Obstacles to effective treatment for HIV and Aids

Social grants are a potential help in overcoming the problematic relationship between poverty and treatment. However, many respondents were unsure if they qualify for social grants. On top of that, many who should qualify for the social grant from an income perspective are not actually receiving one because their CD4 count, a measure which indicates how much a person's immune system has been weakened, was still higher than 200. The current structure of the social grant requires patients to maintain a CD4 count below 200 to continue receiving the grant. This is an obvious deterrent to patients to adhere to their antiretroviral treatment and thereby boost their CD4 counts to healthier levels. The high costs of running CD4 and viral load tests (which assesses the potency of the virus in the blood stream) prevent many clinics and hospitals from regularly administering these tests. However, regular CD4 and viral load testing could provide patients with the psychological boost of being able to see the progress they are making by strictly following their ARV treatment, and this would encourage greater adherence to treatment. Once started, ARV treatment must be taken for life, and breaking off treatment can cause the virus to become immune to the medications currently in use. The survey suggests many ways in which treatment in Namibia can become more feasible and effective. These include greater patient involvement; incorporating prevention and treatment information specifically targeted at the lesbian and gay community into mainstream awareness campaigns; providing more information about reproductive rights and responsibilities; including men's voices as an integral part of prevention; offering viral load and CD4 tests more frequently; promoting inexpensive nutrition education programmes; providing income support to poor people living with HIV and Aids; focusing on counteracting and eliminating stigma and discrimination; highlighting ongoing treatment successes rather than failures; offering treatment information in the home languages of patients; and conducting further research into treatment adherence problems and different counselling approaches.