I am diabetic, asthmatic and HIV-positive

Her looks are deceptive. You can never guess that her outwardly healthy body and cheerful attitude masks not one, but three chronic diseases. Mosalagae Tollito* is a 39-year old mother of two kids, aged 12 and 8 years, and she has suffered from Asthma since early childhood. At 23, she was diagnosed with Diabetes. She went to a clinic and reported itching in private parts, but did not think it important enough to tell that she was also urinating frequently. The medication she got did not improve her condition.

“Two weeks later I went to a family planning clinic where I came across a pamphlet with signs and symptoms of Diabetes. When I read that, I said this is me! I went to the healthcare worker to check for Diabetes. My blood glucose levels were very high and could not be controlled with oral medication. “I was admitted for two weeks in hospital. There I was given insulin and that made me feel better. Since then I have been taking insulin twice daily,” she shares. But this was not the end of Tollito’s woes. At the time of her first pregnancy in 2004, she tested positive for HIV.

This was a devastating blow for her. She had contracted the virus from her partner who continued to remain in a state of denial. She delivered a baby boy through a C-section because of her diabetes.“Fortunately my baby was HIV negative. My partner was positive but he had hidden that fact from me. I did not know his status at that time. When I told him about my status he lied to me that he had gone to the clinic and tested negative. “It was only later that I found he was positive. Things did not work out well between us and we parted ways.

I later found another partner who was HIV positive but he was honest with me and we are very happy with each other.” Tollito started on anti retroviral treatment (ART) in 2012 on the insistence of her doctor. Her CD4 cell count was 586 at that time and she was not feeling sick at all. But, she says because of her Diabetes, the doctor did not want to take chances and put her on ART right away. She was tested for TB also but thankfully did not have it.“I am on medication for three chronic diseases - Asthma, Diabetes and HIV.

I get the drugs for all of them on the same date at the same health facility, which is a walking distance from my place. I am fine now, as you can see,” said Tollito who also volunteers as a community health educator. “There is still a lot of stigma around HIV/AIDS in the community and families,” cried Tollito. There is more gender bias and stigma in women living with HIV in the communities, as patriarchy issues still exist. She says that she was lucky to have a strong family support, which she thinks is very important for people living with HIV. Yet, when she goes out in the community talking about HIV, many still do not want to disclose their status, especially women.

“We need to tell people that HIV is a chronic disease and not a death sentence. Being HIV positive is not the end of the world”. She believes that while innovative approaches in healthcare delivery are essential to tackle the double-disease burden of communicable and non-communicable diseases (NCDs), existing platforms for HIV and TB detection, care and management can be leveraged effectively for NCD services to address populations’ needs holistically. At the same time, she says, effective counseling by health workers work wonders. *Tollito is a pseudonym used to protect the interviewee’s identity.