The Sunday Mail
Tariro Mhute
IT is past midday and Portia (name has been changed) (22) arrives at a local clinic in Filabusi, Matabeleland South, after a seven-kilometre walk from her homestead.
Winter is fast approaching, and it is windy, she bends down to wipe the dust off her feet using a cloth and fixes her mask before walking briskly towards the gate.
From a distance, she reckons the clinic is not as busy as she had anticipated.
She quickly washes her hands with the soapy water at the entrance and cheerfully waves at the other clients before sitting at the very end of the wooden bench, placing her feet on the social distancing warning sticker on the floor. She waits patiently before she can collect her antiretroviral therapy (ART) medication.
The Results and Acceptance:
The Journey
“I tested positive for HIV and was initiated on ART in February 2019 while I was eight weeks pregnant with my second child,” she said.
“I had visited the antenatal clinic after the nurse did the routine HIV test and I found out about my status.
“Although I was very ill at the time, I just assumed it was pregnancy-related sickness.
“It came as a shock. After being initiated on ART, the nurse took me through adherence counselling, and I was handed over to the Point of Contact (POC) — a Pathways volunteer stationed at the clinic for continued adherence support at community level.”
Pathways is a project funded by the US government’s President’s Emergency Plan for AIDS Relief (PEPFAR), through the United States Agency for International Development (USAID).
The project is implemented by Catholic Relief Services (CRS) in partnership with Insiza Godlwayo Aids Council (IGAC) in Matabeleland South and other implementing partners across Zimbabwe.
The Pathways project aims to revitalise community and facility linkages so that orphans and vulnerable children (OVC) living and affected by HIV become healthy, stable, safe, and schooled.
Pathways supports OVC and their caregivers to sustainably mitigate the impact of the virus on themselves and their communities.
At the same time, the programme ensures that pregnant and lactating mothers living with HIV do not transmit the virus to their children.
“The volunteer enrolled me into the Pathways OVC project. At first, I was a bit hesitant but the POC clarified the stages for Prevention of Mother to Child Transmission (PMTCT). I did not want to transmit HIV to my child,” said Portia.
“Later, I started the Integrated Mother Baby Course (IMBC) sessions which were being facilitated at the clinic by the POC as well.
“I did the IMBC sessions with other pregnant and breastfeeding mothers where I learnt a lot about taking care of my baby.
“The IMBC platform also allowed me to meet other women who are in the same situation and share ideas to support each other.”
The IMBC model provides a platform for postnatal depression prevention support for pregnant and lactating mothers living with HIV and on ART.
Additionally, it also provides pregnant and postpartum mothers with skills to manage their mood, recognise how depression and stressors (including HIV) can affect their parenting efficacy, their relationship with others and adherence to ART treatment.
The Intervention: A worthy cause
“IGAC through the POC and health officers assisted me with disclosure and psychological support as well,” she added.
“My first viral load sample was collected three months after I was initiated on ART and it was very high because I had issues with disclosing my status at home.
“At that time, I was so stressed and failing to cope, I was not adhering to my prescribed ART medicines at all.
“However, the POC continued offering treatment literacy service.
“She did not lose hope but kept encouraging me; she was my pillar of strength. She even conducted home visits when I failed to show up at the clinic for my adherence support sessions.”
Portia’s viral load sample was collected upon completion of adherence counselling and showed great improvement — her viral load had dropped.
The viral load results came out “target not detected’ (TND), meaning the HIV level was so low that the virus was no longer detected in normal blood tests.
Seven months later, she gave birth to a bouncing baby girl and after Early Infant Diagnosis (EID), she tested negative for HIV at six weeks.
Her baby was commenced on a course as she continued with IMBC sessions.
Her last viral load test was done on February 5, and she returned TND results.
“I am so grateful to the Pathways project; my baby is HIV negative because adherence counselling and mentorship I got form the nurse and the POC”, said Portia with a huge smile.
Journey towards epidemic control
Since 2018, the PEPFAR, through USAID Zimbabwe, has been supporting the CRS Pathways Project in offering child-centred, family-focused, community-based, and evidence informed interventions to 61 385 OVC and their caregivers.
The project is implemented in nine districts; Guruve, Mazowe, Harare, Gweru, Nkayi, Lupane, Bulawayo, Matobo and Insiza and focuses on HIV epidemic control ultimately contributing to the UNAIDS 95-95-95 global goals.
Zimbabwe has made significant progress towards achieving epidemic control, however, it remains important that these positive gains are sustained.
This can only be achieved through rigorous efforts aimed at tracking the remaining undiagnosed HIV positive children and adults like Portia and at the same time facilitating testing and linking them to treatment for comprehensive epidemic control.
Tariro Mhute is the CRS-Pathways communication and documentation officer ([email protected]). Additional reporting by Osiah Chinemo ([email protected] )
