Africaid improves quality of life for HIV-positive adolescents under HIV-sensitive case management

Chitauro1 is a sixteen-year-old double orphan who lives in the rural village of Mudzi, a Child Protection Fund (CPF)-supported district in Mashonaland East Province.

He fell sick in 2007 to such an extent that the health facility became his second home. Chitauro tested positive for HIV and was initiated on Antiretroviral Treatment (ART).

When his mother died in 2009, the cake of his life turned sour since no one wanted to live with him because of his HIV status. That is when he was taken to All Souls Children’s Home in Mutoko, where he stayed for 3 years. In 2015, Chitauro was returned to his maternal relatives, who began to neglect him by letting him sleep in the car and sometimes outside the house in an open space; nobody cared whether he took his medication, nor were they concerned about his refill and clinic review dates.

Due to neglect, Chitauro defaulted on ART for six consecutive months. He was taken in by his uncle, who did not support ART, but believed in traditional medicine.


Zvandiri Regional Coordinator, Priscilla Matyanga handing over Maruva Trust medication to Chitauro’s foster parent in Mudzi district.

Chitauro’s health started to deteriorate and he was not taken to the hospital.

In 2016, Chitauro was identified by a Community Adolescent Treatment Supporter at Kotwa district hospital when he came for treatment on his own, staggering. He was referred for CD4 count test, and the result was 3ml/cell. Since he did not have funds to pay his medical bills, a CATS referred him to the Zvandiri Mentor, who contacted the Department of Social Welfare for Assisted Medical Treatment Order (AMTO).

The Mudzi Case Management Officer then held a family conference to establish who could take care of Chitauro and his condition. His aunt volunteered to stay with him at her house.

After two days, Chitauro fell sick and was admitted to Mudzi Hospital. It was at that point that Africaid’s Head of Programs, Technical Advisor and Regional Coordinator were in the district and paid Chitauro a visit. Unfortunately, the health facility did not have some of the medications that were prescribed by the doctor.

Africaid, through Maruva Trust, purchased the medication that was not available at the health facility and delivered it to the foster parent. Chitauro has greatly improved, he can now play with the foster parent’s children, walk on his own and feed himself. He is currently receiving enhanced care from a CATS and the Zvandiri Mentor.

Under the National Action Plan for OVC and with funding from the Child Protection Fund, Africaid has been supporting the Ministry of Public Services, Labour and Social Welfare (MoPSLSW) to integrate HIV-sensitive case management services for children and adolescents across Zimbabwe. Africaid’s role has centred on training and mentorship of Provincial- and District=level Social Welfare and Protection Officers on HIV-sensitive case management, as well as linking CATS and Case Care Workers. Significant advances have been noted by the Ministry of Public Service Labour and Social Welfare, Ministry of Health & Child Care and UNICEF in terms of identification, referral and management of children and adolescents with HIV in need of child protection services.



Africaid restores hope for HIV positive children, adolescents and young people in Zimbabwe

*Chipo lost hope to live, however, she gained confidence and rekindled the desire to pursue her hopes and dreams after getting in contact with a Community Adolescent Treatment Supporter (CATS) at Gweru Provincial Hospital in September 2016.

Chipo’s story was one of abuse, depression and hopelessness until she came in contact with Africaid through the USAID-supported DREAMS initiative.

She is the last born in a family of 4, and she grew up staying with her father and her stepmother in Kwekwe. Her biological mother passed away when she was young as a result of HIV related illnesses, and she also contracted HIV at birth. She grew up experiencing ill health, and her father was not willing to take her for HIV testing and counselling. She only came to know of her status at the age of 10, when her maternal grandmother who lives in Gweru took her for HIV testing.

Despite her grandmother’s attempts to get her treatment, her abusive father and stepmother often denied her access to medication, as he believed in traditional healing. Eventually, Chipo could not take the abuse and fled from Kwekwe, joining her grandmother in Gweru.

Chipo was depressed, and this affected her social life and adherence to medication. She developed suicidal tendencies and told herself that she had no purpose to live. Health care workers at Gweru Provincial Hospital noted Chipo’s high viral load and linked her to a CATS at the facility for enhanced care where she received daily mobile message alerts and weekly home visits. Chipo was excited to meet the CATS who are complementing Zimbabwe’s national efforts to achieve epidemic control by increasing the number of children, adolescents and young people with HIV on antiretroviral therapy (ART), as well as providing subsequent support for those on treatment. Chipo was invited to a support group where she met other adolescents with HIV who come together to share their experiences. This was such an experience for Chipo and she is now attending these meetings regularly. CATS at Gweru Provincial Hospital referred Chipo for other services under the DREAMS initiative. Funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through USAID and the U.S. Centers for Disease Control and Prevention (CDC), DREAMS  is an ambitious partnership to dramatically reduce HIV infections among adolescent girls and young women. The goal of DREAMS is to help girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored and Safe women.

