Newlands Clinic in Zimbabwe: changes lives for young people with HIV

Born with HIV and living on the streets in Zimbabwe is a double challenge to say the least, but this was the situation for Anashe* who was orphaned in 2007, when he was 12.

He used to socialise with a cohort of five adolescent boys whom he considered close friends, but even so he did not disclose his HIV status to them until 2010.

Finding food was a major challenge for Anashe. He used to beg on the streets or look for left-over food in restaurant litter containers. “My friends and l used to wake early and deploy each other to different places. After an hour or so we then returned to the base with some food, which then we shared but this was not easy at all,” he said.

According to the Zimbabwe National HIV & AIDS National Estimates 2013, the HIV prevalence rate among adolescents and young people between the ages of 15-24 years is 5.31 per cent. Adolescents and young people living with HIV have many unmet needs, and in some places, efforts to support them are making a real difference.

Newlands Clinic: support where it’s needed

In Zimbabwe, if you collect medication from a local clinic you are supposed to pay $1 as an admission fee. However, Newlands Clinic in North East of Harare Metropolitan Province offers HIV prevention, counselling, treatment, care and support services entirely free of charge. This is made possible through the mother organisation of Newlands Clinic: Swiss Aids Care International, funded by donations and by contributions from the Swiss Agency for Development and Cooperation (SDC).

Matthias Widmaier, Newlands Clinic country director, said: “HIV therapy is free for Newlands Clinic patients. We provide HIV prevention, counselling, treatment, care and support to 5,700 under-privileged adults and children living with HIV and AIDS, particularly women, children and adolescents.”

Accessing HIV treatment became easier for Anashe in October 2009 when he started collecting his free medication at Newlands Clinic. Howver, the major challenge he encountered was a private and safe place to store his medication.

Anashe said: “I used to hide my medication on a nearby gate which was close to our base from 2007 because l did not want anyone to know my HIV status even my friends, in 2010 the caretaker then discovered that l have a tendency of visiting the same place often and that is how he got to know about my HIV status.” After this, Anashe decided to disclose his HIV status to his friends.

Extra support

Newlands Clinic offers additional support to patients such as food aid and payment of school fees if they need it. A vocational skills programme is financed by Swiss Aids Care International and carried out by Africaid Zvandiri. Here, HIV positive adolescents and young people are assisted to secure employment with an income to support them both now and in the future.

Anashe joined the Zvandiri Programme in 2013 and in 2014 he was trained to be a community adolescent treatment supporter. He was responsible for counselling and supporting a cohort of HIV positive children and adolescents who lived on the streets by visiting them where they slept and hung out on the streets. He identified any challenges they faced with adherence and traced those who were defaulting with their treatment. He also referred children and adolescents to service providers to deal with for possible opportunistic infections, treatment failure, child protection issues, psychosocial support and sexual and reproductive health needs.

In 2014, Anashe also joined the vocational skills programme where he trained as a painter and decorator at Harare Polytechnic College. He is now a professional painter.

In 2015, 1,803 children, adolescents and young people accessed a wide range of youth- friendly services from Newlands Clinic. The clinic runs a special adolescent corner (Zvandiri Centre) and this facility allows adolescents and young people to meet and share experiences. Peer counsellors offer further support by counselling sessions and specialised support groups.

Anashe said: “Newlands Clinic and Africaid’s Zvandiri programme alters my life through knowledge and skills which l acquire from them.”

In Zimbabwe, there is need for such clinics in all ten provinces so that adolescents and young people across the country can access friendly services. This will help Zimbabwe reach the UNAIDS ‘90-90-90’ target. This states that 90 percent of people with HIV will know their status, 90 percent of all living with HIV will receive antiretroviral therapy and 90 percent of all receiving antiretroviral therapy will have viral load suppression.

http://www.keycorrespondents.org/2016/06/01/newlands-clinic-in-zimbabwe-changing-lives-for-young-people-living-with-hiv/

Adolescents with HIV-not to be left behind: Eshan & Alina

It was on an exquisite morning, the weather was as cool as a cucumber; the ground was filled with many adolescents both from Zvandiri and others from Harare’s oldest suburb Mbare community.

