12 June 2013

Tanzania: 'New' HIV/Aids Drive Aims At Testing Before Tying the Knot

IT is an exciting time in Zanzibar right now. Many weddings are taking place ahead of the holy month of Ramadhan when all adult Muslims are supposed to fast, but it's also an opportunity to draw attention to the AIDS epidemic that continues to have a devastating effect in Africa.

Fasting, according to Islamic teaching, is one of the Five Pillars of Islam and is primarily an act of willing abstention from all food, drink, and sexual acts or both, for a period of Ramadhan (or Ramadan), which is the ninth month of the Islamic calendar, and the month in which Muslims believe the Holy Quran was revealed.

A wedding is a ceremony whereby two people are united in marriage (nikah). Wedding traditions and customs vary greatly between cultures, ethnic groups, religions, countries, and social classes.

Normally every year in Zanzibar, the period before Ramadhan, it is a wedding season! Families in both urban and rural areas are busy. Muslim judges (kadhis) are busy blessing the ceremonies by providing marriage certificates; and it is also time for qasida-a form of lyric poetry that originated in preIslamic Arabia groups and Taarab music to entertain.

But this year's wedding season is exceptional as health authorities are using it to campaign against the spread of HIV/AIDS, adverts before or after the Zanzibar Television news bulletin, calls upon people planning to wed to have voluntary testing.

The TV footage shows a family including an elderly, youths and cheering women who raise their voice with joy, but at the end of the advert, all the participants emphasize on testing before marriage "Let us go for testing, it is important to go for HIV/ AIDS testing at least three months before marriage."

Dr Ahmed Khatib Reja, head of the Zanzibar Integrated HIV/TB/Leprosy Programme (ZHTLP) says although the problem of HIV/AIDS is lower than other countries in the Eastern Africa region, we need to have strategies to minimize the spread of the disease.

According to the National Bureau of Statistics (NBS) 2012 survey, HIV/AIDS prevalence on Unguja Island is 1.2 per cent while in Pemba it is 0.3 per cent, and Reja says the community should take all the necessary steps in combating the spread of the disease.

"In efforts to control the spread of HIV/AIDS we are implementing a number of programmes. Currently the programmes include: counselling and voluntary testing; adherence to treatment; and home based testing," Reja said.

He said the ongoing advertisement encouraging partners preparing for wedding is part of the "counselling and voluntary testing" programme supported by the US government, and that it is effective because already there is change among Muslim cleric who approve/bless the wedding.

Reja, "most of the Muslim judges (kadhis who endorse the wedding) are now reluctant to approve the wedding without HIV/ AIDS testing certificate. At least there is growing awareness among the community to test before marriage. It is purely voluntary, and people are just being encouraged to test."

There are about 56 counselling and testing centres, while pregnant mothers can test in 144 Reproductive and Child Health (RCH) clinics across the islands, also used for Prevention of Mother to Child Transmission (PMTCT) of HIV. The doctor says many people are gathering courage to test.

"We need more people to test, because only 28 per cent of the Zanzibar population knows about their HIV status," he said. He said adherence to treatment is another programme dubbed "treatment as prevention", were people living with HIV are encouraged NOT to stop using the ARVs.

About three thousand four hundred patients have been enrolled for ARVs in Zanzibar, he says. Under the "Treatment as prevention" programme, people living without HIV are also protected because study indicates that proper use of Anti-Retro-Viral (ARVs) drugs minimizes transmission among partners.

There have been mixed reaction among the members of the community about HIV/AIDS testing before marriage, many are scared, but the move has been welcomed and health officials think it is an achievement in the fight against the spread of the pandemic.

Mr Omar Kombo, 26, and Rahma Abdulrahman, 20, got married two weeks ago, "we were asked to go for HIV testing. It needs courage, but fortunately we managed to test two months before wedding."

They informed the 'Daily News' that many people do not know proper time to test as many do it few days before wedding, while health officials advise to test at least three months before weddings.

Sheikh Mohammed Suleiman, one of the prominent preachers in Zanzibar supports and encourages people who want to get married to for HIV testing, "it is good to have voluntary testing to remain safe. People are not forced, but are advised to test."

The Principal Secretary (PS) Dr Saleh Mohamed Jidawi says that families have the opportunity to receive voluntary HIV testing, "their excitement for wedding and getting married should be a catalyst to helping turn the surge against the spread of HIV."

He says that it is so important that, even in a time of celebrations to raise HIV/AIDS awareness. Including HIV education in social parties, can help to reduce people not to feel afraid, and break down misconceptions.

Zanzibar AIDS Commission (ZAC) data indicates that Zanzibar had maintained HIV/AIDS prevalence rate at 0.6 per cent since 2002, but recent statistics shows a rise to one per cent as people are asked to apply additional efforts to combat the scourge.

Minister Juma Duni Haji thinks that Zanzibar can eliminate spread of HIV/AIDS under the new global programme to stop new cases, but calls for homosexual freedom spreading in almost all regions of the world, poses a grave threat to war on HIV/AIDS.

"Zanzibar's permissive culture does not allow homosexual and commercial sex, but call to governments to guarantee freedom of people interested in the behaviours is now a great challenge," the Minister says.

Equally, the Penal Laws in Zanzibar are very strict in the Union of person of the same sex and a person found and convicted in so doing risks a jail term not exceeding seven years. Interestingly so and despite wide spread reports of homosexual activities, there has been no person reported to have been arrested, charged and convicted.

The minister warns that homosexuality, having sex with multiple people and using or sharing syringe for drugs, increases chances of contracting HIV and hepatitis. "In this era of human rights it is difficult to control these unacceptable behaviours."

In this regard, the Minister argues that the government can no longer force people out of homosexuality, commercial sex and using drugs, but can win the war through workable awareness programmes.

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