Chipo was referred to Youth Advocates Zimbabwe (YAZ), a DREAMS partner in Gweru which is supporting adolescent girls and young women with economic strengthening activities. She enrolled in courses on metal fabrication, financial literacy, and entrepreneurship.

Chipo defied all odds by choosing a trade which is mostly male dominated. This is a clear indication of the determination she now has after all the support she has been receiving from CATS.

“I feel empowered and I am confident in myself, at least I have a skill. Now I see myself as someone with a career in life and with something to do for a living,”said Chipo

She is currently attached with a local fabrication company in Gweru, where she is sharpening her steel fabrication skills. She is using the income she is earning from the attachment to do extra mathematics lessons, and she intends to write exams in this subject this year in November. Chipo now has big dreams of becoming an engineer. The once hopeless Chipo has drastically changed to become a determined, resilient and empowered adolescent girl.

“Chipo’s story shows the importance of young people in supporting their peers to cope with their HIV status and continue to pursue their hopes and dreams,” said Nicola Willis, Executive Director of Africaid. “It shows the important role CATS can play in ensuring that adolescents and young people with HIV do not progress quickly to AIDS. The multi-sectoral approach to supporting adolescents with HIV also proved to be effective in Chipo’s case.”

Africaid is implementing the DREAMS initiative with the goal of improving the uptake of HIV testing services among adolescent girls and young women. In October 2016, the organization scaled up its Zvandiri model of differentiated service delivery for children, adolescents and young people in other districts in Zimbabwe with financial and technical support from PEPFAR through USAID and Management Sciences for Health (MSH).

*Name changed to protect identity


USAID awards $20 million to Africaid to improve HIV prevention, treatment, care, and support services for youth

On the 10th of August 2017 at Meikles Hotel in Harare, the U.S. Embassy, acting through the U.S. Agency for International Development (USAID), and Zimbabwean private voluntary organization, Africaid, signed an award of $20 million to improve HIV care and treatment for children, adolescents, and young people.

At the event, USAID/ Zimbabwe Mission Director Stephanie Funk stated: “USAID is proud to partner with Africaid to help Zimbabwean children and adolescents live longer, healthier lives. The United States stands with the people of Zimbabwe in an effort to end the HIV epidemic.”

Registered General Nurse and a Community Adolescent Treatment Supporter pose for a photo after a young people’s support group.

The signing ceremony commemorated and launched USAID’s support to Africaid of $20 million to scale up and expand its innovative Zvandiri model for five years, from 2017 to 2022, in 22 priority districts in Zimbabwe. The Zvandiri model seeks to improve children’s, adolescent’s and young people’s experience of HIV testing services, diagnosis, linkage to care, disclosure, treatment access, adherence, and retention in HIV care. This will be achieved through a combination of community and facility-based interventions including community support groups, community outreach, child and adolescent-friendly clinics, and Community Adolescent Treatment Supporters (CATS). The CATS work closely with health facilities, families, and communities to respond to the unique needs of young people living with HIV.


Africaid Executive Director Nicola Willis stated: “Africaid is thrilled to receive support from USAID to scale up the Zvandiri model in partnership with the Ministries of Health and Child Care; Primary and Secondary Education; Public Service, Labour and Social Welfare; and the National AIDS Council. Our work will help achieve epidemic control by increasing the number of children and adolescents living with HIV who know their HIV status, getting more children and adolescents living with HIV on treatment, and helping those on treatment to adhere well to their medication and have suppressed viral loads.”

According to the 2015 Ministry of Health and Child Care HIV estimates, in Zimbabwe approximately 77, 000 children and 69, 000 adolescents are living with HIV. Despite significant advances in access to treatment and a decline in deaths due to HIV, HIV-related mortality among children and adolescents in Zimbabwe remains high. HIV is one of the leading causes of mortality in children under five and accounts for 21 percent of children deaths in Zimbabwe. More than 3,400 children and 1,500 adolescents died of HIV-related conditions in 2015.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through USAID and the Centers for Disease Control and Prevention (CDC), has provided nearly $1 billion to Zimbabwe over the last decade for HIV prevention, care, and treatment services. PEPFAR has contributed to major successes in the fight against HIV in Zimbabwe. The annual number of HIV-related deaths has declined 70 percent since 2006. The number of new HIV infections each year has decreased 67 percent since 2003.

