Adolescents living with HIV: A generation to protect and support.
By Richard Nyamanhindi
Coming to terms with HIV has not been easy for 16-year old Tendai*. Shy and soft-spoken, he is not completely at ease with telling others about the complexities of growing up with HIV.
“I used to always get sick. I would go to the clinic for treatment that made me better for a short period. I soon would get very sick again. People used to tell me that my blood was weak, but no one ever told me that I was living positively. Everyone refused to play with me because I was always sick,” says Tendai.
“When I learnt I was HIV positive, I did not understand as I had never slept with anyone. My mother’s big sister told me not to tell anyone because there are some people who, when they hear that you are HIV positive, they do not want to get close to you,” says Tendai.
“People here do not completely know what HIV is and when they find out you are HIV positive, they do not want to have anything to do with you, which makes it very difficult for us as children.”
Having lost both his parents, Tendai lives with his aunt in Harare, the capital of Zimbabwe. Here, adolescents aged 7 to 24 years constitute a quarter of the total population and in 2011 they accounted for almost 10 per cent of all new HIV infections reported in the country.
Stigma associated with HIV is such that people, especially young people living with the virus are reluctant to disclose their status even to their immediate family. For children going through the delicate transition to adolescence, this can result in isolation and loneliness, which makes it difficult to access care, treatment and support services available to them.
Tendai came out of isolation when he met Rumbidzai Chifamba, aged, 21, a Community Adolescent Treatment Supporter (CAT) with Africaid, a non-governmental organization that provides support through funding from UNICEF to adolescents and children living with HIV in Zimbabwe. UNICEF supports Africaid to train adolescents living with HIV/AIDS as CATs, conducting follow up, and training of health workers on Youth Friendly Health Services (YFHS) and community mobilization. The support contributes to increased access to treatment and improved adherence by HIV positive adolescents.
Rumbidzai works closely with Village Health Workers and nurses in her community and pays regular visits to Tendai in his home. She checks whether he is taking the HIV medication correctly and consistently and simply lends him a friendly ear.
“Adolescents need social, physiological and moral support, they need someone to confide in and share their life experiences with,” says Rumbidzai. “It is not easy to support an adolescent because they need to be monitored continuously, otherwise they let things go.”
“In their restless nature adolescents find it difficult to adhere to treatment as they are constantly out of their homes on school sporting activities and other activities. They are also on the move visiting family members, while orphans are always between family members seeking their care and support — like food and financial help, thus making it difficult to adhere to their medication,” adds Rumbidzai.
With Rumbidzai’s help, Tendai also joined a psychosocial support group for adolescents living with HIV called Zvandiri, a Shona word meaning, “Accept me as I am.” The group that meets every Saturday at a local clinic provides children and adolescents with a safe space where they can share their experiences, challenges, learn life skills and forge new relationships.
“During the meeting, we are asked questions, we perform dramas, we play games, we talk about what is going on in our lives, we discuss sexual reproductive health and we are given advice,” says Tendai. “I feel very good, I feel at ease because I am with children who have the same challenges as me.”
Tendai knows very well how difficult it can be to cope with the challenges of being a teenager living with HIV: “If a young person who is HIV positive has no one to support them, they are going to think a lot about negative things and stress about their HIV status,” he says.
Tendai has also become part of the Peer Advisory Board (PAB) – a group within Zvandiri that relays information about other children living positively in a community to CATs such as Rumbidzai who then make follow-ups and referrals within their communities.
A CAT such as Rumbidzai also does home visits, discusses challenges facing the children with parents or guardians, counsels sexually active youths on disclosure and early pregnancies among other things.
In Zimbabwe, only a small proportion of adolescents who are long-term survivors born with HIV have access to antiretroviral treatment, and most receive it through limited numbers of specialized centres in urban and peri-urban settings.
NGOs such as Africaid play a key role in bridging this gap. Thanks to Rumbidzai, Tendai was able to gradually come to terms with his life as an adolescent living with HIV and learn the importance of adhering to antiretroviral treatment. Through the Zvandiri Support Group, he met other children with whom he can talk freely about common concerns in a non-judgmental environment.