As one prepares to have the much dreaded HIV test, many seek comfort in the counsellor’s common phrase: “HIV is not a death sentence”. Paul Gwada took those words seriously.
“Although I was saddened to find out I had the virus, I decided to look at the flip-side. I quit school for lack of fees after my parents died yet I’ve learnt a lot and today I work for organisations which seemed beyond my dreams ,” says a beaming Paul, an infectious smile on his face.
He had hopes of playing for the national football team, Harambee Stars, but had to settle for business — selling used items, staging video shows and painting in his Kaloleni neighbourhood.
But after two years, he was in and out of hospital, suffering from pneumonia and recurrent tuberculosis, so his doctor suggested the HIV test. He took time to make up his mind. For a month Paul weighed his options and eventually went for it.
The positive result got thoughts of his child, wife and thriving business flooding through his mind. He sought solace from his aunt who, in turn, introduced him to a support group.
“Talking to my wife about getting tested was difficult. After she too tested positive, we knew there was no time for a blame game,” Paul said.
“Knowing my HIV status helped propel my life. I have since gone back to class to study HIV management and today I am peer counsellor and nutrition advisor,” he adds.
When he had the second test, he was found to have a CD4 count of 5.
CD4 cells are a type of white blood cells and a vital part of the immunity system. HIV highly affects these cells by reducing their number. The lower the CD4, the higher the chances of falling prey to opportunistic infections such as meningitis, pneumonia and tuberculosis.
Dr George Taitumu of the SOS Medical Centre says: “A low CD4 count means high viral load and vice versa. It is advisable to test for viral load but because of cost, most just test for the CD4 count to give an impression of the viral load.
“It is opportunistic diseases that end up causing HIV related deaths as a low count means the patient is severely immuno-suppressed.”
The higher the number the stronger your immune system. People without HIV infection have about 700 to 1000 CD4 cells in a drop of blood the size of a pea. HIV infected people are considered to have “normal” CD4 counts if the number is above 500 CD4 cells in that same size drop of blood.
One warning: It is important to test the vital organs of the patient, particularly the liver and kidney.
Should they be compromised, it would not be advisable to take the ARV therapy as the toxicity of the drugs would only worsen the condition of the organs, Dr Taitumu says. But the ARV therapy boosts the CD4 cell count, in turn reducing the viral load.
As the world marks 22 years since the inception of World Aids Day, Paul looks back on the 10 years he has positively lived with HIV and looks forward to many more.