Sharing of ARVs sends shockwaves

MARANYANE NGWANAAMOTHO
Staff Writer | Tuesday December 7, 2010 00:00

Reports from various parts of the country indicate that some patients on anti-retroviral (ARV) treatment share ARVs with their friends and even foreign partners who, under government policy, cannot be enrolled for treatment. Yesterday, a phone call to Tutume Primary Hospital revealed that even though this behaviour was first alleged to be between locals and foreigners, it is actually Batswana who share the pills among themselves. 

'I cannot deny that locals share drugs with foreigners, but what we have established is that Batswana share the medicines with their neighbours, relatives and friends,' said Rakubu Kagisano, an ARV nurse at Tutume Primary Hospital. 

He said that they usually have a failure clinic on Wednesdays to assess people who are on treatment but do not seem to be getting better. He reports that currently they have more than 100 people who are on treatment with their viral load remaining constant despite the treatment. 

'We think that for the viral load not to be reduced could be because people are not taking the treatment properly as directed by the doctor, and that the virus could have developed resistance to the treatment already,' he said.    

Kagisano said that missing treatment could complicate patients' health because if they miss treatment even for a day, two or three the percentage of the treatment in the body would not be enough to suppress the virus.

It would, therefore, rise again and even develop resistance to the treatment.  'The virus multiplies faster; so if people share treatment it means they are not going to have enough of the medicine in their bodies to keep the viral load down which is a very risky behaviour,' he said.  This behaviour is reported to be mostly among teenagers even though it is common across all age groups. 

The same practice of sharing treatment has also been confirmed at Mbalambi Health Post where this was noticed the day that some women, aged between 30 and 40, were fighting after one of them refused to return the pills that she had been 'lent'. 

'We only realised this when these women were arguing because the other one would not return the pills she had asked for from her friend,' said Usina Modise, a counsellor at Mbalambi Health Post.  It is unclear why people share treatment because they are not staying very far from the health post where they go for their treatment. It has also been noted at Masunga Primary Hospital that people go for refills days before their due dates, while others even come with extra pills. 

An ARV dispenser at the hospital, Shanganane Socks, says that they have not investigated to find out why treatment finishes before the prescribed period. 

However, he says that they have been given different reasons for this state of affairs.  'People have their reasons and among them they mention vomiting and that the pills spilled,' he said.  Patients say that after taking the pills they sometimes vomit and therefore need to take another pill. 

Occasionally, due to nausea, the patients decide not to take the drugs until they feel better. 

Some people say that the pills spilled and therefore had suffered a shortage, he said. Socks said that they are surprised that people could still miss their treatment because before one is enrolled for treatment regular intake of pills is stressed during intensive counselling campaigns.

'Every patient who is supposed to take treatment goes through adherence counselling where they are taught a lot including the need to take treatment,' he said.