In the midst of dozens of patients waiting to be seen, I spent a
long time today with a 10-year-old boy named Meshack and his
mother. Meshack has been on HIV medicines for several years, but
they are not doing what they should. The virus is multiplying in
his blood, and he has virtually no immune cells. It's clear that
either the medicines are not working or he is not taking them.
At first, his mother claimed that they have no problem taking
the medicines, but we eventually got to the point where she could
tell me how much of a problem it is getting him the medicines every
day. She runs a small food stall, and she doesn't usually get home
until after he is in bed. So, Meshack is almost always missing his
evening doses of the medicines because there is no one to supervise
His mother doesn't want to enlist anyone else's help because HIV
is so stigmatized in their community. She doesn't want to risk
losing her business; people would stop coming to her restaurant if
they knew she had HIV. She travels almost two hours to come to our
clinic in Eldoret, rather than going to our clinic closer to her
home, so that no one will know they come to a HIV clinic.
After our long talk, she agreed to make new efforts to make sure
that Meshack gets all of his medicines. I had to say over and over
again how we only have one more set of medicines once these
first-line medicines stop working. Then, that's it - there won't be
anything left to help the boy. The Doctor V
sympathetic-but-scare-tactic approach. I think she got it though.
I'm giving them another chance to make it work with the current set
of medicines and hoping….
This is exactly why we put so much time and effort into studying
and improving medication adherence here. It's such a challenge to
take all of these medicines every day, and yet so vitally important
to keeping children alive.