A Stealth Visit to Save a Life

AIDS work in Cambodia

A doctor in Cambodia draws blood to test for HIV. Photo by David Snyder for CRS

In Cambodian villages, CRS staff and partners go house to house to make sure HIV-positive patients are taking their medication. Sometimes, though, patients decline this home-based care. CRS field staff sent in this story of how, with perseverance and tact, they overcame one woman’s reluctance.

“Stigma and discrimination about HIV are decreasing in Cambodia, but self-stigma and fear remain in some areas. We saw this with Mrs. Sophear, who is 27 years old and lives in Yieng village with her husband.

“While she was pregnant, she went to a local hospital for her prenatal care and was told that she was HIV positive. She was very worried and did not tell her husband. When the time came to give birth, she took steps to prevent mother-child transmission of the virus, but hid the reason from her husband.

“She went quietly to a clinic and got an immune system test done in August 2009. The result showed that she should start treatment for HIV. She decided that she did not want the home-based care team to go to her home, but would instead go to the clinic by herself for followup.

AIDS work in Cambodia

Antiretroviral medications and card showing the treatment schedule of a CRS beneficiary in northwest Cambodia. CRS funds home-based care to make sure HIV-positive people take their medication properly. Photo by David Snyder for CRS

“The team—staff from CRS partner Caritas Cambodia–respected her decision. But, six months later, she did not show up at the clinic. The home-based care staff was worried that she dropped out, but was also afraid to go to visit her. They said she was ‘afraid that people around her house would know.’

“The team discussed the case and decided to send one staffer to go as a friend, without a motorcycle and without bag or anything that would show she belonged to a care organization.

“So Mrs. Chreb, a Caritas home-based care worker, went to visit Sophear. The husband was not at home and the two women could talk together. Chreb learned that Sophear acknowledged that she had HIV and she wanted to get treatment but did not have money to go. She got some money and promised to go the next day. Chreb told her that our staff would provide assistance to her.

“Chreb also counseled her a long time to make her understand the importance of talking to her husband.

“Sophear did go and got a new appointment for a CD4 count [immune system test], along with more counseling in the hopes that she will discuss the situation with her husband. She is in good health and will get started on antiretroviral medication after the test and preparation for treatment.

“Sophear’s baby is now 10 months old and was tested. The results have not come yet, but the child is in very good health.

“We’re happy Sophear agreed to go for treatment. The next challenge is bringing her to a point where she will discuss HIV with her husband and make him go for testing–for the wellbeing of the entire family.”

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