Dr. KK and Sister AG are owners of one of the earliest private clinics in Addis Ababa that preformed HIV tests. We were honored they took a moment to talk to us…

Seleda: How did you start?

Dr. KK: We have been running a modestly-sized clinic for the past 25 years. About a year and half ago, we extended it to include HIV testing. The AIDS clinic is now almost a separate clinic due to the huge demand for the service. It employs 5 full time employees including a doctor, a nurse, a lab technician, a counselor and office manager.

Seleda: How many patients do you see in a week?

Dr. KK: We see about 40-50 patients per week.

Sr. AG: It depends. Sometimes we see as many as 100 patients per week.

Seleda : What motivates your clients to seek your service?

Dr. KK: Most come to take the HIV test and learn about the results just for themselves. Perhaps, they have some concern and want to know the truth.

Sr. AG: Some of them come because they are either going abroad and need a certificate or are getting married and want to know the results of the test.

Seleda: What is the demography of your patients?

Dr. KK: The vast majority is within the age group of 18-35 and tends to be male.

Seleda: What is the test like? What does it involve?

Dr. KK: There are 3 sets of tests. We have two blood tests we call "rapid tests" that take minutes for a result. Negative results from both of these rapid tests are taken as an indicator that the person is free from the HIV virus at the time of testing. Any positive from either of these two rapid tests is followed by a detailed test called "Elysa" test, which is used to confirm the positive call.

Seleda: How many hours or days does the test normally take?

Sr. AG: Just 3-4 hours for all the three tests. In a day our clients can have their results.

Seleda: Given the seriousness of the implications of the test, what kind of reactions do you see from your patients?

Dr. KK: A "negative" result of course causes extreme happiness and we see some of our women patients breaking into "Ililita" and bracing and kissing our medical personnel.

Sr. AG: The men are a little bit reserved; but I have seen some crying out of happiness.

Dr. KK: On the other hand, a positive result gets mixed reaction. A good number of our male patients seem to take it as if it was expected and react rather mildly. We seem to hear sayings like: "IgziabhEr be-ager yameTwn innE mn adergalehu". It is sad in a way; this nonchalant attitude.

Seleda: How about counseling? Do you offer it? Are you required to do so by regulatory bodies like the Ministry of Health?

Dr. KK: Yes, we do have a strict counseling procedure. All patients are offered and are required to take what we call "pre-test" and "post-test" counseling irrespective of the outcome.

Sr. AG: I have the responsibility of providing the "post-test" counseling. Actually, I had taken a compulsory one-month training in counseling given by the Ministry of Health.

Seleda: What kind of things do you counsel?

Sr. AG: If the tests come positive, we urge and advise them to refrain from further unsafe-sexual practices. We urge them also to keep their results private (between them, their family and their doctor or nurse) as they will face extreme discrimination from society and employers if they make it known. We are required to tell them that with a positive result, they need to take precaution not to pass it to others through sexual or other close contacts that transmit the disease.

Dr. KK: In the case of a married patient, we require that they bring the spouse and have them tested also. The spouses need to be informed about the result.

Seleda: Do you see any difference in number, demography and attitude over the months and years you have run this clinic?

Dr. KK: Yes. The number is increasing, without any doubt. This is very disturbing. The age group is still the same with men in the ages of 18-35 being the typical patients. The attitude has become more complacent and that worries me a lot.

Seleda: What is the most difficult part of your job at the clinic?

Dr. KK: Obviously communicating a positive result to a patient. What makes it worse is the knowledge that these people can’t do a single thing about it in terms of medication. The cocktail of medication AIDS patients in the developed countries take to prolong their lives is simply unavailable in this country. The country and the patients cannot afford medications that cost 5000-10,000 Birr per month and these patients go home and will be without any kind of treatment that may prolong their lives.

Seleda: How about talk of importing from cheaper sources?

Dr. KK: Yes, we have heard on the radio and TV about plans to import these medicines from cheaper sources like India, but nothing has come out of it. As of now, there is no place I can send my patients to buy this medication. This is the hardest part of our job.

Seleda : Any last thoughts?

Sr. AG: Yes, I think the government and international groups need to do something about the cost of medication. I do not know anyone making a salary of 10,000 Birr every month, let alone spend it. How long can we let these patients go home with no hope of any sort?

Dr. KK: Well, it is a sad situation and we are on the forefront and see its effect and death toll it is taking on the society everyday.