Driving in to the soccer ground main entrance l could see Zvandiri adolescents carefully marking out a soccer field.. One by one, the five a side soccer teams started to arrive – excited, young boys, 8-12 year olds from Zvandiri, proudly escorted by their coaches , their older peers also from Zvandiri. The teams were from Highfield, Mbare, Epworth, Dzivarasekwa, Kuwadzana and Budiriro.

Adolescents in the soccer pitch were thrilled when they set their eyes on Eshan, our organiser for the day, as he arrived in his blue “Chelsea” jersey. Eshan is a young football fanatic from the UK.

Despite all the strides from advocates, communities, policy makers and government ministries and youth serving organisations which programme on children, adolescents and young with HIV, this cohort is still vulnerable in many spheres of society including sports and other talent show activities like modelling. Talent, a 10 year old boy, stated “I love soccer but I don’t get a chance to play at school because we’re told we can’t because of our status”

Playing sports helps one to stay in shape, teaches how one can organize his or her time, it boosts friendships, and builds relationships with peers. Due to high rate of HIV related Stigma among young people in Zimbabwe, adolescents with HIV have been sidelined in participating in different activities including sports due to suspected HIV positive status of which according to the African Youth Charter ,it is the right of every young person to participate in all spheres of society.

9 year old Eshan Mir envisions children, adolescents and young people with HIV living happy, healthy and fulfilled lives.

“When l thought of this activity l wanted to see true smiles of children and adolescents from Zvandiri , having a chance to play football and have fun.” says Eshan.

As a result of collaborative efforts from different slants the soccer tournament attracted many children and adolescents from Mbare community, they attended the tournament as spectators.

“I wrote an e-mail to my head teacher and he puts it in the news letter asking for soccer kits donations from school children, my mother’s friends then donated the Maruva football kit” added Eshan. The boys were so proud wearing their Man U, Barcelona and Real Madrid shirts!

Underscoring the sentiments, Alina Mir (11 Years), sister to Eshan mobilised resources for adolescent girls so that they can participate in a modelling contest as she deeply felt that the group need special attention for them to feel confident, valued and to believe in themselves.

“My brother was going to prepare a football tournament and l felt that l should do something for the girls so that they are not left out..” Says Alina

Community Adolescent Treatment Supporters (CATS) who gave a hand in the coordination of this tournament were excited by this incredible opportunity which was granted to their peers.

“ Deeply from my heart l would like to thank the Maruva Trust team together with Africaid Zvandiri for organising this tournament, as adolescents living with HIV we also desire to be involved in different sporting activities and l would also like to thank Eshan and his parents for mobilising a full football kit for us.” says *Takunda.

Maruva Trust are individuals, families, schools, churches and communities in United Kingdom who have supported the Zvandiri Programme since day one, 12 years ago. There are children in Zimbabwe alive today because Maruva funded their medication when there was no other way to get treatment. There are children, adolescents and young people who have acquired their education because of school fees which they received. More than 1200 HIV positive children and adolescents have been able to attend support groups every month for the past 12 years because Maruva supported these support groups, we also have a cohort of children who can now see and hear because Maruva funded their glasses or hearing aids and many children who have benefited in many other ways.

*Name changed to protect identity

‘HIV is manageable in Zim’

By Samantha Nyamayedenga

When I came to the UK in September 2015 to study at the University of Sussex, I was told that the HIV medication I was on, was not available, which was frustrating.

It was frustrating because instead of taking a single pill containing different antiretroviral drugs, as I had been doing at home in Zimbabwe, I now had to take three different pills a day.

