KAMPALA

Ugandan health workers are concerned by the growing number of HIV-positive teens who are abandoning their HIV treatment after turning to bogus religious leaders.







"Over the years we have noticed a growing trend of adolescents and caregivers who have withdrawn from treatment with a belief of having been cured of HIV/AIDS in church," said Cissy Ssuna, the counsellor coordinator at Baylor College of Medicine Children's Foundation Uganda, which treats more than 4,000 HIV-infected children, 750 of whom are adolescents.







Rebecca Nakityo, 17, spends every free moment watching gospel TV, reading the Bible or praying in church. The soft-spoken teen - who has lived with her aunt and uncle since her parents' death several years ago - told IRIN/PlusNews she believed she was cured by God six months ago.







According to Nakityo, as the pastor's voice reverberated through the church hall, she felt filled with the healing power of God. Nakityo now regularly gives testimonies about her "healing" and has stopped taking her ARVs.







By the time many young people find their way back to the health system, it is too late. "We had a client who was in church; they brought her and dumped her at Baylor - we tried to treat her but it was too late," Ssuna said.







Pressure







She noted that the practice was more common among Pentecostal churches than other religious denominations; while teens often made the decision to abandon treatment on their own, peer pressure was also a factor.







A 2007 study by Uganda's Makerere University's Infectious Disease Institute found that 1.2 percent of 558 respondents initiating ARVs discontinued therapy because they believed they had been spiritually healed. Four out of six restarted therapy, but three required much more expensive second-line salvage therapy.







One spiritual leader told IRIN/PlusNews that patients were misled by unscrupulous pastors. He advises HIV-positive believers to pray for healing but continue with their medication.







"The missionaries knew that very well - that is why they built churches alongside hospitals," said Bishop Dunstan Bukenya from the central district of Mityana.







According to Mary Kiwanuka, who has an adolescent daughter living with HIV, the influence of television evangelists should not be underestimated. "These children are exposed to too much television which shows people being healed," she said. "In their circumstances, with too much peer pressure and the pill load, if there is an alternative they take it."







Ssuna said rather than criticizing the church, her organization was trying to work with spiritual leaders to encourage teens to stay on treatment rather than abandon it for religious reasons.







Reaching out







"We have gone to some churches where our clients go and we want to start having dialogues so that we and the spiritual leaders speak the same language," she said. "We want them to come in and support us."















We had a client who was in church; they brought her and dumped her at Baylor [clinic] - we tried to treat her but it was too late







Between March and October 2009, Baylor enlisted trained spiritual leaders after they noticed that many people - especially adolescents - had quit treatment. The adolescents returned piles of drugs to Baylor and officers on home visits found patients were not taking drugs.During that period, Baylor brought two spiritual leaders to the clinic twice weekly to counsel the adolescents and caregivers.Counselling involved prayer, rationalization of the clients' status, the role of ARVs, the importance of adherence and coping mechanisms. Prayers were held for groups or individuals.Clients said the visits were uplifting and alleviated distress."However, many clients also asked 'why is God punishing me?', 'what did I do wrong?' or 'why me?'," Ssuna said.Baylor and other HIV service providers now want spiritual counselling to be a standard part of the HIV package offered to patients."Spiritual care has a role to play in HIV/AIDS care and treatment programmes - spiritual leaders should be brought on board to provide this support," she added.en/kr/mw