Why HIV positive mothers in Tana River take medicine secretly
Women in Tana River County are forced to secretly take HIV medication against their husbands' wishes, who believe the disease is "God's will" and forbid treatment.
What you need to know:
- Women in Tana River County are forced to secretly take HIV medication against their husbands' wishes, who believe the disease is "God's will" and forbid treatment.
- Health officials report a 48 per cent stigma index in the region, where HIV survivors face violence at home and ostracism in the community.
- Despite efforts to combat misinformation, women like Hanna Mwanahawa and Hawoo Ibrahim continue their desperate struggle—burying medicine under trees.
In the dead of night, a woman digs a small hole beneath a tree behind her house. Her movements are practiced, deliberate, and most importantly—silent. Inside a nondescript tin container lie the pills that keep her alive, a secret she guards with her life. For Hanna Mwanahawa*, this nightly ritual isn't about superstition or hidden treasure—it's about survival in a home where her husband has forbidden medication for the virus they both carry.
"My heart still falters at telling my story," says Hanna, momentarily looking away from her children playing nearby. "I guess I'm not bold enough, or maybe my heart still holds some sneaking bitterness I have thought long dead." She adjusts her headscarf, a momentary pause in her narrative. "Sometimes I try to convince myself I've healed from all this, but when I begin to tell my story, I realize I'm still a patient of a scarlet wound left unattended."
Hanna Mwanahawa is an HIV survivor in Tana River County, fighting daily against her husband's will just to stay alive.
Trust betrayed
For nearly a decade, this mother of two lived believing she understood love from a position of trust. No one could convince her otherwise about her husband.
"He was well-cultured, hardworking, and energetic," she recalls. "I didn't notice or hear any escapades about him from any corner. He is the only man my heart has known and still identifies with."
Theirs was a life of harmony—not a moment of uncertainty or disquiet. An obedient wife, Hanna covered her insecurities with his assurance. For seven years, she drank from what she calls "his cup of affirmation" and worshiped him like a lord. She never foresaw her faith in the goodness of this man losing its edge—until 2021.
"He started getting sick frequently," she remembers. "A simple flu would overwhelm him, and these sicknesses kept coming at him fast, one after another, leaving little space for relief."
Back in the village, whispers grew. People attached all sorts of narratives to their situation, but one particular rumour caught Hanna's attention. Her "prince charming" was rumoured to have contracted what the community referred to as "that big disease"—their euphemism for HIV, which they avoided naming directly out of superstitious fear it might invite the virus to their doorstep.
"I tried to ignore the rumours until the incessant gossip got the better of me, and I had to ask my husband," she says. "It did not go well with me that day."
Her genuine concern was met with violence—blows and kicks that left her reeling. Her faith crinkled, her curiosity adjusted. The anger unleashed upon her was, she realized later, a clear testament to an irritated glare covering a sickly swell of shame.
The diagnosis
Mathias Sango, a village elder with decades of experience mediating family conflicts, has seen this scenario play out countless times in his community.
"Many couples avoid testing, preferring to live in denial rather than face reality," Mathias explains, his weathered hands gesturing emphatically. "They make excuses for their failing health, attributing it to anything but HIV. By the time they accept the truth, it is often too late."
Weeks later, Hanna's husband fell ill again. "He was in bad shape, and I had to stay with him in the hospital," she recounts. "With my curiosity unsettled, I decided to secretly take the HIV test."
The test confirmed her worst fears—she was HIV positive, and so was her husband.
"For a moment, I looked at the man in that hospital bed," she says, her voice barely audible. "I wanted to scream at him, but remembered this was our new reality."
She waited until he was strong enough to leave the hospital before telling him what she had discovered. His reaction stunned her.
"He was not shocked," she says. "He didn't look surprised at all."
The moment was marked with absolute silence. The lightest footstep would have echoed between marble floor and gilded dome. He took his time, just the two of them in that dawn, trying—as Hanna describes it—"to hide his sorrows with a piece of lemon before he could say a word."
"He didn't speak regarding what I told him I had found out," she continues. "Instead, he asked me to go call the doctor to discharge him. It hit me that he didn't care."
