Mambo - The healthier lifestyle magazine for Africans
Empowering Africans in the UK to get the most out of life, good health and well-being. MAMBO aims to provide readers with news and features on how to live a healthy lifestyle without putting their health, and in particular their sexual health, at risk.
In October 2017, Public Health England reported an 18% drop in the numbers of people diagnosed with HIV in 2016 – this includes 18% fewer diagnoses among people of black African ethnicity compared to 2015.
This was the first time that we’ve had such a significant drop and it is was all down to a combination of things we can all do to make a difference.
New ways to stop the spread of HIV
The HIV epidemic started more than 30 years ago but recently there have been some big changes which we want to share with you and make sure everyone knows about. The number of HIV infections is starting to come down in some areas and this is down to a combined approach to stopping HIV. It’s no longer JUST about condoms, HIV treatment is now a part of our armoury against HIV – and part of protected sex.
1) Treatment as Prevention (TasP)
If someone is on effective HIV treatment and has an ‘undetectable viral load’ they cannot pass on HIV. (The viral load is the amount of HIV measured in a blood test – most clinics in the UK classify undetectable as being below 20 copies/ml.)
We are saying this based on findings from the PARTNER study which looked at 888 gay and straight couples (and 58,000 sex acts) where one partner was HIV positive and on effective treatment and one was HIV negative. Results found that where the HIV positive partner had an undetectable viral load, there were no cases of HIV transmission whether they had anal or vaginal sex without a condom. It can take up to six months from starting treatment to become undetectable.
What this means: This is exciting news as it means treatment is a new way to stop the spread of HIV. Don’t forget though that sex without a condom still means you can get or pass on another sexually transmitted infection (STI) and can result in a pregnancy.
2) Pre-exposure prophylaxis (PrEP)
PrEP is a course of HIV drugs taken by an HIV negative person who is at risk of getting HIV to lower their chance of becoming infected. When taken correctly, PrEP significantly reduces the chances of becoming HIV positive.
In England PrEP is not currently available on the NHS routinely, although 10,000 people will be taking it as part of the IMPACT trial, which started this autumn. In Scotland and Wales PrEP is available on the NHS.
What this means: If you are likely to be exposed to HIV, PrEP is another way to protect yourself.
3) Post-exposure prophylaxis (PEP)
PEP is a month-long course of HIV medication taken by an HIV negative person after possible exposure to reduce the chance of getting HIV. When started in time (within 72 hours, but within 24 hours is best) PEP can stop HIV infection after sex without a condom (or other exposure) with someone who is infectious – but it does not work every time.
What this means: PEP is the third way HIV treatment can be used to protect yourself, a doctor will assess whether you will be eligible or not depending on the risk taken.
Testing and treatment saves lives
In terms of stopping HIV this new information is monumental and the facts show that people power can dramatically reduce HIV transmissions. Regular testing means more people with HIV will be diagnosed and taking treatment – so they will be less likely to become ill and less likely to pass on HIV.
Despite the good news of a drop in HIV rates, 54% of newly diagnosed black African people were diagnosed late in 2016, which means they will have an increased risk of developing an AIDS-defining illness. The British HIV Association (BHIVA) recommends everyone with HIV starts treatment when they are diagnosed. This is because a study called START found that starting straight away significantly reduced people’s chances of developing AIDS-related illnesses.
So the problem we have is that although lots of us are being diagnosed and getting onto treatment in time, an even bigger proportion are finding out they have HIV at a point where their immune systems have been damaged. Regular testing is the linchpin of reducing late diagnoses and keeping people well.
Additionally, people are extremely infectious when they are first infected with HIV which is why early diagnosis is so important – if you are on effective treatment and have an undetectable viral load you cannot pass on HIV.
The Simple Science
HIV stands for Human Immunodeficiency Virus. It was identified in the early 1980s and belongs to a group of viruses called retroviruses.
HIV uses your CD4 cells to reproduce, destroying them in the process. These are important cells which co-ordinate your immune system to fight off illnesses and infections. As the number declines, you may not have enough to keep your immune system working properly. At the same time the amount of HIV in your body (the ‘viral load’) will usually increase.
Without treatment your immune system will not be able to work properly and protect you from ‘opportunistic infections’.
Effective treatment will mean your CD4 count increases and your viral load decreases – hopefully to ‘undetectable’ levels.
The viral load test shows how much HIV is in your body by measuring how many particles of HIV are in a blood sample. The results are given as the number of ‘copies’ of HIV per millilitre of blood – for example 200 copies/ml.
An ‘undetectable’ viral load does not mean there is no HIV present – HIV is still there but in levels too low for the laboratory test to pick up. Different laboratories may have different cut off points when classifying an undetectable viral load, however most clinics in the UK classify undetectable as being below 20 copies/ml.
