In Zambia's Copperbelt, 'foot soldiers' in the fight against HIV make a difference for hard-to-reach groups

Mirriam Phiri Biemba, the head nurse at Twapia Health Center, has noticed that more people are coming to her clinic, including many who never used to cross the threshold.

Twapia is in Ndola, Zambia’s third largest city and the capital of Copperbelt Province, the country’s copper mining region. Due to its proximity to the border with the Democratic Republic of Congo and its mining communities, Twapia’s population of over 30,000 is diverse, and includes many groups who are at high risk of HIV infection. These groups include mobile populations such as truck drivers and miners, discordant couples, and adolescent girls and young women. These are the people who have started coming in greater numbers to the Twapia clinic, to learn their HIV status, to begin anti-retroviral therapy, or ART, if needed, or to seek treatment or preventative services for sexually transmitted infections.

Why the change? Nurse Biemba credits the USAID-funded Zambia Community HIV Prevention Project, or USAID Z-CHPP. The project, implemented by Pact, has “helped us a lot,” Biemba says.

“More people are coming,” she says, “especially people who are harder to reach.”

More specifically, Biemba says, Justin Mwaba and Daniel Chiofu are to thank. Mwaba is a lay counselor and Chiofu a peer educator – volunteer roles that they hold in their communities through Z-CHPP. These young men are essentially foot soldiers in the ongoing fight to achieve HIV epidemic control in Zambia.

In their daily work, they map and visit “hot spots” – areas where those in high-risk groups are likely to gather – and engage individuals in sensitive conversations about their lives, and what they can change about their behavior to mitigate the risk to themselves and their sexual partners of HIV infection.

Often, they work as a pair, so if Chiofu convinces his client to be tested for HIV, then Mwaba can test on the spot. They refer HIV-positive clients to Twapia Health Center, where they are immediately enrolled to begin ART.

Since he began as a peer educator in 2017, Chiofu has provided HIV prevention education to more than1,000 men and women and referred clients for a range of high-impact services including HIV testing, STI screening, family planning and voluntary medical male circumcision, with plans to reach many more. A client who stands out in Chiofu’s mind is a 15-year-old girl who had been raped, who he referred to the clinic for counseling and post-exposure prophylaxis. She was later confirmed to be HIV negative.

Chiofu is proud of his work. He knows that he and Mwaba are changing people’s lives for the better, and Nurse Biemba knows too.

USAID Z-CHPP is a five-year cooperative agreement with USAID aimed at reducing new HIV infections in Zambia. The project uses a package of combination prevention activities in 14 districts across five provinces, selected due to their high HIV burden.