Caroline Mueni, Project Officer for the Global Fund HIV Program, encounters this kind of reaction frequently in her work across Tana River County.
"Rising cases of HIV are influenced by a combination of domestic opposition and faith-related factors," Caroline explains. "These manifest as stigma and discrimination against people living with HIV, particularly within families and communities."
A new betrayal
That evening, when Hanna and her husband returned home, their conversations took on the tone of a master and servant. Her heart hungered with questions thirsting for answers, but he offered none. Dusk came, the day ended, giving way to what Hanna describes as "a long night, the end of all dreams, sleepless."
"When he woke up the following morning, he left for his parents' home," she says. "He only returned later in the evening with another woman, introducing her as his second wife."
The shock hit Hanna like a thunderbolt. She remembers losing consciousness, then waking to find her new co-wife attending to her, placing a warm cloth on her head.
When she opened her eyes, the co-wife left to call the husband. As the woman walked away, Hanna studied her posture—noticing she wasn't well, moved with weakness. Hanna knew her from somewhere but couldn't immediately place her.
"He came in and told me about her," Hanna continues, "and why he had decided to bring her home to stay with us. He told me she was 'one of us'—like us—meaning she was also HIV positive."
Could this woman have been responsible for their condition? Hanna wondered, her lips forming unspoken words, her spirit protesting against speech.
Hanna Mwanahawa and Hawoo Ibrahim continue their desperate struggle—burying medicine under trees and taking pills during showers—in a daily battle for survival against both the virus and the men who gave it to them.
Later that week, realisation dawned. The woman had been widowed nearly two years earlier—she was the wife of her husband's friend who had reportedly died from hypertension. Hanna remembered how her husband had helped this woman mourn and how he kept tabs on her welfare.
"It never occurred to me he would bend that low to prey on her," Hanna says. "For once, I didn't know the man I got married to."
God's will as death sentence
As though her pain wasn't enough, Hanna's husband called both women to a night meeting and warned them against taking medication for their condition. He threatened that any betrayal would be dealt with viciously, terming their condition as "a God-chosen fate that ought not to be challenged."
"In my heart, I hurled huge insults at him and was about to walk away," Hanna recalls. "But where was I going to go? Whose guest was I going to be in a land that stigmatizes HIV survivors to death?"
Daniel Mkamba, the County Aids and STI Coordinator, nods grimly when he hears stories like Hanna's.
"In pastoralist communities particularly, some men are sceptical about medication and may even prevent their wives from taking antiretroviral drugs," Daniel explains from his office surrounded by HIV awareness posters. "While stigma is sometimes less severe within urban couples, in traditional communities it can be deadly."
Hanna knew she had to find a way out. Talking to someone was an option, but finding a person to trust was difficult. Her co-wife took their husband's word as law and never dared to disobey him. Together, they were bound to what Hanna calls "a knot of misery and ignorance," living only to count their days.
"The second week, I feigned sickness and went to the hospital," Hanna says. "The co-wife was my company—of course, I knew she was my assigned watch. But while there, I was smart enough to share my predicament with a doctor in the consultation room."
The doctor immediately called for help from a local organization assisting survivors in accessing antiretroviral drugs (ARVs). Together, they hatched a plan to get her the medication secretly.
"I left the hospital with a can labelled differently, only I knew they were ARVs," she explains. "Immediately I got home, I knew he would inspect the drugs and find out, so I found a place under a tree behind our house, dug a hole and hid them there until I would need them."
For more than two years, Hanna has been surviving this way—taking her medication secretly while watching her husband and co-wife deteriorate in health.
"I wish I could help my co-wife," she says, "but I can't do it myself as she would detect something and tell my husband. I've used friends who are survivors to try and talk to her. In those cases, I have to play dumb. The way she responds to counsel is problematic because, at night, she tells our husband everything that happened during the day, and he'll be there the next day to chase away our help."
Hanna has discussed her condition with her brother-in-law, a medical professional who delivers her drugs when she's about to run out. She takes her medication at night, while showering, so her husband doesn't suspect.