I’m in the UK studying for a Masters in Development Studies and recently we had a class discussing on what role health plays in the interaction with citizenship. The main subject was HIV, and it was interesting to see the different assumptions people make because of the difference in prevalence in HIV between countries such as the UK and Zimbabwe.

Access to antiretroviral medication

In the UK in 2014, the adult rate of HIV prevalence was 0,19 percent (AVERT) compared to 16,7 percent in Zimbabwe (UNAIDS). Furthermore, in the UK 91 percent of HIV positive adults are on treatment compared to 63,4 percent in Zimbabwe (UNAIDS).

It is well known that poverty is a driver of HIV, and of course the UK and Zimbabwe have very different economic situations which can help explain the difference in HIV statistics. Everyone in the UK, should they need it, has access to antiretrovirals which is very unlike the situation in some parts of Zimbabwe.

In the UK in 2014, only 29 children were newly diagnosed with HIV and only three children were known to have acquired HIV from their mothers (AVERT). In Zimbabwe 6,6 percent of new HIV cases were from mother-to-child transmission (UNAIDS). However, it is fair to point out the rate of babies born with HIV in 2009 was 29 percent, so progress is being made.

Failings to deal with HIV

Despite the difference in access to medication between the two countries, I have observed that both Zimbabwe and the UK share the same failures in dealing with HIV. For example, there are barriers to HIV prevention in both countries due to stigma and discrimination and lack of HIV knowledge.

HIV is still associated with certain groups of people in the UK, who consider it “the disease of the gay”. In Zimbabwe, it is considered by some as “the disease caused by promiscuity”. Therefore many people living with HIV in Zimbabwe are not keen on disclosing their status for fear of being judged.

Even though HIV seems to be under control in both countries there is still a number of people who are not aware of their HIV diagnosis. In the UK 17 percent of people living with HIV are undiagnosed and in Zimbabwe only 30 percent of young people are aware of their status. The major drivers of these situations are the lack of knowledge and stigma.

Managing HIV

In our class discussion, many people said that HIV was only manageable in the UK and nowhere else, especially Africa. Even the person who led the lecture agreed with the rest of the students. I wanted to raise my hand and tell them that I disagreed.

I wanted to tell them that I am a person living with HIV from Zimbabwe who is doing well because actually HIV is manageable in Zimbabwe. I wanted to say that my immune system is very strong thanks to the structures in place there. I did not speak up because I was afraid of generalising Zimbabwe’s situation regarding HIV. The only proof that I could provide in arguing against my fellow students was my own personal experience which I was unprepared to share.

Had I been prepared enough in sharing my story it would have gone like this: My main concern is that taking antiretroviral drugs for the rest of your life can sometimes result in treatment fatigue. What happens if the quantity of drugs you need to take increases? Is this not demoralising? I have no problem with the combination of antiretrovirals that I am currently receiving in the UK. However, when I was told I needed to take combination therapy in three drugs instead of just a single I felt disheartened. From this personal experience I learnt that we should exercise caution and try to avoid generalising HIV as only manageable in the UK. — Key Correspondent.

Source:Herald

http://www.herald.co.zw/hiv-is-manageable-in-zim/

Reaching adolescents with HTS Information using peer to peer mobile discourse

Africaid, in collaboration with UNICEF, have embarked on an innovative project with the aim of reaching out to adolescents in all ten provinces in Zimbabwe with HIV Testing Services (HTS) information including HIV Prevention, Treatment, Care and Support through an innovative methodology (U-Report).

In March, Community Adolescents Treatment Supporters (CATS), managed to respond to 1 209 cases. U-report is a free SMS social monitoring tool for community participation, designed to address issues that the population cares about. Currently, the system has registered more than 10 648 adolescents and young people including girls and young women across Zimbabwe including those who are in remote areas.

DREAMS partners to offer comprehensive package to adolescent girls and young women through layering of services

Recently, Makoni DREAMS project Secretariat, Africaid, in collaboration with Management Sciences for Health (MSH) and National AIDS Council of Zimbabwe coordinated a district planning meeting with the aim of consolidating a work plan which will be implemented in the next 6 months.

