4^th Year School of Medicine, University of Nairobi
Nairobi, July-September 2016

HIV is a global phenomenon that affects many in the world. Nowhere is this burden greater felt than in Africa with its many other infectious diseases that still bedevil us. As an immunosuppressing disease, HIV predisposes one to other infections like TB and even cancer. Infected people thus tend to have many more comorbidities and reduced quality of life. The stigma associated with HIV infection is sometimes an underestimated determinant in the general outcome of infection. Therefore patients not only need medication but also an understanding and empathetic health care system that enables them attain the highest possible quality of life

It is with this in mind that I looked for an elective that would help me:

• Understand the Antiretroviral (ARV) therapy regimen available to patients in this country vis-à-vis the internationally recommended one and how it is varied depending on age of patient
• Learn how to give wholesome healthcare to the sick including but not limited to medical and psychological support.
• Participate in testing, counselling and Education of people on HIV, how to minimize risks of exposure and for the infected, how to live with the disease and still maintain normal social functioning.
• Consolidate my clinical skills in terms of how to handle patients right from the point of first contact to when diagnosis is made, management instituted and thereafter follow up of the patient.

FACES Kenya under their STEP program provided this opportunity for me. Through the program I went over and beyond my objectives. I was able to learn the strides we have made as a country in providing ARV to the infected, from the time the government only gave ARVs to those with low CD4 counts to now when everyone diagnosed with HIV is put on ARVs

I was also able to learn how misinformed and outdated the stereotyped perception of people living with HIV is. For a long time mass media has been awash with macabre pictures of severely wasting individuals with sores and all manner of diseases. People who were more dead than alive. And for a long time that is the image that has been propagated and perhaps contributing to the stigma. Through this program I was able to see firsthand how those diagnosed early and receive appropriate management are able to lead normal lives.

The experience also enabled me participate and learn how to give Provider Initiated Testing and counselling (PITC) and for those who are sero-reactive, how to start them on treatment and also follow up. I also learnt that in the journey of living with HIV diagnosis is a mere first step. Patients must be supported medically and more importantly at the community level eg through family for best outcomes. This eases the burden and in the long run will contribute to reduction in stigma which in my opinion is the largest contributor to people avoiding testing or noncompliance with treatment.

I thank Faces Kenya for the opportunity to participate in the drive towards a HIV free world through stopping transmission by availing the best possible care to those living with HIV.

I would recommend this program to any medical professional or student who would like to learn how people are diagnosed with HIV, managed for both HIV and any opportunistic infections and how such primary level care is important in stemming the advanced cases most of us may be accustomed to. All in all to ensure all positive patients live positively.