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Imagine trying to keep a life-or-death secret when it touches almost everyone you know. The statistics tell you that many people with whom you live, work or socialize share the same secret. Indeed, everyone you know has a parent, child, friend, colleague or neighbour, who share this secret. Yet you can never be sure who to confide in.
If people see you going to the clinic every month or popping a pill every day, they might start calling you by a nasty three letter word: “HIV”. You see, while the virus can take a decade or more to kill you, the public scorn can happen in an instant.
So you hide. Perhaps drop out of treatment altogether, or refuse to even get tested. You sacrifice your physical health to avoid committing social suicide.
This World AIDS Day, MSF doctor and photo-blogger Robert Verrecchia meets HIV positive people helping their communities in Democratic Republic of Congo.
“HIV kills whoever wants to die”, says Thembisa Mhbobo, a young woman from Khayelitsha township in South Africa, and her straightforward observation is as true today – when quality anti-retroviral treatment is freely available – as it was 15 years ago, when a lack of treatment was leading to wholesale death among the township’s population.
The fact is that nobody should be dying of AIDS today, nobody should even be infecting others: as long as you are on dutiful, daily and lifelong treatment, you have close to zero risk of passing on the virus to your partner or unborn child.
So why is it that AIDS is still killing 140,000 South Africans every year, and every year infecting three times this number - the equivalent of the entire population of Khayelitsha?
Young people, especially women, are among its first victims: every four minutes another young South African between the age of 15 and 29 is infected.
In October 2015, we commissioned Khayelitsha hip-hop artist P’zho to compose and produce a song for World AIDS Day 2015 that would deliver a simple yet powerful message to young people about testing, treating and preventing HIV.
All experts agree: to stand a chance of curbing the progression of an epidemic that has already killed double the number of people than World War I, the time to accelerate the fight against HIV is now.
But this cannot be achieved through mathematical models and theoretical plans elaborated in cozy air conditioned offices.
It needs affected communities who are willing to break the tragic burden of secrets and stigma, and who encourage each other to follow a simple, but oh-so-difficult to apply, mantra: “please condomise – get tested – take your ARVs”.
So for this year’s World Aids Day on 1 December, Médecins Sans Frontières/Doctors Without Borders (MSF) in South Africa has joined forces with people living with HIV in Khayelitsha, to broadcast far and wide through the township, especially towards young people, that there is life beyond HIV.
Choose treatment, choose life – beat complacency.
Thembisa Mhbhobo, 24, is playing with her three-year-old son, Andile, in their shack in a crowded corner of Khayelitsha, a sprawling township near Cape Town, South Africa, where young women are among the highest risk groups for contracting the disease.
The young mother with laughing eyes first found out she was HIV positive in September 2008, but she refuses to be another statistic.
“HIV kills whoever wants to die,” she says fiercely, before swallowing the little pill that keeps the virus in her bloodstream at bay, ensuring that she stays well enough to care for her son."
But it hasn’t been easy. “Coming from the clinic that day, I felt like everyone could tell I was HIV positive,” says Thembisa. “I didn't know whether or not to cry, but I told myself that I will soldier on. The nurse who spoke to me told me that nothing would happen if I take my treatment and I condomise. Nothing is going to change.”
But while accessing and taking her treatment is quite simple for Thembisa, she has had to confront the stigma that still surrounds the disease in South Africa.
“I was in shock when I came from the clinic, and I think this made me disclose my status to a friend of my mother. Then I went to another friend's house. When I got there, they were talking about HIV, so I told them as well, but they thought I was joking.”
Her mother was very accepting of her status. She didn’t shout at her or cry, but simply told her to be more careful now that she knew she had it.
“Not everyone in Khayelitsha has a problem with people with HIV,” says Thembisa. “We also go to support groups. But some people are judgmental, of course, and will not want to speak to you or date you because they don't even understand how people get HIV.”
She wants people to know her status, she says, because hiding it doesn't help.
“I volunteered to be on the mural because the youth don’t have much courage like I do. I'm hoping the mural will help young girls to not feel alone once they've found out about their status and they build courage from my bravery. When they see that it's a young woman in the mural, they can find hope that they can still live for many years.”
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