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infecting the unborn baby, as well as to improve the health of the pregnant mother. This programme, Lesotho Minimum PMTCT Package, provided pregnant mothers with minimum short-term HIV treatment for the duration of their pregnancy. It was introduced in Lesotho in 2007 (Mdougal, Moteete & Mohai, 2010). To comply with this requirement, some of the participants undertook the test. Queen had this to say:
…..when I first knew I was living with HIV and AIDS is when I was pregnant. I was very hurt, because at that time it was common to associate HIV with adultery and knowing that I never had any sexual relationship, also the fact that my partner was unfaithful; he would spend nights and nights away from home. I felt very hurt that I have been betrayed by my husband (Queen).
Testing as a voluntary move
HIV testing is a voluntary activity that individuals can decide to do. As I mentioned in Chapter One, a lot of campaigns were made in Lesotho, to create awareness among the people about the importance of getting tested to know their HIV status. Some of these participants took the leap to participate in the KYS campaign. The other bold step of testing as demonstrated by Thato reads thus:
I tested once at LPPA because I learned from an HIV session during a workshop for support groups that even though a person may look healthy, she can still have HIV. I then realized that I too was still healthy despite my occasional chest pains, I thought I needed to test, after all HIV can affect anyone (Thato).
Thato’s motivation for testing was intrinsic and two- fold. It could have been prompted by the knowledge she acquired from the workshop, or it could have been prompted by the
“occasional” minor chest pains that she felt, which she then decided required further medical investigations.
In the three scenarios illustrated above, it is worth noting the bold nature of the steps that the women took. In the first example, Maliketso could still have opted for other investigations around her cough other than testing for HIV (as will be seen from the literature about women in other countries who resorted to traditional herbs). In the second case, Queen too could
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have decided not to enroll in the Prevention of Mother-to-Child Transmission of HIV (PMTCT), and in the third case, Thato could still have attended a workshop, and done nothing about the knowledge that she acquired from it. In all these cases, I consider the steps that the women took, bold steps of acting on the information available and of making further inquiries about their health. This step required courage and initiative.
To bring things into perspective, let us briefly look at the HIV testing process as illustrated in Figure 5. 1 below:
Figure 5.1 Steps in HIV testing (voluntary testing)
Source: Ministry of Health HTC guidelines, 2010
In each of the steps in HIV testing, it should be noted the multiple bold steps that are involved.
Taking a decision to step into the unknown, uncovering the stone when you do not know what is hidden underneath it metaphorically speaking, takes a lot of bravery and effort. In the earlier chapter (Chapter Three), I gave a profile of these women and noted that all of them only went as far as primary education with one exception, who also had tertiary education. The majority entered the testing process with only that basic education, and found themselves all of a sudden being overwhelmed with medical terms and processes such as “counselling” – a session that enquires about one’s sexual life – let alone talking about ones sex life being a taboo in the Sesotho culture. This notwithstanding, the women took a bold step of going ahead with it, divulging their sensitive personal information about their sexual practices, the number of partners they have had and whether or not their sexual encounters were protected and the possibilities of having
Individu al drive to test
Pre-test
counselling Consentto
testing
The actual test
Results and interpretation
post test counselling
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HIV as a result of unprotected sex etc. Over and above that, these women are faced with the daunting experience of watching the blood sample going through a testing process to determine whether or not HIV is there, while simultaneously being taught about what to expect; then the waiting period which can be fraught with anxiety followed by the arrival of the results, and one having to communicate the result to the counsellor in order to ensure that they understood the lesson she/he gave during the session. When asked what the result says, the woman then has to respond to the counsellor saying” it is positive”, and this act can be seen as another bold step of coming to terms with this life time condition.
Maliketso said, “I was happy about the HIV positive result” - perhaps “relieved” would be a better word, as she was somewhat anticipating the diagnosis due to her frequent cough.
There is another step after the result – that is being spot-on in terms of further steps – making thorough investigations of the HIV strand through conducting a CD4 test to establish the body’s immunity level. This is another bold step these women take when they, after testing HIV positive, still undergo the additional critical step of determining whether or not they needed to start on HIV treatment. The final step within the HIV testing phase is the issue of who they disclose to; how will they react and who will act as one’s buddy for treatment support? The next section is where we find what the women have to say about disclosure and the various reactions from the different people (partners, friends, children and community) that they disclosed their condition to.