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For more than 30 years, the American people, through USAID, have contributed over $3 billion in assistance to Zimbabwe.  Current projects include initiatives to increase food security, support economic resilience, improve health systems and services, and promote a more democratic system of governance.

 Africaid is committed to improve the quality of life of children, adolescents and young people living with HIV.

 For additional information, please contact:

U.S. Embassy Public Affairs Officer David J. McGuire at HararePAS@state.gov

Africaid Communications Officer Tinashe Rufurwadzo at tinashe@zvandiri.org


Power of peer-led interventions

In Binga district, lives of adolescents and young people with HIV were in disarray because of negative attitudes and behaviours from members of the community. Adolescents and young people were in a difficult situation given that there was no one of their age who could give them support, encouragement in adhering to their medication, offer psychosocial support, or provide, and a place where they could meet and discuss issues that affect them on daily basis.

Adherence was a major challenge for this age group, as some were taking medication without an understanding of what it was for; in other cases, caregivers delayed telling their children about their HIV status and why they were taking ARVs.

Mr Musiabwe Lizadi, a Primary Counsellor who is based at Siadindi Clinic, described the ordeal, as he was responsible for attending to adolescents and young people with HIV during their clinic visits.

It is important to note that before the introduction of the Zvandiri model in Binga, Primary Counsellors were finding it difficult to offer tailored physical, social and mental services to adolescents and young people because of the differences in age and life situation.

The Community Adolescent Treatment Supporters (CATS) training provided a solution by empowering HIV positive mentors to provide the needed services, or refer adolescents and young people to needed medical care. UNICEF, the Ministry of Health and Child Care (MoHCC), the National AIDS Council of Zimbabwe (NAC) and other stakeholders, supported the CATS trainings. Adolescents and young people with HIV are now able to interact with the CATS during home visits, where CATS provide HIV and adherence counselling, monitor adherence and pill count, and offer clinical reminders. Adolescents now have a dedicated day on weekends to visit the health facility for review and refill.

Currently, adolescents and young people with HIV in Kotokoto Village have formed a support group with 35 programme beneficiaries; at this support group, participants discuss issues and challenges that they face in both private and public spaces, and how best they can overcome them.


Tafadzwa: Transforming the life of a young woman

“The Zvandiri program has helped me to realize how l should live as l am. l am now ready to go into the community in order to help other children, adolescents, and young people to adhere well to antiretroviral treatment and fight all forms of stigma and discrimination,“ said Tafadzwa.

Tafadzwa is a 22-year-old, double-orphaned young woman who was born with HIV. She stays with her grandmother in Mount Darwin, in Mashonaland Central province.

In 2004, she was bedridden as a result of continuous illness.

Tafadzwa stayed at Karanda Hospital for so long that it was declared as her second home. Her grandmother decided to tell her about her HIV-positive status while Tafadzwa was hospitalized. While this helped Tafadzwa to understand her persistent illnesses, she lacked the necessary information, counseling, and support she needed. She struggled to come to terms with her diagnosis and to adhere to her new ARV medication. At the same time, she faced stigma and discrimination from her peers and in her community.

In October 2016, Africaid scaled up its Zvandiri model of differentiated service delivery for children and adolescents in Mount Darwin district with financial and technical support from PEPFAR through USAID and Management Sciences for Health (MSH). This is when Tafadzwa’s life was transformed. She was selected by Chitse Health Facility in Mount Darwin to be trained as a Community Adolescent Treatment Supporter (CATS). In November 2016, she participated in the week-long CATS training, together with 28 other adolescents and young people living with HIV. However, Tafadzwa did not participate in this training on her own initiative. She became involved in the program to fulfill the wishes of her caregiver.

On the first day of training, Tafadzwa did not interact with anyone, even with other new CATS, who she already knew from her health facility. She spent most of her time crying, without disclosing why she was so upset. Africaid staff members attempted to engage her, but Tafadzwa would only say that no one cared about her and that the solution to her current situation was death.

