Let's stop turning blind eye to those born with virus

Tomorrow is World AIDS day and Melody* is over the moon! It is her birthday, a day she holds dear because she has learnt to count her blessings twice each 1st day of December. But this one is even more special. Melanie is also graduating from university! 
When Melanie was born 22 years ago, there was no celebration. Her mother had been extremely sick throughout her pregnancy and no one believed Melanie would survive. She came prematurely, five weeks before time. While she fought for her life in the newborn unit, her mother was fighting for hers in the ward a floor below. Unfortunately, while she made positive strides, her mother succumbed to the complications of AIDS without ever laying eyes on the daughter she bore. She has no idea who gave her a name. 
This was 1999 and HIV/AIDS was only whispered about. Melanie never knew what it meant to breastfeed, to have a mother hold you to her bosom. She spent the next 17 months in the hospital before she was eventually transferred to a children’s’ home. She has never known if she had any other kin. Her mother was unmarried and Melanie wonders if she was even accorded a funeral. This is all she knows of her origins. 
Being in a children’s home at the sweeping turn of the century with a pandemic razing down the continent did not inspire any hope for an HIV-positive orphan. The homes were ill-equipped to care for them and the general expectation was that Melanie would barely survive toddlerhood. But survive she did and eventually access to HIV treatment caught up with her. She was five when she was initiated on highly active anti-retroviral drugs (HAART). 
2004 was the year lady luck smiled down on her and Melanie finally found a home to her name. She was adopted by a couple that was particularly interested in caring for an HIV-positive orphan. It was the first time Melanie experienced family and she never looked back. 
Not only did she thrive, she flourished. Her new parents strictly adhered to her treatment protocol while striving to protect her from stigma. Though she knew her status, she did not really understand what it meant, remaining largely oblivious to her reality. 
However, this wasn’t meant to last forever. Through school, Melanie was slowly exposed to what HIV infection looked like to other people. She began to realise that she did not belong to the class of normal people. Whenever HIV was mentioned in the media, in school and on billboards, the only message she heard was that HIV was a shameful condition for people who were careless and had unprotected sex. She could not relate to the message. 
The older she grew, the more resentful she got. She desperately wanted to be normal. She resented her clinic visits, her medication, her counsellors and sometimes even her parents. The more they tried to reassure her, the more she felt that they only took her in because of pity. She was not handling the adolescent transition well. Even worse, society wasn’t helping.
Melanie is a representation of our very special group of adolescents and young adults, who against all odds, are here today, having survived congenital HIV infection or infantile infection. We joyously celebrate them as they are a constant reminder that we remain on course in taming the virus. They were never expected to see their fifth birthday, but today they are starting families of their own! 
Despite these phenomenal achievements, our biggest downfall remains in the poor management of HIV stigma. In the advocacy world, we have made great strides. HIV awareness champions like Doreen Moraa Moracha have inspired hundreds of thousands by telling their story of being born and living with HIV, injecting the much needed positive spirit for many like herself. 
However, we are still failing miserably by the message we are giving the young ones during their most difficult transition. Conversations about HIV prevention in our public arena and schools focus on those who are negative and how they should protect themselves. To those born and growing up with the virus, the message is that they are the evil enemy lurking out here waiting to pounce on unsuspecting victims and infect them. No child or adolescent should have to live with such a burden! 
This hacks away at their self-esteem and mental well-being, threatening everything that their loved ones have worked so hard to achieve. The trauma occasioned by the stigma has forced many to rebel against their treatment, refusing to take medication. This endangers their lives as their immune status is compromised and they run a dangerously high risk of developing resistance to the lifeline medications they take. 
We are a country that prefers to bury our heads in the sand when it comes to addressing comprehensive sexuality education. If we won’t have candid conversations with our children about the adolescent transition and sexuality, how will we initiate the conversation with those whom their condition requires deeper, soul-baring engagements about the same? 
These young people are growing up around us. We must never subject them to the need to hide their chronic illness because of stigma. It is our responsibility as a society, to adjust our mindset and communication to fit into their needs. They should never have to question why their parents had to pass on the virus. They must be treated like all other children with chronic illnesses such as asthma, congenital heart conditions or childhood diabetes. 
This blind spot in our society is the very reason we shall not honour this year’s theme to End Inequality! Access to medication is not the only driver of inequity, stigma is too!

Dr Bosire is an obstetrician/gynaecologist