By Rachel Kakraba
It is a bold and giant step in Ghana’s HIV fight. Although, gradually scaled up, the success of HIV Self Testing is said to be overwhelming. For two years, it has been implemented among high-risk populations, such as sex workers. The intervention promotes more secure and confidential testing with immediate treatment. Already, about 50 Districts, in endemic regions, including Western and Central are implementing this novelty in support of the HIV fight said to be a far-reaching measure to control the deadly disease. Although there are no set clear estimates of targets to be captured under the programme, the clarion call from the Ghana AIDS Commission is for the public to patronize this service as it seeks to attain the UNAIDS targets of 95-95-95.
Human Immunodeficiency virus (HIV) is an infection that attacks the body’s immune system. Acquired Immunodeficiency Syndrome (AIDS) is the most advanced stage of the disease. HIV targets the body’s white blood cells, weakening the immune system. This makes it easier to get sick with diseases like tuberculosis, infections and in some cases cancers. According to the World Health Organization, HIV remains a major global public health issue, having claimed 40.1 million lives so far with ongoing transmission in all countries globally. Statistics from the United Nations Programme on HIV/AIDS (UNAIDS) which provides a compilation of the world’s HIV/AIDS epidemic, indicate every two minutes in 2021, an adolescent girl or young woman is newly infected with HIV. The COVID-19 pandemic also led to disruptions to key HIV treatment and prevention services, pushing millions of girls out of school, and spikes in teenage pregnancies and gender-based violence. Director of Technical Services, Ghana AIDS Commission, Dr. Fred Nana Poku, said about one point six -six percent of Ghanaians had HIV, as at the end of 2022.
“Of all the people living in Ghana about one point six -six percent have HIV as at the end of 2022. On the average over the past five years, new infections stand at about 20, 000. But as of 2022, there were 16,574 new infections. Then as at 2021, new infection was 16 thousand nine hundred thereabouts”
Strategies for eliminating HIV menace
To reduce or eliminate HIV in the country, Ghana has adapted a UNAIDS target and policy, the 95-95-95, to be achieved by 2025. This means 95 percent of the population must test to know their HIV status. Again, 95 percent of those who test positive are to be placed on highly effective Antiretroviral therapy. And 95 percent of those placed on medication should achieve viral suppression. As of June, this year, statistics from the Ghana Aids Commission showed that the country had achieved 71.8 percent under the first 95, which is testing to know one’s status. It is also doing about 87.4 percent in placing patients under highly effective Antiretroviral therapy, whereas with regard to viral suppression, which is the last 95, 68. 1 percent has been achieved. This is a progression the Commission describes as slow. It is therefore employing other interventions, such as HIV Self Testing. Believed to be an effective preventive measure and gateway to treatment, it empowers people to know their status themselves. Director of Technical Services, Ghana AIDS Commission, Dr. Fred Nana Poku, said the intervention holds a lot of prospects having been implemented in some regions and pharmacies nationwide.
“It is a very good innovation that is used all over the world and I’m glad to say that in Ghana we have started HIV self-testing. It has already begun in a way because the testing was done among high-risk populations, for example men who sleep with men, female sex workers etc. It’s very important because it is both a preventive and gateway to treatment. It empowers people to know their status by themselves.”
Dr. Osei, explained that “We have two types of self-testing, the testing done by yourself better known as the unassisted and the assisted where someone else such as a pharmacist conducts the test for you. It is an innovative way to reach more people to identify those people who have HIV and are not in the know. You know HIV you can have the infection for ten years, five years, fifteen years, without any signs and symptoms until it breaks you down with AIDS then it becomes obvious”.
Position of Medical Laboratory Scientist
Medical Laboratory Scientist, Dr, Dennis Adu Gyasi, commended the initiative, but expressed some concerns over storage. He said such issues must be addressed to safeguard integrity of the test kits.
“The algorithm suggests that, if you are doing, HIV test you don’t do just one test. When you visit the hospital, they won’t perform just one test and let you know if you are HIV positive or not. You will go through about three different tests. There are some tests when you put them at higher temperatures even when you put water on them you will have results.
Views of the public
An intervention such as HIV self-testing can only be successful with acceptance from the public. Views of the general public were sought on the HIV self-testing kits.
Ama, a trader, said, “The good part is, you can just be at home without going to the hospital to get tested. You can just order it or go to any nearby pharmacy to get it and then know your status and work towards it. The best way is to go to the hospital to check so they can prescribe or give you medications”
Gloria seamstress, it seems it’s the simplest way of checking whether you are positive or Negative in relation to HIV. I think it is very good and makes it simple and easy for everybody to check and know his or her status.”
Nana Kwame, “after checking and you realize you are positive and you don’t want other people to know; with the help of the internet, you can just go online and google and take precautionary steps so you don’t show too much symptoms for people to know”.
Maya student “The kit is good but it’s 50/50 because if I go and Check and I find out that I’m HIV positive, I will be scared to tell others because of the stigmatization. It is good when you go to the hospital, so they can send you to counsellors to counsel you about it. But when you do it on your own and find out you are HIV positive you might not tell anyone and still go about carrying the virus around”.
Aboagye teacher “The kit is free and you want me to go and buy it. I would rather visit the hospital for advice. If I have that vim to go and check it, I will opt for the hospital and get more advice there”.
Issues of cost
Although the test kits were initially free at public health facilities, however, it attracts a fee at participating private pharmacies. With no clear regulation of prices of products especially in the private sector, prices of the product may therefore differ. Director of Technical Services, Ghana AIDS Commission, Dr. Fred Nana Poku called on the private sector to partner it to promote fair pricing of the test kits.
“We are expecting that the prices and the cost involved will not be too expensive for people to be able to buy themselves. The call to all those that are involved, government and the private sector should work more collaboratively in a sustained to bring the price down”
Dr. Osei, said the test kits have been designed with psychological support before and after a test in mind. “We have in the kits some call lines that you can call to receive counselling and in fact where you access the test kits, is supposed to have received some amount of pre-test counselling”.
The use of the Rapid HIV Self-Test kits even when results are reactive, requires about three other confirmatory tests. Remember, whether you are positive or not, HIV is not a death sentence, therefore, always seek help.
