‘They offer me hope’: Beating HIV stigma with group assist in Zimbabwe

By Farai Matiashe/Al Jazeera

MUTARE: When Marvel Mwatamawenyu examined constructive for HIV as a younger man greater than twenty years in the past, he thought he had signed his dying warrant.

His society informed him that HIV and AIDS, which had been spreading quickly in Zimbabwe within the Eighties and Nineties, had no remedy.

Mwatamawenyu examined HIV-positive in 2003 after going to donate blood at a well being facility close to his home in Matika village, simply outdoors Mutare in jap Zimbabwe. “I used to be shocked. I didn’t consider it,” the 51-year-old father of six informed Al Jazeera.

“I later bought sick and well being employees inspired me to take antiretroviral remedy (ART) medication which I’ve been taking since 2004,” the tall, wiry man mentioned, referring to the usual HIV remedy that was first rolled out within the nation that very same yr.

Mwatamawenyu is one in every of about 1.3 million individuals dwelling with HIV in Zimbabwe as we speak. Within the 20 years since he was identified, a lot has modified.

When ART was first launched world wide, sufferers used to take a mixture of many medication, however the remedy is now obtainable in fixed-dose combos that enable individuals to take only one or two drugs.

Taken day-after-day for the remainder of an individual’s life, ART stays essentially the most accessible HIV remedy globally as a result of it’s efficient in stopping the virus from replicating within the physique and is cost-effective, significantly in low-income communities.

Although ART doesn’t remedy HIV and AIDS – there isn’t any remedy – it helps sufferers’ immune techniques and reduces mortality and morbidity. The illness can be now not a dying sentence, regardless of its seriousness.

AIDS-related deaths peaked in Zimbabwe within the Nineties and new HIV infections had been excessive within the early 2000s when Mwatamawenyu was identified. However the figures have declined over time due to interventions like ART, and consciousness campaigns on stopping mother-to-child transmission.

For these dwelling with the illness, many say the sense of group they’ve managed to construct has been a lifeline – extra than simply the medical care.

Stigma

Mwatamawenyu, who speaks at 1,000,000 miles a minute, is the preacher of a small spiritual group. He mentioned that when information reached his congregants that he had HIV, most left him.

“They thought I used to be dying. About 70 p.c left. They thought I might transmit HIV to them simply via a handshake.”

Folks grew to become conscious of his well being standing due to his frequent visits to the native clinic, strolling distance from his house, to gather his treatment and for routine checkups, Mwatamawenyu mentioned.

He had additionally misplaced his father to AIDS within the mid-Nineties.

Whereas his congregants had been afraid, his household was at all times supportive, significantly his mom.

“She inspired me to take ART,” he mentioned, additionally including that his spouse was HIV-negative however handed away in 2007 from an unrelated sickness.

Born and raised in Chimanimani, some 150km from Mutare, Mwatamawenyu shares his story with others who’re a part of a bunch of individuals dwelling with HIV from their village.

Group member Ruth Mlambo, a mom of 4, examined HIV-positive in 2002 when a health care provider revealed that her husband was constructive and had been taking ART medication.

“He hid it away from me. It was painful,” the 53-year-old former bookkeeper and healthcare employee mentioned, recounting the distressing reminiscences.

Mlambo mentioned they stored the analysis a secret from the group on the request of her shy husband till he handed away in 2004. When she lastly revealed she had HIV, she confronted stigma and discrimination.

“My late husband’s family members didn’t know that he died from AIDS, in order that they accused me of dishonest following his dying,” mentioned Mlambo.

Newly widowed and left to take care of her school-aged youngsters whereas struggling along with her well being, she was helpless and the longer term was unsure, she recalled.

She has carried her scars since.

95-95-95

Final yr Zimbabwe reached the Joint United Nations Programme on HIV/AIDS (UNAIDS) goal dubbed 95-95-95, whereby 95 p.c of individuals dwelling with HIV needs to be identified whereas 95 p.c of these dwelling with HIV needs to be on ART treatment and 95 p.c of these ought to obtain viral suppression.

