Healthcare workers have discovered that HIV patients on treatment sometimes stop taking medication in the mistaken belief that they have been healed - despite knowing the disease is incurable.
The issue relates to the “undetectable viral load” diagnosis patients receive when their antiretroviral therapy starts working and causes the amount of virus in their blood to drop to an extremely low level.
The confusion arises because of a misunderstanding of what an “undetectable viral load” means. People who hear this result when they go for testing are quick to jump to the wrong conclusion that the virus is no longer in their blood, that they are therefore no longer sick and have no need for treatment - and they default.
A snap survey by Health-e News in a rural community in Mpumalanga found that when asked what the words “undetectable virus load” meant, all the respondents said it meant they no longer have HIV.
Sam Vilakazi, a patient from the City of Mbombela, had blood taken for his CD4 count to be measured. When the results came back with an undetectable viral load, he assumed he was no longer infected and stopped taking his antiretroviral treatment.
“At first things were fine. And then I started drinking again, smoking and having sex without a condom. Even though my partner told me that it was impossible for me to be HIV-negative and I should have asked more questions, I ignored her because I thought she was jealous that my virus was gone,” Vilakazi said.
“After months of not taking treatment, and with my bad behaviour, things went from good to bad. I became seriously ill. When I returned to the clinic I was told that I should not have stopped taking my treatment. I was ill because I defaulted.”
According to nursing sister Dumisile Shabangu, when a patient has an undetectable viral load, it doesn’t mean the HIV virus is no longer inside their body. It just means that their medication is working and that a number of virus particles in their blood has dropped so low that they cannot be counted.
“For most tests used clinically today, this means fewer than 50 particles of HIV per millilitre of blood. Reaching an undetectable viral load is a key goal of ART. An undetectable viral load means a person is about 96% less likely to transmit the disease,” Shabangu said.
Gugu Ngema also made the hasty decision to stop taking her ARTs.
“English is not my mother tongue and sometimes the explanations we get from nurses are not clear. I remember when I was told about my undetectable viral load, I asked the right questions to find out what that meant. A nurse said ‘the virus is not detected in your body and you will not infect another person with the HIV virus’. And so I stopped taking my treatment. Then I got sick and lost so much weight and I was embarrassed to go to the clinic, I so began using traditional medicine until my family advised me to go back to the clinic before things got any worse,” Ngema said. - Health-e News
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