AIDS - When there is nothing left to lose

I refused at first to take the treatment because I knew I was dying. I also remember another doctor telling my relatives that I would not make it. After a while, I decided to take these medications only because I had nothing left to lose.

I am Zoliswa Magwenthsu, living in Site C in Khayelitsha. I am 46 years old, a mother of five children and living openly with HIV. I trained as a nurse and before I became ill I was working at the WARMTH (War on Malnutrition, TB and Hunger) project here in Khayelitsha.

I became sick in February 2002 and was diagnosed with TB pneumonia and hepatitis. I decided to test for HIV and tested positive. I was referred to the MSF clinic in Khayelitsha. The doctor at the MSF clinic told me about ARVs and said it would reduce the amount of virus and illnesses that I was getting. My weight at that stage was 48kg, 20kg less than my normal body weight.

I refused at first to take the treatment because I knew I was dying. I also remember another doctor telling my relatives that I would not make it. After a while, I decided to take these medications only because I had nothing left to lose.

By the fifth day, like a miracle, I felt I had more appetite and strength and started to gain weight. I have never felt pain like I did before since then. I was taking Efavirenz and AZT/3TC. After six months on treatment, I started having horrible dreams about snakes and frogs - nightmares - as well as mood swings from sad to happy to angry and I felt easily frightened.

I knew that Efavirenz could cause vivid dreams and mood swings but I was not sure that these could happen so long after starting treatment. I spoke to Laetitia, a counsellor who works with MSF on the ARV program, and she told me that Efavirenz could still cause these things even though I was on treatment for six months. I then decided to go to my doctor and ask him if I could stop taking Efavirenz because I could not cope anymore. My doctor agreed and swopped Efavirenz for Nevirapine. Since then I have had no problems.

I have decided not to have any more children because I cannot afford to support another child, I do not want to expose them to the risk of being HIV positive and I am older now at 46 years. This was important for me to think about because I was also told that the babies born to women taking Efavirenz could not develop properly during pregnancy. I was taking Efavirenz for the first six months of treatment and was beginning to feel healthy again. It is important for all women taking Efavirenz to be aware of this and to plan accordingly.