Sisterhood in suffering
Caroline from the Global Fund HIV Program has documented dozens of similar cases across Tana River County. She explains: "The husbands insist it's God's will, forcing us to find ways of delivering medication secretly. It's a sad state of affairs."
According to Caroline, in many cases, women face resistance from their partners regarding condom use or treatment adherence, further fuelling transmission. She notes that while faith-based organizations often contribute positively to HIV awareness, certain beliefs can inadvertently lead to risky behaviours, limiting the effectiveness of public health campaigns.
Hanna's story echoes through the experiences of other women in Tana River. Hawoo Ibrahim has dealt with a cruel husband who infected her with HIV six months into their marriage.
"Whenever he would make a sale from his cows, he would not come home for a week," Hawoo recounts. "He would spend money on sex workers in Garsen town, then return when he was almost broke."
It was during these escapades that he contracted the virus and came home sickly. He refused to take drugs and warned Hawoo against it too, threatening to kill her if she disobeyed.
"I was not going to escort him to the grave this early," she says firmly. "I have young children to care for. If I had to be disobedient for them to live, so be it."
Several times when he caught her taking medication, he would beat her until she vomited the pills. Then he would ransack their entire "manyatta" (traditional homestead) for any hidden drugs and destroy them.
The price of survival
During the reporting of this story, this journalist was pursued three times with a machete by the husband of one of the HIV survivors—an effort to ensure their family secret remained hidden. It exemplifies the lengths to which some men living with HIV will go to protect their secret, preferring to kill or die in silence.
Hawoo's final resolution was to ask for a divorce—a request granted after a thorough beating, with her husband blaming his condition on her.
"He used to say that I prayed for him to get the disease," she explains. "That if I never wished him bad luck, he wouldn't have contracted HIV."
She left for her mother's home, where she lives with her children while taking care of her health. But even there, stigma follows like a shadow.
"I can't fetch water with other women," she says with a sad laugh. "I have to go when everyone else has left the water point because they think if I touch the well handle, I'll leave the infection there and they'll contract it."
Mathias Sango has observed such community reactions first-hand. "People avoid them, refuse to trade with them, and even their children face rejection," he explains. "Some believe merely associating with them could mean they're also infected."
The village elder describes how simple illnesses such as mild flu or unexplained weight loss immediately spark gossip, with speculation linking the affected person to HIV/Aids.
"Couples fear being associated with someone who might be infected. I've seen divorces happen because of such suspicions," he reveals, attributing this to widespread illiteracy. "In our society, education levels are low. Many people drop out at junior primary school, leaving them vulnerable to misinformation about HIV/Aids. We need more community-level education to change this narrative."
In gatherings, Hawoo knows her place—other women won't sit near her, and other children don't play with hers. She plays with them herself, teaching them how to respond to stigmatizing comments.
"All my children are healthy and well," she says proudly. "I followed instructions properly to safeguard them. They didn't deserve any of this. Nobody does."
Breaking the silence
To combat stigma and misinformation, County Aids Coordinator Daniel has enlisted religious leaders.
"We are engaging clerics to spread awareness in mosques and during public barazas," he explains. "Religious influence is strong here, and we believe it can help change perceptions and encourage acceptance of treatment."
According to the National HIV and Aids Stigma and Discrimination Index, Tana River County, along with other coastal counties, has a stigma index of 48 per cent, posing significant barriers to HIV prevention and treatment efforts. A 2016 study highlights that fear of being labelled HIV positive leads many women to avoid delivering in health facilities, despite the availability of skilled care.
Despite ongoing efforts from health officials like Daniel and Caroline, both they and community leaders like Mathias agree that the battle against HIV-related stigma is far from over. Without continuous education and community engagement, survivors will remain trapped in a cycle of rejection, secrecy, and ultimately, preventable deaths.
Back at her home, as another day ends, Hanna prepares for her secret ritual—retrieving medicine from beneath the earth, taking it in hidden moments, then burying it again. She fights not just a virus, but the very man who gave it to her, and a community that would rather pretend she doesn't exist. For now, her medicine remains buried under a tree—along with her hope that someday, the stigma too will be laid to rest.
*Name changed to protect medical privacy.