A sweet darkness:
. . . as moonlight HIV testing sparks progress
DONNING a skinny jean with a small black purse packed with condoms and morning-after pills, Catherine, steps in at Musami Growth Point along the Nyamapanda-Harare corridor. It’s a Friday night at the busy growth point and she hopes to maximise on the numbers and make a killing.
Heavily face-powdered with glittering lips accompanied by a strong perfume scent while her black blouse is exposing her hairy navel presumably to entice her catch, Catherine is among sex workers who ply their trade along the busy Harare-Nyamapanda highway, though oblivious of the risk of HIV infection that comes with her line of work. She has never had an opportunity to get tested for HIV due to several reasons.
Before she could even settle, she notices a tent with several banners with messages such as “Know your status”, “Get tested, get treated” and she goes to enquire what the function was all about. She is told that there is an HIV night testing programme right at her work place.
Night testing is what she needed, as she finds the nearest health centre not so friendly for people (sex workers) like her. Besides, she argues that she will be resting during daytime and has no time to queue at a clinic.
“This is what I needed (a night testing facility). There is no way I could have gone to the clinic to get tested. I rest during the day as I work at night so I never find time to go to the clinic,” she tells this reporter before she gets tested.
“Besides the staff at the clinic are hardly nice to people like us (sex workers). It is the attitude that you get at the clinic that will stop you from even going there. But here nobody notices us in the dark.”
She is among several sex workers across the country who, through the newly heralded night testing initiative - better known as moonlight testing have had the chance to get tested.
It is not only sex workers who have benefited from this programme according to the Ministry of Health and Child Care as preliminary findings indicate that more men were being tested under the cover of darkness.
Generally known for their poor health seeking behaviour, hence hardly found near a health facility as long as they feel “well”, thanks to moonlight testing, more men are accessing HIV counselling and testing services.
During that Friday night at Musami Growth Point, Saturday Lifestyle also caught up with a 48-year-old man who had just had his HIV test and had tested positive. “I have never had an HIV test (sic) all my life because I have never been bedridden. I have never seen the need to go to the clinic to have an HIV test; surely that would be wasting my productive time.
“I have just tested positive and have been referred for a second test at the clinic. I think I’m ready to start the treatment and I’m confident I can still live long if I start on and adhere to my medication,” says the man who only preferred to be identified as Mhofu.
“My wife has always had the tests each time she was pregnant. She tested HIV positive last year when she was pregnant, but I’m grateful that she gave birth to an HIV negative baby because she got preventive medication during the course of the pregnancy until she gave birth,” he added.
“Even when my wife tested positive and asked me to go with her to the clinic for a test, I still refused insisting that I was not sick. I didn’t find it necessary but I’m grateful that today I have accessed such a service at my convenience,” adds Mhofu.
The Ministry of Health and Child Care through the support of its partners introduced the initiative in 2016, as they sought to bring services to the people, demystifying HIV while breaking barriers that hinder people from getting tested for HIV in a conservative nation that continues to grapple to openly talk about the health risks of unprotected sex.
Catherine adds that night testing does not only give them cover of the darkness but reduces the burden of having to travel to testing centres where they are sometimes asked to pay for a health card. Apart from that queues are often very long which makes the process cumbersome for someone like her.
“Besides, some women in commercial sex work don’t want to be seen to be frequently visiting testing centres for fear of being judged so I hope we will continue to get such services so that I know my status all the time,” she adds.
In his 2017 study entitled “Experiences of Moonlight Testing in Harare”, National Aids Council provincial manager, Adonijah Muzondiwona cites that moonlight testing increases accessibility of voluntary counselling and testing services and linking clients to treatment and care while targeting high risk populations that are hard to reach.
Muzondiwona adds that the initiative sought to cater for populations that are busy during the day and those who are afraid of being stigmatised if tested during the day.
He however, noted that among other challenges the initiative faced was the fact that they were likely to deal with drunk clients who may be difficult to control and hinder effective counselling.
Community Working Group on Health director, Itai Rusike believes the initiative is a welcome innovation arguing that without adequate participation and engagement of the sex workers and other key populations on HIV testing, the evolution towards Universal Health Coverage could compromise the provision of quality health services for these groups.
“This innovative approach should not leave anyone behind as there is need to also include other key populations such as drug addicts, prisoners and others in closed settings.
“These groups are recognised as being particularly at risk and affected by HIV and they are consistently under-served in our country.”
In one of his songs entitled “Kune Rima” off his 2000 hit album “Chimurenga Explosion”, legendary musician Thomas “Mukanya” Mapfumo bemoans the evil in the dark cover of the night, but it seems with moonlight HIV testing, darkness brings forth desired results.
Indeed people like Catherine and Mhofu hope the country will continue with the initiative which gives them the cover of the night while being tested at their convenience.