can treat So if we can't treat then we more of us are getting sick so the most important thing is We need to end the stigma we need to end the discrimination because someone who has HIV has the infection and doesn't have AIDS and is on treatment is It's just like anyone else. I mean they're very normal member of society. They do everything very well. Yes They can live for and they live for a long time. So We shouldn't really discriminate against these people We should be encouraging each other because the more people get tested and treated The less likely I am to get it because I don't have anyone to collect it from okay So then and lastly and final this is the last question because you mentioned something We do need to wind up because you then politics will be coming through I've heard a quote Very briefly if you can say that if you don't have HIV you're not in fashion or even worse HIV is just a disease like any other cut to home. Oh my god as much as you can live a normal life Can you explain the difference between living a normal life and carrying this? In why in actual in conclusion so that we can close the show down. Okay, so the difference is the diseases that with you contract they Can't recover or you get better after a while or their Impacts on your body is not so severe But with HIV if you get HIV and you don't you don't get tested and you don't start your treatment You only live normally if you're on treatment if you don't start your treatment It knocks out your immunity completely. So you have Almost no immune cells. So you will get many other infections and it will take you down That's a difference between so many other diseases and HIV. So yes, if you're in treatment, you'll be okay but if you're not You will not be okay Right, there is no chance and the only way you can be on treatment is by getting tested and so yes Please anyone out there if you know that you're having a sexually active life tough for that You do get tested several times a year and I forget about this take my even if it means going far away like doctor said Unfortunately, this thing has to be done do get tested so you can get treated so you can save your own life Thank you so much for tuning in. It has been wonderful. Asante Sanna for coming to the show Dr. Leon Ogoti. Thank you for having me. It has been health and Monday It is hashtag health and Monday hashtag wine in the morning My name is show much. I can be found on join us come much higher on Twitter alone Thank you so much for tuning in coming up next is youth in politics