Children, adolescents and young people with HIV from Mberengwa, Midlands province welcomed the Community Adolescent Treatment Supporter (CATS) model in their community as they used to face challenges in opening up on issues that affect them. Mberengwa is a rural district which is prone to droughts and high temperatures, but rich in minerals such as gold, iron ore, emeralds and asbestos. The mining activities in the area results in adolescents and young people failing to adhere well to their medication and honour clinic visits as they will be searching for the precious stones.
Before the scale up
There was a gap for adolescents and young people living with HIV in terms of accessing health services and their response to HIV services before the scaling up of the CATS model to Mberengwa. “This area is rich in minerals; as a result most of the adolescents and young people in the area spend the bulk of their time in illegal mining.” Said Charity the Zvandiri Mentor for Mberengwa. “This results in them defaulting on their medication as they have no time to visit health facilities for medication and support.” The CATS model is transforming the way the beneficiaries are accessing services as some CATS who are involved in gold mining are offering the needed support to their peers at the ‘mines’. Apart from the mining activities in the area, health facilities are far away from the communities with some adolescents and young people having to walk through distances of close to 10 km. This resulted in the low up take of HIV services. Some who braved the long distances could not share their stories with health care workers for fear of being judged. “Most of my peers confess that it was difficult for them to share their challenges with staff at the facility due to the age gap. They ended up just collecting their medication without seeking advice on Sexual Reproductive Health issues.” Added Prisca a CATS stationed at Mnene Hospital.
In October 2017, Africaid received a Multi Year Award from USAID which seeks to improve children, adolescents and young people’s experience of HIV testing services, diagnosis, linkage to care, disclosure, treatment access and adherence. CATS work closely with health facilities, families, and communities to respond to the unique needs of young people living with HIV. “As CATS, we are responsible for counselling and supporting a cohort of HIV positive children and adolescents in our community through home and clinic visits. We identify adherence challenges, trace treatment defaulters, and proactively identify and refer children and adolescents in need of further investigation for possible opportunistic infections, treatment failure, child protection and psychosocial support.” Explained Prisca. “As CATS, we are excited about the changes that have been brought to our community by the model.
“Adolescents and young people are now free to visit the health facilities where they have a chance to discuss issues around disclosure, adherence, sexual reproductive health and relationships in support groups. Most of our peer no longer miss their appointments!” In Mberengwa district, 38 CATS were trained and each CATS offers differentiated service to 65 children, adolescents and young people living with HIV. The scale up project will ensure that adolescents and young people living with HIV are resilient, empowered and knowledgeable about their sexual reproductive health and rights.
Stakeholders applaud CATS work
Stakeholders in Mberengwa commended the work of the CATS whom they said were addressing the critical needs of children, adolescents and young people living with HIV. “Adolescents and young people are now feeling more comfortable to talk about their health with their peers (CATS) because they are of the same age.” Said Community ART Nurse for Kheth’ Impilo, Sandisiwe Mahlangu. Social Welfare Officer Fortunate Mlambo concurred, “CATS help us identify children, adolescents and young people with HIV who require support from our department. Young people are open to their peers and they disclose issues that they would ordinarily keep to themselves. This has enabled us to unearth cases of child abuse and neglect.” Fortunate agreed that Support groups were equipping adolescents and young people with skills, knowledge and information and most of those who attend them were now confident to express themselves.
“On issues around refill and adherence, CATS are more acquainted because they also have information on the medication which their peers are taking. We have also noted that the use of SMS reminders has improved the uptake of medication by children, adolescents and young people. CATS are also working closely with Case Care Workers in the community and with their knowledge; they make the work of other community cadres easier.”
Africaid Zvandiri Mentor agreed with the stakeholders stating that the CATS were supporting the 90-90-90 targets which aim at making sure that people are tested for HIV, receive HIV treatment and have a suppressed viral load by 2030.