Empowering teens living with HIV
Scaling up peer-to-peer interventions
Every time 20-year-old Zena Adam says ‘kujiamini’, she smiles, and holds up a pair of closed fists in a show of strength and triumph. It is the Kiswahili word for ‘confidence’ that resonates with 884 other children, youth and young adults living with HIV and receiving services at PASADA in Dar es Salaam.
When Zena first came to the Pastoral Activities and Services for People Living with HIV (PASADA), a community-based social service agency operating under the umbrella of the Catholic Archdiocese of Dar es Salaam, and a UNICEF partner, Zena was six years old, and anything but confident. Her father had recently died, her mother was getting ill and decided to check her daughter for HIV. Zena tested positive.
“I was young and I didn’t even know what was happening to me. I was made to feel different all the time,” Zena says, “children wouldn’t play with me, they wouldn’t even give me water.” Even her aunt forbade her children to touch Zena. “It felt really bad. I would sit and cry ‘why me, why me’.” But coming to the PASADA centre for medical treatment and counseling was the beginning of change.
“This changed at PASADA. They made me feel welcome, normal and gave me confidence,” Zena says. Tanzania carries about 5 per cent of the global HIV burden amongst adolescents. HIV prevalence among 15 to 24-year-olds was 1.4 per cent in 2016 (2.1 per cent among females and 0.6 per cent among males). The disparity in the prevalence between males and females is most pronounced among younger adults, with the number of women in all five age groups between 15 and 39 (15-19, 20-24, 25-29, 30-34, 35-39) more than double than that of males in the same age groups according to the Government of Tanzania HIV Impact Survey.
Reaching young people with HIV, especially girls who are more likely to be HIV positive and have less resources and community support to treat the disease, is critical. “If we can manage to reach them, they know HIV is not a death sentence. They have a future, and they can reach it."
Aside from the health services, the peer-to-peer programme led by the Community Adolescent Treatment Supports is the unique factor. This UNICEF-supported programme is where Zena met young people like herself from around the country, speaking with confidence about how they overcame the challenges of HIV and fulfilled their dreams.
“I knew then that I too had a future,” she says. Currently, there are about 500 adolescents enrolled in this monthly, tailored programme.
The programme includes a morning health talk, and sessions with doctors, nurses and social workers who discuss sexual health and reproduction issues. Following which participants are divided into smaller groups based on interests and talents such as soccer or singing, and have time to play, dance, interact and engage with their peers. “This time is uniquely set aside for adolescents to meet and hang out,” says Nelson. “The programme is forward looking and includes life skills and practical training that offer participants a future horizon. Guest speakers are invited too, with a focus on entrepreneurs,” he adds.
The confidence that Zena acquired over the period of time with the support of the centre and her family has helped her continue with her secondary education with zeal. The computers and data entry classes she took at the peer-to-peer programme equipped her with important employable skills. However, Zena has a different plan for herself. “I want to be a youth counselor. Not just any counselor, but the country’s top counselor for youth with HIV,” she adds.
She has already started counseling adolescents at the centre. “Now that I have the knowledge, I explain to other children that this is not the end of the world,” she says. Zena is currently counseling a 15-year-old boy living with HIV, who was stigmatized. “I make him understand that he is not alone. Knowing someone else who has been through this has given him confidence and he is now studying hard to fulfill his dream of becoming an engineer,” she says.
“When you become empowered, nothing is impossible,” Zena says. She says people with HIV “work harder at everything”, but the right education and counseling energizes them to prove themselves. “It’s not the end of the world. This is what I know, and this is what I tell them,” she says.
Even with the most supportive adults, adolescents need to hear these messages from peers. “When older people talk, they just put in their headphones and roll their eyes,” Zena says. “Young people have their own language, it’s important to talk to them on the same level, not in a commanding tone like adults.”