Monrovia — Smartly seated behind his computer, crunching out numbers and making calls to colleagues, Anthony*, a 38-year-old father of three, is amongst those looking to check the spread of HIV in Liberia. He received confirmation of his own positive status after testing in 2007.
"Although I felt bad, I wasn't like other people who want to commit suicide," said Anthony, treasurer of the Liberian Network of People Living with HIV. But he said he was particularly concerned about his children: "I felt that they were still small and needed my support in school."
Prior to his diagnosis, Anthony was teaching at a community school. Once tested, he quickly became the target of gossip.
"There were some people in the community who saw me at the hospital and started carrying news around," he said. But this stopped when he began taking his antiretroviral pills and "came up well", showing few signs of physical ill-health. While Anthony's partner is also HIV positive, all of his children, the youngest of which is four years old, are negative. They are unaware of their father's status.
Successive surveys over the past few years have put Liberia's HIV prevalence rate at around 1.5 per cent, less than half that to be found in neighbouring Cote d'Ivoire. But as the executive director of the National Aids Commission, Dr. Ivan Camaner, points out, the rate means that in actual numbers, about 38,000 Liberians are infected with the virus. He warned strongly against complacency.
Shifting Attitudes
Until a few years ago, many Liberians were dismissive about the threat posed by the virus that causes Aids. "Something must kill you anyway," was a phrase often heard in youth gatherings. The Aids acronym was mocked as: the American Intention to Discourage Sex.
But attitudes are changing.
Young activists share Camaner's sense of urgency. Albertha Yates, a 21-year-old freshman student at the University of Liberia, is host of Let's Talk About Sex, a radio program which promotes safe sex. She is also part of the Economic Empowerment Program of Adolescent Girls (EPAG) sponsored by Liberia's Ministry of Gender and Development. She said, "People are aware of HIV, but there are just certain things they don't know about the disease".
Campaigns for safer sex have run into problems in the past over Liberians' resistance to condom use. Yates said young people still complained about condoms taking the pleasure out of sex, but stressed it was vital to stay safe. She encourages young girls to always carry a condom, especially when visiting their boyfriends. "It doesn't mean you are a prostitute. No. Is it because of that few minutes of satisfaction that you want to risk the rest of your life?"
Dr. Julia T. Garbo, deputy program manager of the National Aids Control Program (NACP), recalls people spurning condoms in the past, putting water and sand in them rather than using them for their intended purpose. But she said activists were now making some headway.
"We have people in the field distributing condoms," Garbo said. "We have people every now and then coming up to ask for them."
Garbo said Liberians were now better informed about HIV and how the virus could be tackled. "We went from community to community, sensitizing the population about HIV and the facilities that are available for testing and treatment," she said.
With the help of the Global Fund to fight Aids, Tuberculosis and Malaria, treatment of HIV positive patients in Liberia is free, said Garbo.
She confirmed that HIV was more common amongst Liberian women than men. A survey by the Ministry of Health and Social Welfare carried out in 2007 showed a prevalence rate of 5.7 per cent amongst pregnant women.
Complications
One of the complications in tackling HIV in Liberia has been the high number of refugees. Liberia's 14-year civil war led to big population movements across borders. Only now that the country moves towards stability have some of the thousands of Liberians in refugee camps in the region begun returning home.
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But this poses a new challenge.
Garbo said although there are no scientific estimates of the infection rates amongst returning refugees, the number is significant enough to impact the country's infection rate as market women, students and truck drivers were coming across the border with the disease.
Some refugees amongst the tens of thousands of Ivorians who crossed into the border county of Nimba during Cote d'Ivoire's post-election violence last year were also infected.
"We are treating them for malaria, severe anemia, tuberculosis, HIV and cancer too," said Mary Lankah, a physician assistant and officer in charge of the Saclepea Health Center.
During the early years of her administration, President Ellen Johnson Sirleaf, who is the chairperson of the National Aids Commission, said HIV will have a major impact on the country's developmental agenda unless its "growing rate can be controlled".
* Not his real name
