A report released recently showed that the prevalence of HIV was on the rise in adolescents and young adults.
It partly attributed this rise to the shift of focus from prevention to treatment.
One of the most important things in every field, but above all in public health, is what you may define as institutional memory. What do I mean by institutional memory? It’s what we call the lessons taught to us by our forefathers, the lessons taught to us by previous generations so that we do not repeat their mistakes.
A perfect example is the drought in Kenya, that ‘hadn’t been witnessed in a period of 40 years.’ If you ask anyone below 50, they have no recollection, but if you asked a 60-year-old, they could probably speak of those times and the impact of the drought. That is what I refer to as institutional memory.
When HIV cases started being reported in Kenya, what to a large extent saved many lives, were the donations and support by programmes such as PEPFAR. There was a massive inflow of funding toward advocacy campaigns around prevention. Medication was made available to treat the HIV associated symptoms and slow down progression to Aids.
This was a time that HIV/Aids was viewed as a death sentence, when no one would dare touch a HIV Patient and some practitioners would wear masks around these patients.
Then we started getting anti-retroviral drugs -- expensive drugs that once again were made available as part of PEPFAR support, among others. The advocacy campaign was reinforced with messaging around testing and how it was important to know one’s status.
Kenya laid out a good infrastructure for the prevention, testing, and subsequent treatment of HIV Positive patients, and because of that a whole generation was spared.
That was 20 years ago, if not more.
Now we have young people growing up who don’t appreciate the horror of what HIV is. Unfortunately, our cultural norms haven’t changed much whereas, in some communities, it is still considered taboo to talk about sex.
In some homes, parents still feel embarrassed to talk about sex and children end up learning about sex from pornographic websites or from peers, or, worse still, from the streets as the case in some underserved communities. Little of that information includes sexually transmitted diseases in which there are many including syphilis, gonorrhoea but by far the worst, historically, has been HIV.
There’s a knowledge gap that exists for the younger generation who lack the institutional memory of the effects of HIV.
It is time to ask ourselves, as the statistics are clear, how do we communicate to adolescents and young adults?
This is a pertinent question, as the campaigns that worked 20 years ago won’t work now and certainly not in this digital age.
It is a question policymakers and stakeholders at a local level need to ask, as in the face of dwindling donor funds, locally sustainable solutions would be needed.