Modern HIV treatment means that many people with HIV are living long, healthy lives and if you’re taking HIV medication and have an undetectable viral load you cannot pass on HIV.
Testing is for HIV is free, confidential and simple – you can even do it at home. If you are diagnosed with HIV you will be able to start treatment straight away. This will keep you healthy and by joining forces to get everyone tested and onto treatment, the rates of people being diagnosed with HIV should continue to drop.
Thomas is a civil engineer from Huddersfield, originally from Uganda. On 2 September 2016 his job took him to Hoxton Overground in Hackney, London. What followed has changed his life forever …
‘As a civil engineer my job takes me all over London – it’s one of the reasons I love my job so much. In September last year I found myself in the East End, checking the signposting at Hoxton station.
I hadn’t been there long before I was startled by a man waving a leaflet in my face. He was telling me about prostate cancer and asking whether I’d ever been checked for the disease.
That man was Errol McKellar – a local mechanic who has been working in Hackney for over 20 years. At first I didn’t take much notice, but Errol didn’t give up and continued to tell me that he had been diagnosed and treated for prostate cancer six years earlier. He told me that one in four black men gets prostate cancer in the UK – double the one in eight risk faced by white men. He asked my age and said that I should really think about speaking to my doctor about my potential risk.
I still didn’t take much notice of Errol but I agreed to take a few leaflets – mainly to keep him quiet!
I continued with my day as normal and it wasn’t until much later the same evening that I actually looked at the leaflet. I noticed that urinary problems were one of the symptoms of prostate cancer. I’m an incredibly fit and healthy man – I exercise most days and eat a healthy diet.
However, over recent years I have noticed a need to urinate more often. I’ve always put this down to the fact that I drink a lot of water and it wasn’t until I read the leaflet that I thought it might be something more sinister.
I decided to book an appointment with my GP for peace of mind. At first he was reluctant to give me a blood test as he didn’t think I needed one – I really had to push for it. I was therefore incredibly surprised three days later to hear that my PSA reading (prostate-specific antigen – a high level can mean you have a problem with your prostate) was slightly too high for a man of my age. I was referred to the hospital for a biopsy, but I didn’t feel too worried – I was confident that I would be OK.
However, on 27 October 2016 I received the devastating news that I had prostate cancer.
I couldn’t believe it. How could someone so fit – a regular cyclist, runner and triathlete – be living with such a serious disease? It didn’t make sense and I found it very hard to process the news.
I have a wife and two young children and so my thoughts quickly turned to them and I became incredibly worried and distressed about the future. I couldn’t stop thinking about death, asking myself “Why me? Am I going to die? Will I see my kids get married?”
As a family, we’ve struggled to come to terms with my diagnosis – especially my wife – but things are slowly improving. After further investigation, I found out that the cancer is still contained within the pelvic region and I was immediately placed on hormone therapy, which I’m still receiving today. I also had four and a half weeks of radiotherapy. Although I’m still undergoing treatment, my PSA reading has dropped significantly and I’m feeling very positive about the future.
Within the African community the word ‘cancer’ and in particular ‘prostate cancer’ is still a massive taboo. If you’re diagnosed, you keep it to yourself.
My father died two years ago. At the time my stepmother said that he had died of ‘complications’ but I now wonder whether he too had been living with prostate cancer. I’m determined to go back to Uganda to find out.
For a long time pride has overruled everything in my community but we must stop it overriding our health. If prostate cancer is caught early, it can often be successfully treated.
I’m determined to do everything I can to follow in Errol’s footsteps and get people talking about this disease. Errol saved my life – I now want to pass the message on to help save another man.
If you’re a black man over 45 years old, find the confidence to speak to your doctor about your prostate cancer risk and whether you need to be tested.’
Horcelie Sinda Wa Mbongo is the reigning Miss Congo UK. She is actively engaged in various inspirational community projects. Mambo’s Takudzwa Mukiwa spoke to her to find out about what it means to be Miss Congo UK.
Mambo: Congratulations Horcelie on being crowned Miss Congo UK. When they announced that you were the winner, what went through your mind?
Horcelie: When they said my name, tears covered my face. I stopped thinking about the pageant at that point as I reflected on the journey of my life and how far I have come.
Mambo: What motivated you to take part in the contest?
Horcelie: Miss Congo UK to me was a great way to get more involved in the community here in the UK to raise awareness of HIV. I volunteered in South Africa on an overseas volunteering programme for 18-25 year olds, funded by the UK Government. As part of the programme I also had to complete an ‘action at home’ and I decided Miss Congo UK would be a suitable way for me to deliver this.
Mambo: What do you hope to achieve in your year as Miss Congo UK?