The meeting was also attended by implementing partners ; SAfAIDS, Population Services Zimbabwe, Family AIDS Care Trust Mutare (FACT) and government ministries including the Ministry of Primary and Secondary Education, Ministry of Public Services Labour and Social Welfare and the District Administrator.

Africaid Zvandiri Programmes Manager encouraged DREAMS partners to layer services so that beneficiaries can access a comprehensive package to achieve DREAMS targets.

HIV stigmatisation still rampant…Early disclosure encouraged

By Shamiso Yikoniko (Published In the Sunday Mail) December 13 2015

Despite the strides in the fight against HIV, stigmatisation is still rampant and unfortunately it is not sparing children who are born with the virus.

When one acquires the virus through peri-natal transmission and lives with it through adulthood, they usually have to go through various dilemmas, ranging from status disclosure to stigmatisation. Worst still, in some communities contracting the virus is still regarded as a death sentence.

For 20-year-old Tanyaradzwa Moyo (not her real name) who shared her life experiences during the recently held International Conference on AIDS and STIs in Africa (ICASA), the journey has been a tough one.
Tanyaradzwa found out that she was living with HIV in 2007 when she was in Grade Seven.

“Having grown up a sickly and frail child, I always thought I was different from other children. The sad thing is that even my mother did not suspect HIV to be the reason behind my health problems.”

“I was attacked by herpes zoster twice, first on my right hand in 2005 and then on my left leg. On both occasions, my mother was advised to have me go for an HIV test but she ignored the advice,” added Tanyaradzwa.
Nevertheless, Tanyaradzwa’s health continued to deteriorate as she was always afflicted by several opportunistic infections.

Tanyaradzwa’s mother then took her for an HIV test at the Highfield Polyclinic and she was found to be HIV-positive.
“After being diagnosed with HIV, my mother did not tell me of my condition.

“My condition was only revealed to me when I was referred to Harare Central Hospital. Then, I didn’t know what having HIV meant, all I cared about was being well and being ‘normal’ like my peers,” Tanyaradzwa said.
She was first given cotrimoxazole for about a week while receiving counselling sessions so that she could understand her condition. Thereafter, she was put on first line treatment.
And she was well again!

But at secondary school, Tanyaradzwa faced discrimination from her peers and teachers.

“I suffered from a persistent dry cough and everyone at school suspected that I was suffering from HIV and from then on, I started facing stigma. I couldn’t make any friends at school, l couldn’t participate in any school activities and teachers would always shout at me because I was not performing well.”

“I kept asking myself why this happened to me. During that time, I thought I was the only child living with HIV. At one time I stopped taking my medication for about three to four months and I got sick again.”

Tanyaradzwa would go for treatment advice and counselling without her mother and there, she would lie that she was taking her antiretroviral medication. However, her CD4 count was telling a different story as it had dropped dramatically, which in itself is a sign of non-adherence.

“I became suicidal and all I wanted was to die. That is the reason l stopped taking medication. I was asked to bring my parents but lied that I was staying alone. I was then advised to join a support group. At first I was hesitant since I was thinking that I was the only young woman living with HIV,” she said.

It took several counselling sessions for Tanyaradzwa to agree to join a support group. She however, was pleasantly surprised to discover that people of various ages where living with HIV.

“Attending the support group restored my hope. I regained my confidence and felt that life had to go on,” Tanyaradzwa said.

“In 2009, I was put on second line treatment since first line treatment had failed. Although I had received a new lease of life, I was being monitored for adherence by a Community Adolescence Treatment Supporter.”

The Community Adolescence Treatment Supporters (CATS) programme, which is administered by an organisation called Africaid Zvandiri, was established in 2009 with the aim of providing community-based treatment, adherence, monitoring and counselling for youths living with HIV. Tanyaradzwa’s mother also got tested and was found to be HIV-positive.

