Makoni | “I want to thank DREAMS for helping me to pay my school fees from last term and also registering for my subjects. All hope was lost when I failed to obtain my Ordinary General Education Certificate in 2015, but DREAMS has given me hope for another future,“ says Gracious.
Gracious is an 18-year-old girl who was diagnosed with HIV at the age of 13. However, her family was afraid to tell her about her HIV status and instead told her that she had a heart condition. Gracious told her friends at school that she was on medication for her heart condition. However, the friends suspected that she was HIV positive because she was sick so often. Gracious took her medication to school in order to prove her friends wrong. However, her teacher saw the ARV medication and informed Gracious that it is for people living with HIV. This experience devastated Gracious, who stopped adhering to her ARVs.
In February 2016, the head of guidance and counseling at Gracious’ school attended a DREAMS Initiative training on Comprehensive Sexuality, HIV, and AIDS Education, presented by SAfAIDS, Africaid, and the National AIDS Council of Zimbabwe. Following this training, the teacher referred Gracious to the Zvandiri program for counseling and support and be linked to other services for young people living with HIV. Gracious began attending the local Zvandiri support group and learned that she was not alone in her experiences. She became a regular member of the support group, where she acquired information and skills from her peers on growing up with HIV, including the importance of treatment adherence. She received a pill box to manage and monitor her medication, improving her health.
Gracious’ pill box helps her to keep track of her medication
Gracious’ local clinic nominated her for Community Adolescent Treatment Supporter (CATS) training. Following the training, led by Africaid and the Ministry of Health and Child Care (MoHCC), Gracious connected with young people in her community to provide counseling, support, and follow up so that they could also be helped to adhere to their ARVs. Gracious is mentored by the Zvandiri Mentor and during CATS coordination meetings, and receives daily supervision from the nurse at her designated health facility, who also attended Africaid and MoHCC trainings to provide child and adolescent HIV testing services for children, adolescents, and young people.
“I benefited from being a CATS because I had been defaulting a lot on my medication. After the training, I am now taking my medications well,” said Gracious.
With financial assistance from the Family AIDS Counselling Trust to pay her school fees, Gracious repeated the two subjects she failed the previous year. The school’s head of guidance and counseling also invited Gracious to help plan and implement a school-wide anti-stigma campaign. Following this campaign, two students shared the challenges they faced as adolescents living with HIV as they struggled with adherence and their deteriorating health. Gracious connected with each of them to support their treatment adherence and contribute to their improved health. Gracious also identified a student facing severe food shortages at home and worked together with the school to plan a fundraising day to provide her with assistance.
“Besides me, there are also other children that are benefiting from me. I helped a girl who was being discriminated at our school and the training from Africaid has helped me to help her. I also give thanks to Africaid for helping us,” she explains.
In November 2016, Gracious completed her final exams to earn her Zimbabwe General Certificate of Education at Ordinary Level (ZGCE O-Level). She can now pursue further studies and hopes to study law, with the long term goal of offering free legal assistance to organizations that implement programs for orphans and vulnerable children, including adolescents and young people living with HIV.
Through the DREAMS and Game Changer program, Africaid seeks to improve outcomes for children and adolescents throughout the HIV care cascade by improving the uptake of HIV testing services, linkages, adherence, and retention in care.
Gracious’ story illustrates how the DREAMS program, with funding from USAID through Management Sciences for Health (MSH), offers multiple services for adolescent girls and young women. Trained, supported teachers initially identified and referred Gracious to Zvandiri for peer-led community treatment support. Together with trained, mentored health care workers, Zvandiri CATS supported her to adhere to her medication, resulting in her being AIDS-Free. She received psychosocial support, assisting her to become resilient. Educational assistance transformed the likelihood of Gracious being able to pursue further education. She is now determined to become a lawyer. Now as a trained, mentored CATS, she has been empowered to support her HIV positive peers so that they, too, are Determined, Resilient, Empowered, AIDS free, Mentored, and Safe.
In Year 1 of the DREAMS Initiative in Makoni, 7,440 individuals between the ages of 15 and 24 received HIV testing and counseling (HTC) services and learned their test results, with 310 individuals testing positive for HIV. In financial year 2017, quarter 1, under the Game Changer program, 273 children, adolescents, and young people are currently on ART, and 274 are receiving community-based care through the CATS program.
In the six DREAMS implementing districts in Zimbabwe, 60,372 individuals received HTC services and got their results. In financial year 2017, quarter 1, 4,327 children, adolescents, and young people are currently on ART in 24 Game Changer districts, while 4,371 are receiving care in their communities from CATS. Through these programs, Africaid will continue to support girls like Gracious to be empowered and to empower others.