A Question of Life or Death - Human Rights Watch

At first we had only women. Then last year, we had 10 men in a support
group. So now we have some mixed groups—men, women, children.
Men are sometimes opposed to testing.... Many men also don’t tell
their wives if they have done the test…. Some couples are both on ARV
but do not tell each other. Some people divorce because of the test.
We have some women in our support group who have not told their
husband about their status. 89
The secrecy in the home can become an obstacle for child health care. This starts
right after birth: women raise suspicions when they do not breastfeed their baby, as
it is now known that breastfeeding can lead to HIV infection. Due to intense
pressure, many HIV-positive women breastfeed or feed babies a mix of formula and
breast milk; both approaches increase the risk of HIV transmission. 90
We interviewed a community health worker in Nyangoma village, Nyanza district,
who is looking after Prisca, age four. Prisca is HIV-positive and on cotrimoxazole, and
her mother is taking antiretroviral drugs. Prisca is the child of her mother’s second
marriage; her mother remarried after her first husband died, likely of AIDS. The
mother has not told her new husband about her HIV status, and has also not told
him about Prisca having HIV, as this would reveal her status as well. She has
managed so far to treat her child secretly, but as Prisca is developing side effects
and further health complications, this is proving increasingly difficult. 91
Stigma and discrimination in health facilities
A few years ago, stigma and discrimination against AIDS patients were rampant in
health facilities. This situation has improved, according to many counselors and
health professionals. Most people interviewed during this research did not have any
89 Human Rights Watch interview with caregiver, GROOTS Mothers Development Center, Mathare slum, Nairobi, August 10,
2007.
90 According to the WHO, breastfeeding by an infected mother increases the risk of transmission by 5–20 percent to a total of
20–45 percent. WHO, Antiretroviral Drugs for Treating Pregnant Women And Preventing HIV Infection In Infants: Towards
Universal Access: Recommendations for a public health approach (Geneva: WHO, 2006),
www.who.int/hiv/pub/guidelines/pmtctguidelines3.pdf (accessed April 10, 2008), p. 5.
91 Human Rights Watch interview with community health worker, Nyangoma, Bondo district, Nyanza province, August 18,
2008. We learned of similar cases in Mathare. Human Rights Watch interview with social worker, Mathare slum, Nairobi,
August 14, 2008.
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