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14th December 2016

Self-Tests Help Migrants Fight HIV

In the depths of America’s Depression, Franklin D. Roosevelt said, “The only thing we have to fear is fear itself.” His words ring true in today’s fight against HIV/AIDS, as social stigma still deters people from seeking diagnosis and life-sustaining treatment.

Medtech is providing a solution: self-tests that can be easily done in private, giving results in less than 20 minutes. The tests could encourage millions of migrants, who are among the most vulnerable to the virus, in taking the first step toward saving their lives.

HIV has ceased to be a death sentence thanks to brilliant pharmaceutical breakthroughs, innovative community outreach and global commitment. Yet migrants too often fall through the cracks of healthcare programs, deterred by fear, poverty and discrimination.

“Don’t call the police! They will return me to the refugee camp. I want to stay in Nairobi for my children to have a better future,” cried Halimo, a pregnant Somali refugee who learned of her HIV diagnosis at a healthcare center run by the International Organization for Migrants in Nairobi.

Unsurprisingly, “Encouraging migrants to test for HIV has been difficult,” says Triza Wairimu, a counselor at the center.

Refugees who already have had their lives turned upside down may hesitate to obtain HIV testing – especially in clinics that don’t provide anonymity.

“Patients do not always get the confidential space they need,” said Joanne Cyr, a clinical psychologist who worked in Africa with Médecins Sans Frontières. “I’ve even seen women being tested for HIV in front of other women in the waiting room. Men who come in with their partners will usually refuse to get tested in this situation.”

To reach the 14 million people believed to unknowingly carry HIV,  the World Health Organization in November 2016 urged that self-testing be used. The veil of privacy could give people breathing space to make the decisions necessary to care for themselves and their families.

Making diagnosis easier could take the fight against HIV/AIDS to the next level. Between 2009 and 2016, infections among children in sub-Saharan Africa dropped 60 percent. Yet despite the amazing progress against the disease, the region remains HIV’s epicenter, accounting for two-thirds of new infections globally.

The mobility of the population may make fighting AIDS in sub-Saharan Africa particularly challenging. Africans have crossed borders for thousands of years to seek food or work, graze herds, or escape famine or violence.

Globally, more people were forced from their homes in 2015 than at any time recorded since World War II.  Some 15 million people were displaced in mid-2015, up 45 percent from 2011. Violence, exploitation and separation from family and community norms can make refugees particularly vulnerable to HIV. The most vulnerable of all are children, who accounted for an astonishing 51 percent of the world’s refugees in 2015, many of them traveling alone, according to the UN High Commission for Refugees.

In Bentiu, a makeshift camp in South Sudan, where millions have been displaced in the fledgling country’s protracted civil conflict, IOM workers work with existing health and support programs to provide counseling for expectant mothers living with HIV. “When I’m alone, I feel stress,” said one mother, sitting with six other women as they embroidered and beaded necklaces. “I am happy spending time with others in this group to share our stories and support each other.”

Halimo, the Somali refugee in Nairobi, has learned that life goes on after diagnosis. “I was devastated and thought that was the end of my life,” she recalls. “I cried and cried. The nurse calmed me down and told me that, if I take care of myself, I will live.”