Rogers Sibande (54) is making a comeback from a long-term severe illness that almost robbed him of his own life. He is feeling strong, and he cannot stop talking about his journey - and actively encouraging his community to get tested for HIV. "Please go to a health facility to test so that you can start treatment if you test positive, especially if you are a man. We, men, do not like going to the clinic, but we have to. I take my antiretroviral medicine (ARV) every day and I am feeling strong now. I would have died if I had not tested and started treatment,” says Sibande.
When Sibande first arrived at the Mashishing Community Health Center (CHC) in Lydenburg, Mpumalanga, he was very ill and struggled to walk. Seeing that his health condition needed urgent attention, Sister Mndebele immediately asked Dr. Christi Jackson, a senior medical technical advisor at health non-profit, Right to Care, to see him.
“When I first saw Sibande, he was extremely weak,” says Dr. Jackson. “He explained that he had visited a private doctor who treated him for HIV and then went to a nearby hospital. He had failed to respond to the first line regimen of ARV l medicines. He was not on a second line regimen of medicine but wasn’t doing well and had a lot of side effects. His HIV viral load was extremely high, CD4 count very low, and he had skin problems. He was also treated for tuberculosis (TB).”
The amount of HIV in the blood is called viral load while CD4 count is a measure of the health of the immune system. ARV treatment lowers the viral load of a patient living with HIV and increases their CD4 count.
Dr. Christi Jackson called a Right to Care specialist to discuss her patient’s condition. After conducting an HIV drug resistance test and getting the results, they agreed that Roger was eligible to change to TLD, a three-in-one combination of the antiretroviral drugs Tenofovir, Lamivudine, and Dolutegravir. Health experts consider TLD as the gold standard in HIV treatment because it has fewer side effects than other HIV treatments and is proven to rapidly suppress viral load in adult and adolescent patients with HIV. “That day, Sibande started on boosted TLD while continuing his TB treatment,” says Dr. Jackson.
Sister Letty Mndebele, the operations manager at the clinic from the Mpumalanga Department of Health, comments, “Every patient that walks into my facility deserves the best care so they can recover and find their strength again. So, I made sure Sibande took his treatment. When he was very frail, I took his treatment to him at home and also gave him a nutritional supplement. I worked closely with Dr. Jackson.”
Sibande attended follow-up appointments at the Mashishing Clinic, and over time, his HIV viral load decreased, his CD4 count improved, and his TB was cured. He is now well on his way to full viral suppression.
Sibande reflects on the period of his illness, saying, “Back then, I was weak. It was a difficult time for me. When I arrived at the Mashishing Clinic, I felt so cared for by Dr. Jackson and Sister Mndebele. I was excited about the new medicine prescribed by Dr. Jackson - TLD changed my life. Now, I am a living legend.”
The United States President's Emergency Plan For AIDS Relief (PEPFAR)-funded USAID-supported treatment programs ensure that all who test positive are immediately placed on HIV treatment and are provided support to stay on lifelong treatment to achieve viral load suppression. Sibande is one of 284 641 people living with HIV (PLHIV) on ART, amongst the total population of 360 351 PLHIV in the Ehlanzeni district.
The Mashishing Clinic is one of 140 health facilities in Ehlanzeni District, Mpumalanga, supported by Right to Care with assistance from USAID under the terms of the Cooperative Agreement: Accelerating Program Achievements to Control the Epidemic (APACE) in South Africa.
Senior medical technical advisor at Right to Care, Dr Christi Jackson, visits her patient at home and is pleased with his progress
Rogers Sibanda lives with HIV and takes his antiretrovirals daily