By Sandra Bisin
A UNICEF-supported programme provides HIV/AIDS counseling and treatment as well as life skills training for adolescents in Tanzania, where young people are at high risk and often lack access to services and support.
DAR ES SALAAM, United Republic of Tanzania, 30 January 2015 – “My mother died when I was 4. My father died when I was 9. Then I started to get really sick. My auntie took me to the doctor’s. They did a test and told me I was HIV-positive,” 17-year-old Neema* remembers. She lives with her aunt in Temeke, a district of Dar es Salaam, Tanzania’s capital. “I grew up knowing I was HIV-positive. I got used to it,” she says. “But for a long time, I suffered from isolation and the bad jokes other children did about me in school. But now it’s all over. I have a business and I have plans for a better life.”
Neema is one of 50 out-of-school HIV-positive young people who were trained in entrepreneurship and management of microbusiness by a local faith-based organization called Pastoral Activities and Services for People with AIDS Dar es Salaam Archdiocese (PASADA), a UNICEF partner. Most of the children and adolescents getting support from PASADA were orphaned by HIV and AIDS and have been stigmatized by their communities. The centre offers them psychosocial support, social networks, access to HIV care and treatment, and life skills and sexual reproductive health education.
Children and adolescents in Tanzania are disproportionately affected by HIV. According to 2012 figures, an estimated 250,000 children aged 0-14 years and 140,000 adolescents aged 10-19 years in the country were living with HIV. Tragically, fewer than three in 10 eligible HIV-positive children accessed life-saving HIV treatment, compared to almost seven out of 10 adults.
Number one killer
“AIDS is the number one killer of adolescents in sub-Saharan Africa,” says Dr. Alison Jenkins, Chief of UNICEF Tanzania’s Children and AIDS programme. “A generation of children in Tanzania have grown up living with HIV and are entering adolescence without continuity of treatment and care because they did not benefit from the prevention of mother-to-child transmission programmes, were lost to follow-up, or at times fell out of care. Identifying these adolescents and giving them access to life-saving HIV treatment before they fall ill, as well as providing them with care and support, is critical to their health and well-being.”
With support from UNICEF, PASADA uses various outreach approaches to identify HIV-positive children and adolescents, including provider-initiated testing and counselling at their network of health centres, home-based testing, testing at children’s homes and street children drop-in centres in Dar es Salaam. In the past year, they have tested more than 14,000 children and adolescents aged 0-19 years, with those found HIV-positive accessing care and treatment.
A better life
“Through PASADA, I took a three-day training two months ago and learned how to make batik. They also told us how to start and manage a business. Each piece sells for 12,000 Tsh (US$8) at the local market. I have already sold seven pieces. I am really excited,” Neema says. “I have also become the leader of a teen club that supports other young people living with HIV, giving them life skills, an opportunity to share experiences and engage in creative activities. I have gained a lot of confidence.”
Through PASADA, nearly 1,000 HIV-infected children and those affected by HIV are currently reached by these clubs providing psychosocial support and life skills to reduce loss to follow up, improve treatment adherence and health outcomes.
Central to making better progress is the recognition that HIV counselling and treatment should be part of wider services that are more sensitive to adolescent needs, such as sexual and reproductive health and family planning information, and guidance on disclosure. To address inequities and remove barriers that prevent adolescents from accessing prevention and treatment services, UNICEF and UNAIDS are launching the ‘All In!’ initiative, which paves the way to ending adolescent AIDS by aiming to reduce new HIV infections among adolescents by at least 75 percent, and increasing HIV treatment to at least 80 per cent of adolescents living with HIV. These global goals will be achieved through context-specific programmes including prevention, testing, treatment, care and social change that focus on adolescents living with HIV or most at risk.
* Name changed