HIV Specialist - June 2021 - 27

I
T TOOK A TWO-DAY JOURNEY THROUGH
torrential rains and fl ooded roads to reach our
clinic in Mwanza, Tanzania-a n area of East
Africa with 7.2 percent HIV prevalence.1 There
were other HIV clinics closer to their village, but then
rumors could spread and the stigma weighed heavily
on them. They feared that his perpetual cough would
lead him to be even more ostracized than his HIV diagnosis,
as was often the case. His parents died from
AIDS and his grandmother tried to remember to give
him nevirapine/lamivudine/zidovudine despite her
advanced dementia. He was just skin and bones, and
we would later fi nd that he had a viral load (VL) of
175,000. His chart indicated that he was four years old,
but he could easily be mistaken for only two. He suffered
from severe acute malnutrition that was caused
by poverty, food insecurity, HIV viral failure, and kifua
kikuu- " big chest/cough " in Swahili, or tuberculosis
(TB). I admitted him to a 1,000-bed government hospital
with minimal lab and treatment capacity.
WWW.AAHIVM.ORG HIVSPECIALIST JUNE 2021 27
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HIV Specialist - June 2021

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