“It was explained to my mother that the only way I could have contracted HIV was through mother-to-child transmission,” said Tanyaradzwa.As Tanyaradzwa grew into a woman, another challenge presented itself.

“I became interested in starting a relationship but the dilemma was how I was going to reveal my status to my partner. I have been dating this guy for three years now and I only managed to disclose my status after one-and-a half years of dating,” she explained.

“One day when I was coming from collecting my medication, my boyfriend insisted on carrying my bag. I was afraid he would open the bag and see the ARVs,” Tanyaradzwa added.

“After a week, I shared with him my life experiences and disclosed to him that I was HIV-positive. He accepted me as I am and we have bigger plans for the future together. We, however, agreed to abstain from sex until we are married.”

After realising that being HIV-positive is just a condition and not a death sentence, Tanyaradzwa dreams of becoming an HIV/Aids counsellor.

Currently, she is a volunteer with the CATS programme. In Zimbabwe, about 170 000 children below the age of 15 are living with HIV.

Early disclosure encouraged PARENTS and guardians have been urged to disclose their children’s HIV statuses from as early as five years so as to avert adolescents’ HIV mortality rate.

Thousands of young children and adolescents living with HIV have died in recent years as their parents failed to initiate them on treatment.

Lack of access to healthcare services due to either late or non-disclosure by parents has been identified as a leading cause of child mortality.Such children would have acquired the virus through peri-natal transmission.

According to the data released by Unicef last month, the number of adolescents who died from HIV-related infections has tripled in the past 15 years.

Among HIV-affected populations, adolescents are the only group whose mortality figures are not decreasing.
Experts attending the 18th edition of the International Conference on AIDS and STIs in Africa (ICASA) made a plea to guardians taking care of children living with HIV to disclose their HIV statuses early.

Dr Johnface Mdala from IntraHealth International, Namibia, said disclosure is as important as adherence.

“Earlier disclosure helps young people to learn about their condition, to develop skills to cope with their condition and to be involved meaningfully in their care and decisions about their health,” said Dr Mdala.

“In Namibia, we have developed tools aimed at tackling the matter which includes partial disclosure by the age of five years and make it a gradual process up until full disclosure by the time they reach 10 years.”

Full disclosure involves giving a child all the information about their HIV status. The information is more detailed in terms of what HIV is and how it affects the body.

“It’s encouraged for parents to use illustrations, drawings or cartoons to explain in simple ways what HIV is, how it affects the body and how ARVs work,” added Dr Mdala.

Aids is the number one cause of death among adolescents in Africa and the second leading cause of death among adolescents globally.

Africaid-Zvandiri director Ms Nicola Willis said although disclosure is a difficult process, more people are realising that the earlier, the better.

“We have come a long way in terms of people’s understanding about when is the right time to inform a child that he or she is HIV positive. A few years ago, it was commonly thought that disclosure should be done in late adolescence,” she said.

“We generally advocate that there is no set age at which disclosure should take place as every child has individual needs, experiences and circumstances. Most importantly, they should know their HIV status, particularly if they are on ARVs as this helps to adhere better.

“However, this must be done carefully in the best interests of the child and led by the child’s family. Health care facilities across the country are being trained to support and counsel families in the disclosure process.”
Support groups have also been cited as helpful as this is a place where adolescents can come together to learn more about growing up with HIV, including adherence to ARVs.

The adolescents will also share their experiences. A Unicef official based in Tanzania, Ms Alison Jenkins weighed in to support that disclosure is the key.

“It’s important to start the disclosure process early so that the child doesn’t hear their HIV status from other sources rather than the parents or caregivers,” she said.

Disclosure is the process of informing a person about his or her HIV status.
According to the Ministry of Health and Child Care estimates, 6 176 children out of 156 718 living with Aids in the zero-14 years age group died in 2014.

In 2013, 8 741 died of HIV-related diseases.