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THE anti-retroviral (ARV) therapy unit at the Retreat Community Health Centre is under pressure.

The number of HIV-positive people receiving ARV treatment at the unit has rocketed from nine to an astounding 360 in the past 18 months.

The unit was started in September 2006 after the Victoria Hospital ARV therapy unit in Wynberg could not cope with the waiting list of people needing ARV treatment.

Estella Africa, manager of the Retreat unit, says that while most of their patients hail from Capricorn, Retreat yields the second highest number of people currently receiving the treatment.

Africa says the unit caters for people from Retreat, Muizenberg, Lotus River, Grassy Park, Heathfield and Capricorn, as well as people from Khayelitsha and Philippi who do not wish to receive treatment close to their homes.

Africa says a reason for the sharp growth in the ARV treatment statistics is that the ARV treatment only became freely available in the public health sector after 2004.

She says another challenge for the unit is that many people are living in denial of their status.

"Often people have been living with HIV for years, but only come for testing when they are very sick and their CD4 count is very low," says Africa.

People who are already sick will have symptoms of skin lesions, at least 10% weight loss and chronic diarrhoea. According to her, this is the period when many people unknowingly spread the HIV infection.

Therapy is needed when a person has a CD4 blood count of 200 or less, or if they are HIV-positive and have tuberculosis.

Africa says it is imperative that people go for voluntary testing so that they know their status. People who are at risk are those who have numerous sexual partners, persons who have acquired a sexually transmitted disease and people who have TB.

Africa says that according to her statistics, two out of 20 people who are part of this high-risk group and who have been asked to go for voluntary testing have tested positive for HIV.

A major factor in acquiring the syndrome is alcohol and drug abuse. "When you are drunk your values drop," Africa says. Students, teenagers and people in their twenties are also at high risk. Africa says the solution is simple: "Young people need to abstain for longer, stay with one partner and use condoms".

Henry Lemmetjies, Retreat Community Health Centre manager, says the increase is a cause for concern. "Not only is the huge increase of ARV patients a burden on the state, but the epidemic will result in the loss of a family's breadwinner as well as an increase in the number of of Aids orphans," says Lemmetjies.

Africa says not all people who have HIV need ARV treatment. She says they will start on a wellness programme so that they can stay healthy and will need to have their CD4 blood count tested every six months.

"HIV positive people need to have TB tests and pap smears every year because they are at higher risk of cancer," she says.

Africa says once people start on the ARV therapy they cannot go off the treatment. One of the unit's biggest challenges is to track down people who are defaulting on their medication.

"People stop the treatment when they feel better, but when they stop their first-line ARV treatment, their body will develop a resistance to the medication. They then need the stronger second-line ARV treatment and in fact shorten their life-span," she says.

Lemmetjies urged people to come to the clinic for voluntary HIV testing.

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