The name of the child in this story has been changed to protect confidentiality.
Ploy is living with HIV and has been taking antiretroviral treatment since the age of 11. Ploy went through a phase of poor treatment adherence when he entered adolescence, which further suppressed his immune system, making him even more vulnerable to TB.
Ploy suffered from prolonged fever, chest pain, and oral candidiasis (an opportunistic fungal infection in the mouth), which led to rapid weight loss for weeks before he was diagnosed, in September 2010, with pulmonary TB. His TB treatment included isoniazid, rifampicin, pyrazinamide, and ethambutol. His TB treatment was taxing both physically and emotionally. Ploy struggled with the large number of pills he had to take each day to fight both TB and HIV; his TB treatment alone involved ten pills.
From September 2010, when Ploy started treatment, to October 2010, his health improved dramatically and his weight increased from 34 kg to 37 kg (75 lbs to 82 lbs); however, Ploy stopped taking his medications consistently and his health began to deteriorate. According to Ploy, “taking medications every day reminds me that I have HIV and TB. It is so painful. I want to hang out with my friends and not have to worry about taking medications on time. I just want to live and feel like a normal teenager.”
Ploy has always been afraid of being stigmatized for his positive HIV status due to his very low weight; he is afraid that his friends and work colleagues will discover that he is unwell.
Despite many setbacks, Ploy continued to follow up at the clinic and in May 2011, he became very sick. This time Ploy’s sputum grew drug-resistant M. tuberculosis and M. abcessus (one of many environmental mycobacteria found in water, soil, and dust and distantly related to the mycobacteria that cause TB and leprosy). Ploy had to restart TB treatment with five drugs including a daily injection with streptomycin for two months.
Ploy is determined to continue with his TB/HIV treatment. He quit his job and is staying with his mother. They are helping each other to follow their treatment regimens. Thanks to support from his mother, Ploy’s health has improved. Realizing that he might not have contracted active TB had he better adhered to his HIV treatment regimen, Ploy now shares the lessons he learned about the importance of adherence with other HIV-positive children and adolescents at camps and sessions.