Leading the way for HIV treatment among adolescents

Nasir understands the complexities of being an adolescent diagnosed with HIV/AIDS. Before he turned eight years old, Nasir, who hails from Tanzania, lost both of his parents to HIV. Then, at age 12, he discovered he was HIV-positive. To accept his status at such a young age was problematic.

Adolescents like Nasir who are HIV-positive face unique challenges when acknowledging their HIV status and starting treatment. This includes negative beliefs and attitudes about HIV, a lack of familial support, and social repercussions from the stigmatization of HIV, which can present a complicated reality during a significant time of growth in a young person’s life.

For HIV-infected adolescents, linkage and engagement in care are critical corollaries to long-term health. For Nasir, his outlook on life remained bleak until a facility health worker linked him to a community case worker (CCW) named Esther, who now works for the USAID-funded Adolescents and Children HIV Incidence Reduction, Empowerment and Virus Elimination (ACHIEVE) project. After gaining access to comprehensive and layered HIV treatment services at home (through the CCW) and the Mwananyamala Care and Treatment Centre in Dar es Salaam, Nasir accepted his status. Since then, he has learned how to manage his disease by adhering to antiretroviral therapy, or ART so that he can live a long and productive life.

Now 18, Nasir has been on treatment for six years and his viral load has improved to the point of being at undetectable levels. Further, his treatment adherence performance earned him an opportunity to be trained as a peer educator in 2018. After two years of service, he is now the lead peer educator at Mwananyamala CTC.

“Primarily, I am responsible for checking out fellow young people’s progress on treatment and general wellbeing,” said Nasir.

As a peer educator, Nasir supports young people living with HIV in unique and important ways through their shared experience of living with HIV. Being similar in age has also allowed him to closely connect with the young people, build trust, and link them to the care they need.

Nasir recalled a time when a young person came to the clinic and was found to be HIV-positive. “The boy was devastated and could not listen to anyone,” said Nasir. “He was shouting that it’s better to die now. But I managed to calm him down. We are now friends, and he is also on treatment.”

Since becoming a peer educator, Nasir’s support has been life-changing for many of the young people he has worked with, such as Wazir, an 18-year-old diagnosed with HIV. By following in the footsteps of Nasir and maintaining strong adherence, Wazir’s viral load is now undetectable.

“I was hesitant to accept the fact that I am HIV-positive,” said Wazir. “I would skip medication without a second thought. But seeing how Nasir is thriving motivated me to remain on treatment, and this makes a difference in my lifestyle.”

Through ACHIEVE, Nasir reaches an average of more than 100 youths per month through home visits, counseling, and educational sessions. He also follows up with the young people he works with through telephone calls to remind them to adhere to treatment. 

“Now, we connect as friends, and I have their mobile numbers,” said Nasir. “There are some whom we have the same time for taking medication; whenever I am taking mine, I call them and remind them to take theirs too.”

This personalized level of care is reminiscent of the level of care that Nasir received from Esther, the community case worker, who changed his outlook on life. He hopes to provide a similar experience to adolescent girls and boys living with HIV/AIDS and serve as a role model to them so that they can go on to live happy and healthy lives.

Today, Nasir considers Esther family. “Seeing how she visits our home and supports my family motivates me to do more,” Nasir said. “My goal is to build the same kind of relationship with more young people and support them the way I have been supported.”