THE Mokhotlong district has been found to have the most HIV positive people who are unaware of their statuses, a situation which could spark new infections.
This was revealed during the recently completed Lesotho Population-based HIV Impact Assessment (LePHIA) report dissemination at district level in Mokhotlong.
The final LePHIA results were disseminated in January this year at national level but the results were conveyed starting late last month.
The meetings were meant to update the districts to be aware of their performance and give them an opportunity to comment, improve and strategise based of the report results.
The meetings were led and organised by the Ministry of Health in partnership with ICAP in Lesotho and were attended by the District Health Management Team (DHMT), Health professionals from Mokhotlong Hospital, community councilors and development partners’ representatives in the district.
According to the 2016/17 LePHIA results 35, 4 percent of the people in Mokhotlong do not know their HIV statuses.
Addressing the meeting, the Ministry of Health Senior Clinical Officer responsible for TB and HIV, Anna Masheane, said Mokhotlong has the highest number of HIV positive people who reported to be unaware of their statuses. She added that the district should come up with strategies which will address this challenge.
“These are issues that need to be looked into especially when we need to achieve our 90/90/90 targets and win the fight against HIV in Lesotho and in Mokhotlong,” Ms Masheane said.
“As a district you need to sit down and discuss and look into the problems that could have triggered this.”
Ms Masheane said Mokhotlong is not only challenged by the high number of HIV positive people who reported that they do not know their statuses but also has the lowest viral load suppression (VLS) at 58, 8 percent, which is higher than all the other districts.
“The LePHIA results show that 58, 8 percent of people who are HIV positive and on treatment have very low VLS putting Mokhotlong on the spot again,” Ms. Masheane said.
She revealed in her presentation that males have less viral suppression (49, 5 percent) than females (66, 2 percent). She added that this was a sign that men do not adhere to their antiretroviral treatment (ART).
“This is a sign that there is a challenge of lack of adherence to ART and it is even worse in males. This means men need to be targeted on issues of adherence.
“Because Mokhotlong is the lowest in VLS as compared to other districts, adherence strategies also need to be enhanced by the district to find a working formula,” Ms Masheane said.
She said the use of ART for HIV positive people also varied by district with the lowest proportion of 56, 5 percent also in Mokhotlong while Berea is the highest with 70 percent.
Mokhotlong District Health Manager Kabelo Matjeane told the Lesotho Times said the results were frustrating. She however, said this was necessitated by Mokhotlong’s geographical location being the farthest from the capital, Maseru, which poses more challenges in terms of service delivery.
Dr Matjeane said despite the challenges, she hopes the situation will normalize with the presence of development partners such as Solidar-Med and others in the district, who are working to salvage the situation through and HIV testing survey.
“I’m expecting that the presence of Solidar-Med in Mokhotlong has improved the turnaround time of sending samples for VLS to Butha-Buthe.
“It however, is still a problem for people to come for services due to the terrain and long walking distances which is also worsened by the poor roads,” Dr Matjeane said.
She said the other contributing factor to the VLS prevalence was lack of health centers in the district as they only have nine as compared to other districts which have 10 or more.
Dr Matjeane said some villagers from areas like Moremoholo walk for over 40km to access primary health care (PHC) services.
“There is no clinic in Moremoholo, so people walk for 40km to Mokhotlong Hospital to access PHC and this is catastrophic as they are unemployed with a very limited budgets let alone, they are already HIV positive.
“So, these are the challenges but with Solidar–Med close to us, I believe that there is going to be a difference,” Dr Matjeane said.
In terms of information dissemination to promote the Know your status campaign, Dr Matjeane said they have realised the need to stop working in silos as working in isolation reduces efficiency.
“We have used a new strategy which now include the front liners in the community such as chiefs and community councilors so that the communities take our messages seriously,” Dr Matjeane said.
For her part, Mokhotlong DHMT Public Health Nurse ‘Noi Ramotšekhoane said people from hard to reach areas fail to access valuable information.
“Whenever information has to be disseminated, such villages are left out, so the lack of health workers in some villages is also a contributing factor towards the low number of people who do not know their statuses,” Ms Ramotšekhoane said.