Horcelie: I hope to encourage more discussions on HIV and AIDS in the Democratic Republic of the Congo. I think people are aware of HIV in the community but lack a substantial knowledge of what it really is. I think it is time that people learn about HIV and are taught it is no longer a death sentence.
Mambo: When you won, you spoke openly about being born with HIV and there was a lot of media coverage and discussion on social media. How did you feel about this?
Horcelie: To be frank I had no idea the media would consider my story – I’m happy it is raising awareness. It is crucial that HIV becomes a global discussion and that is what has happened in the media, well at least for now. I hope it doesn’t end with my story but continues with stories of the less privileged who are living with HIV in developing countries.
Mambo: Can you tell us about the work you have been doing around HIV awareness?
Horcelie: I have volunteered with Youth Stop AIDS as a speaker for the UK Speaker Tour campaign – this involved speaking in six universities in the UK on HIV as a global issue. It was an amazing experience speaking with four other individuals who were living with HIV.
Together we visited the Department for International Development, the Scottish Parliament and Terrence Higgins Trust in Glasgow. We met with Members of the Scottish Parliament to discuss the global HIV/AIDS epidemic and the role of governments in addressing this.
We were also featured in the Metro as well as Huck Magazine discussing our experiences of living with HIV, and explaining why we were campaigning with Youth Stop AIDS. I speak about HIV at various events to encourage people to take action and raise awareness.
Growing up with HIV
Mambo: What was your experience of growing up with HIV?
Horcelie: It wasn’t easy at all. Being a teenager in school was challenging as I couldn’t seek advice, even from my teachers, because of fear. And we were not taught about HIV, which made it even more challenging to talk about.
Mambo: What’s the most random question you’ve been asked about HIV?
Horcelie: Someone has asked me if I can still date and I said of course. I mean it is challenging but that does not mean people living with HIV cannot date. That is so absurd to think people living with HIV will not have a love life.
Mambo: What do you think are the most important things that people should know about HIV?
Horcelie: People need to understand that HIV is no longer a death sentence. There are so many people who are living with HIV here in the UK and have access to medication and treatment. Even globally, those who are on treatment live a normal life despite the challenges that come with living with HIV.
Mambo: What do you do for leisure?
Horcelie: I love going to art galleries and attending events with my friends, whether concerts, stand-up comedy or poetry. I absolutely love shopping, I just love buying clothes – I’m really into fashion and style.
Mambo: Who has been a big inspiration in your life?
Horcelie: My biggest inspiration has been God. As a Christian I have put my trust and faith in the Lord. I believe it is God who equips and guides people around me (such as my pastor, my family and friends) to advise me about life. Without the word of God, I do not think I would have the courage to speak about HIV at all.
Mambo: What are going to do after your year as Miss Congo UK?
Horcelie: I would love to work in African countries to learn more about development in education and health in sub-Saharan Africa. I want to also continue my studies for a Masters Degree in Fine Arts.
At Mambo we are always on the lookout for African excellence in the UK and our culinary explorations brought Zoe’s Ghana Kitchen to our attention.
This year she was considered a ‘standard bearer for West African cuisine’ in The Observer’s Rising Star list for 2017. We saw Zoe’s food mentioned on social media, saw her book in Foyles bookshop, she was at festivals and on television. Taku Mukiwa just had to hear the remarkable story of Zoe Adjonyoh and her fabulous Zoe’s Ghana Kitchen.
Who is Zoe?
Zoe is from south east London and was born to a Ghanaian father and Irish mother. She’s a writer by trade who completed an MA in Creative and Life Writing at Goldsmith’s University. So how does a writer become a chef? Interestingly, Zoe insists she is not a chef in the usual ‘chef’ sort of way but is more focused on homemade favourites and traditional flavours.
In 2010, after selling her peanut butter stew from the front of her house during Hackney Wicked Arts Festival, some of her customers and friends suggested that she should cook some more. This led to a Supper Club, hosted in her living room. She sharpened her skills in Ghana in her grandmother’s kitchen and at the famous Kaneshi street market, where she met with cooks who shared their own takes on traditional recipes.
Image credit: Matthew Lee
So what’s the all excitement about?
You may be asking what all the fuss is about if, like lots of us, she makes homemade favourites and uses traditional flavours. Now here is the deal. Zoe is bringing Ghanaian food to the masses, not just Ghanaians. As such, this is about inviting everyone to enjoy Ghanaian cuisine.
Zoe explains: ‘I believe we are on the cusp of an African food revolution. There is a longing to try something that is actually new, not just re-spun, and African cuisines are filling that gap. It’s the last continent of relatively unexplored food in the mainstream domain. For too long Africans have kept this incredible food a greedy secret.’
Since she started out, Zoe has travelled to festivals across Europe and taught people how to cook Ghanaian food. This is a journey we are keen to keep watching as African cuisines continue to get the attention and appreciation they deserve.