Nancy Kalomani is a woman on a mission.
The 35-year-old wants to end new HIV and Aids infections in children, by pushing for the Prevention of Mother to Child Transmission (PMTCT) and connecting those living with the virus to get spouses.
For 15 years, Kalomani has seen it all. From four botched relationships which resulted in her getting three children and contracting HIV.
At the age of 20, she already had two children from two botched relationships and at 23, she was pregnant with her third child.
Having disappointed her parents despite having been forgiven and taken back to school, she ran away from home fearing the wrath of her father who was now taking care of her two children.
On the day she ran away, she met a stranger and ended up in a new marriage.
“He told me he was looking for a wife and for my case, I wanted a place to sleep, that’s how we got married,” she said.
Kalomani said her new husband later became violent and would bring other women to the house and sleep with them on their matrimonial bed.
Not a death sentence
She moved out after life became unbearable and years later, got married again.
“I had stayed for two years without conceiving. When I got pregnant in 2019 I was so excited. Normally, I would start my antenatal clinics late but this one, I wanted to start early when I was just five weeks pregnant,” said Kalomani.
At the clinic, she said several tests were conducted and it was there that she was informed that she was HIV positive.
She broke down.
“My adopted daughter who was 15 years at the time hugged me and asked me to stop crying. She said having HIV was not a death sentence,” said Kalomani.
“She told me that in their school, her fellow students who are living with the virus were healthy. Her sentiments gave me hope.”
She had assumed that she got it from her husband. However, when they went for testing, he turned out to be negative.
“Given that I was pregnant and chances of giving birth to an HIV-positive child were high. I went to a VCT centre and was given ARVs to lower my viral load. When I gave birth, my child was HIV negative,” she said.
Suppressed viral load
She said her husband was put on medication PrEP (Pre-exposure prophylaxis), and they were advised to use condoms incase her viral load was high.
PrEP is taken to prevent getting HIV and reduces the risk of getting HIV from an infected person by about 99 per cent, according to the Centres for Disease Control and Prevention.
“At four months, I did a viral load test and it had been suppressed. When I gave birth to my fourth baby, she was negative even my fifth who is 11 months old is also negative,” said Kalomani.
“Before going into labour, tell your doctor your HIV status to enable them to save your baby at birth. My baby was put on medication within an hour before breastfeeding her.”
The baby was given drugs reserved for infants born in such circumstances. A drug called Zidovudine was administered before she breastfed the baby.
The mother would administer the drug every morning and in the evening, she would administer another drug called Nevirapine.
After six weeks, she discontinued the earlier drug Zidovudine.
She would give the newborn Nevirapine and Septrine until the baby was 15 months old. That is when she stopped breastfeeding -- and she got pregnant again.
“If you are negative and your partner is HIV positive, if you decide to live with them, don’t see it as pity, make it come from your heart, don’t use the status as a weapon against them, just be a support system to them,” she said.
“If you are the one who is HIV positive, appreciate your spouse and take ARVs as recommended to protect them. I never imagined I was HIV positive until I got pregnant and tested positive. People think that it’s only through sex you can get infected. Even good drivers cause accidents.”
Kalomani said her husband is her support system and he reminds her to take drugs as he knows if she doesn’t, he can also get infected.
Now currently runs an HIV and Aids awareness organisation called Rhema, which is also a forum for HIV survivors whose motto is ‘Don’t bury me Alive’.
She is advocating for expectant mothers to get tested to know their HIV status so they can be helped to give birth to HIV-negative children.
“Let’s support HIV people with food to enable them to take the drugs. The government doesn’t support them as it’s not a form of disability. ARVs weaken the body if you take them without eating,” said Kalomani.
In order to end HIV and Aids in children by 2030, Kenya has joined the Global Alliance whose agenda is to ensure no child is born positive for HIV by 2030.
Data from the Kenya Health Information Systems (KHIS) shows that in 2019, over 1.4 million people were living with HIV with 90,000 of them being children aged below 14 years. The number dropped to 78,465 in 2021.
A consortium of the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and the United Nations Programme on HIV and Aids (UNAIDS) formed the new alliance to fix the glaring disparities in HIV and Aids prevention and response.
“New HIV infections among children can be eliminated. Countries should mobilise resources, look at science and technology available to ensure no child is born with HIV,” Ruth Masha, the National Syndemic Diseases Control Council (NSDCC) chief executive.
Dr Masha said that children already living with HIV should get the best treatment to live longer, adding that if they fail to get child-friendly ARV drugs, they will die before their fifth birthday.
According to the Ministry of Health, in 2019 alone, 3,100 children died from HIV-related complications and in 2021, a further 3,091 died before their fifth birthday.
“It’s possible for couples living with HIV to get HIV-negative children if they adhere to treatment,” said Masha.
“Breastfeeding mothers should take medication to prevent mother-to-child transmission. When couples know their HIV status, it’s easier to treat them.”
Masha said 80 per cent of HIV and AIDs help comes from external sources, saying the resources are quickly depleting after Kenya attained the low middle-income status.
“The alliance wants to ensure that countries transition from donor funding to the financing of HIV programmes locally,” said Masha.
“We want to protect the gains by ensuring that those supplies for children remain constant by 2030.”
She said that this financial year, they have a budget gap of Sh10 billion for HIV prevention, treatment and care, adding that Kenya is looking for ways to bridge the gap.
The Global Fund and the US President’s Emergency Plan for Aids Relief (Pepfar) are the major funding sources for HIV drugs.
The Global Fund also funds TB and malaria programmes.
Masha says Kenya has made strides in the prevention of mother-to-child transmission.
In 2013, there were 13,000 new infections in children but in 2021, the number of infections dropped to around 5,000.
In the last 10 years, mother-to-child transmission has reduced from 17 per cent to 9 per cent, meaning that many mothers living with HIV can now get HIV-negative children.
Masha said that the young people are the ones posing a big headache in the fight against HIV pandemic, adding that those aged below 29 years account for over 61 per cent of all new HIV infections in Kenya.
“Young people think HIV doesn’t exist and if it exists is not a serious thing. They take family planning drugs but they don’t protect themselves during sexual encounters as they don’t use condoms,” said Masha.
“In 2021 alone, young people aged between 15 and 19 years accounted for 16,000 new HIV infections.”