In Recognition of World AIDS Day, Med Pak Interviews Sister Sthokozile Zulu From Ikhwezi Morning Star Clinic (Umlazi)
World AIDS Day is commemorated each year on the 1st of December and is an opportunity for every community to unite in the fight against HIV, show support for people living with HIV and remember those who passsed away
Q: How are HIV and AIDS different?
A: HIV (Human Immunodeficiency Virus) is a retrovirus which is mostly transmitted sexually. Once the virus is in the body it takes over the CD4 cells and turns them into factories for its multiplication. As more CD4 cells are destroyed the body loses its ability to fight off infections. A person may be HIV positive, meaning they have been infected with the virus, but physically they may be still well and able to function with very little or no illnesses at all.
AIDS (Acquired Immunodeficiency Syndrome) is a combination of opportunistic infections resulting from a compromise immune system.
Q: Has there been an increase in diagnosis of HIV among staff at the workplace?
A: I wouldn’t be too sure about the workplace since I am not too involved in occupational health. But 2 out of 5 patients that I test are HIV positive. The HIV prevalence is still high in the Umlazi area.
Q: What are the first steps a medical practitioner should take if their patient is HIV positive?
A: • After confirming the results as positive the first step is to do post-test counselling.
• Allow the client to process the results and convey how they feel about them.
• Explain the lifestyle modification and making healthy lifestyle choices.
• Explain what ART is and how it works.
• Clarify any questions and /or concerns that the client might have.
• If the client is ready to be initiated on ART a full screening is done e.g. medical history, TB screening, other opportunistic infections, urinalysis (to rule out any kidney problems), and all other vital signs. Since we follow the Universal Test and Treat if there are no contraindications the client is initiated on ART.
• Collect baseline bloods for CD4 count, ALT (or full LFT), Creatinine (or full U&E), HB (or Full Blood Count) and sputum for TB if the client is presenting with symptoms.
Q: How Common Are False Negatives and False Positives?
A: I have never had any false positive or false negative results since I use the WHO and DOH testing algorithm which uses different tests to confirm results. If there are any doubts, I collect bloods for ELISA.
Q: Why stigma and discrimination matter?
A: Stigma and discrimination can be as devastating as the illness itself and may mean abandonment by a partner or family, social exclusion, job and property loss, school expulsion, denial of medical services, lack of care and support, and violence for those affected by them. These consequences, or fear of them, mean that people are less likely to come in for HIV testing, disclose their HIV status to others, adopt HIV preventive behaviour or access treatment, care and support.