During the training, Tafadzwa engaged in a participatory exercise in which the CATS share their life experiences. She found the process of reflecting and sharing painful memories and experiences to be extremely difficult, and was unable to speak without bursting in tears. Her struggle was apparent in everything that she did—how she reacted, how she carried herself, and the way she isolated herself from others. Her distress was so intense that she was unable to eat during the first two days of the CATS training.

During the training sessions, Tafadzwa slowly began to listen to and benefit from the life experiences of other CATS. She identified with their stories and emotions shared through role plays and meaningful and honest discussions, and began to engage in counseling with the training facilitators. As the training progressed, the training facilitators observed a dramatic change in Tafadzwa’s overall behavior. She began actively participating in all sessions, speaking openly about past events in her life, leading group presentations, and reflecting on her own experiences to develop coping strategies with other CATS. Tafadzwa became an active, strong member of the new Mount Darwin CATS team. She explained that she now realizes that she is not alone and that she is loved and valued. She is no longer just waiting for death.

As a CATS, Tafadzwa is now complementing Zimbabwe’s national efforts to achieve its 90-90-90 targets by accelerating the initiation of children, adolescents, and young people with HIV on ART, as well as providing subsequent support for those on treatment. Under the PEPFAR-funded Game Changer program, she currently supports a cohort of 120 children and adolescents on ART in their health facilities and communities with adherence monitoring, counseling, and support. She identifies adherence challenges, traces patients lost to follow up., and proactively identifies and refers children and adolescents in need of further investigation for possible opportunistic infections, treatment failure, child protection issues, and their psychosocial support, sexual, and reproductive health needs.

Tafadzwa is now ready to work within her team to collaboratively reach 1,600 children, adolescents, and young people with HIV to be linked to and supported by CATS in Mount Darwin.

*Name changed to protect identity Read More


Takudzwa: l am not the only adolescent who is living with HIV

Harare| Takudzwa, a 19-year-old from Harare, never thought that he would be able to interact with other young people. Like most adolescents he wanted to hang out with his friends, to identify with them, and to feel a sense of belonging in his peer group. Like many HIV-positive adolescents, Takudzwa felt lonely, isolated, and afraid when he learned his status in 2016. He feared his peers’ response if they learned that he was HIV-positive, so he withdrew from social interactions and worked hard to conceal his antiretroviral (ARV) medicines. At home, Takudzwa’s siblings looked down on him and called him derogatory names, damaging his confidence and self-esteem. Although Takudzwa’s nurse advised him to carefully adhere to his treatment, he felt hopeless and began to default from his medication, weakening his health.

But Takudzwa’s life began to change in 2016 when he joined Africaid’s Zvandiri program. In support of Zimbabwe’s efforts to achieve its 90-90-90 targets (90% of HIV-positive individuals knowing their status, 90% of those who know their status receiving AntiRetroviral Therapy (ART), and 90% of those receiving ART achieve viral suppression)and with financial support from USAID and capacity building from Management Sciences for Health (MSH), Africaid is currently scaling up the Zvandiri model of differentiated care for children, adolescents, and young people with HIV. Takudzwa is one of 68,000

Our Story counselling game being used by CATS in adherence counselling

of Africaid Zvandiri’s beneficiaries from 24 districts in Zimbabwe.

Takudzwa’s nurse referred him to one of the Zvandiri program’s Community Adolescent Treatment Supporters (CATS). The CATS began visiting him at home to ensure he had adequate information regarding HIV and ART, as well as to provide regular adherence monitoring, counseling, and support. Receiving support from the CATS—someone who understood his experiences and needs—encouraged Takudzwa and motivated him to adhere to his treatment. During the home visits, the CATS interacted with Takudzwa’s siblings and caregiver, improving the support he received at home. The CATS attended Takudzwa’s clinic visits to follow up with him and to liaise with the clinic nurse regarding his progress. Takudzwa also attends the Zvandiri support group in his local community.

Today, Takudzwa adheres to his treatment and his health continues to improve. He now has a much more positive outlook on life and aims to be a lawyer to assist orphaned and vulnerable children.

“When l first knew my HIV status, l thought my dreams to be a lawyer were shattered. But because of peer support, l then realized that being HIV positive does not mean that l am going to die. Joining Zvandiri support groups has restored my high self-esteem and l learned that l am not the only adolescent who is living with HIV. At the support group we discuss various topics, and l now know more about HIV and AIDS,” said Takudzwa.