This helps in lowering HIV transmission and mortality because the 95-95-95 goal leads to 85 p.c of all individuals dwelling with HIV with viral load suppression, in keeping with UNAIDS.

Greater than 1.2 million out of 1.3 million individuals dwelling with HIV in Zimbabwe are on treatment, in keeping with authorities officers. About 97 p.c of these have achieved viral suppression.

Over time, the numbers of individuals dying from AIDS have additionally been declining. In 2002, 130,000 AIDS-related deaths had been recorded in contrast with 20,200 in 2021, in keeping with a report from the UN Youngsters’s Fund (UNICEF).

Behind these strides in HIV prevention and remedy are women and men like Mwatamawenyu and Mlambo who fought arduous to alter their predicament.

Two years in the past, there was a profitable marketing campaign to take away a regulation criminalising the wilful transmission of HIV, as a result of analysis confirmed that girls had been being charged for this crime when venturing out in the hunt for healthcare.

Just lately the federal government tried to sneak it again into regulation, however lawmakers resisted and it was eliminated.

Daniel Molokele, chairperson for the Parliamentary Portfolio Committee on Well being, informed Al Jazeera they spoke strongly towards it. The Ministry of Justice was attempting to get it recriminalised to guard minors, however gender activists mentioned criminalising sexually transmitted infections violates human rights and will increase stigma.

“We hope that within the up to date model of the invoice that clause round wilful transmission might be completely eliminated,” Molokele mentioned.

Evellyn Chamisa, the nationwide coordinator for the Community of Zimbabwe Constructive Girls, an activist group, mentioned involving all stakeholders – particularly policymakers and beneficiaries in every part from prevention and remedy to consciousness – made profitable strides in reaching the UNAIDS goal.

“Letting the individuals personal the epidemic and put them in entrance in programming is vital,” she mentioned.

Group well being teams just like the one Mwatamawenyu belongs to create a platform for individuals dwelling with HIV to get counselling, monetary assets and different social assist.

Again in 2004, he mentioned the percentages appeared unimaginable, however discovering there have been many like him was an enormous reduction.

“I joined some teams of individuals dwelling with HIV and this was a lift. I had developed low shallowness. They gave me hope,” mentioned Mwatamawenyu, his smile brilliant.

Taking a look at ease, Mlambo mentioned she began taking ART treatment in 2014 after falling sick, however HIV and AIDS-related consciousness campaigns on radio and locally modified her life.

She additionally took on entrepreneurship initiatives and began attending counselling periods, she mentioned, including that the thought was to maintain herself busy in order that she didn’t stress.

Teams of individuals dwelling with HIV share an unbreakable bond and the place there’s a bond there may be hope, mentioned Mlambo.

A religious Christian who goes to the Anglican Church, she can be fashionable in her village, having appeared on nationwide TV speak exhibits, in church and on totally different platforms, inspiring many along with her journey.

Martha Tolana, an HIV/AIDS activist, mentioned whereas there was nice political will within the battle towards the illness in Zimbabwe, HIV assist teams present a haven for individuals dwelling with it.

“Offering peer counselling, recommendation and assist on acceptable diet, remedy and adherence assist, coping with stigma and discrimination, in addition to livelihoods assist has been a recreation changer,” she mentioned.

“House-based care additionally began within the assist teams,” Tolana mentioned, referring to psychosocial assist given to individuals dwelling with HIV of their houses by casual or formal caregivers.

Zimbabwe has additionally been making progress in lowering mother-to-child transmission. It’s necessary for pregnant moms to get examined for HIV and if they’re constructive, they get treatment to forestall transmission to their unborn child.

Although the present mother-to-child transmission price is eight p.c, which continues to be excessive, it has declined from 30 p.c in 2004, in keeping with UNICEF.

Following the dying of his spouse in 2007, Mwatamawenyu remarried in 2009. His new spouse has given beginning to 4 youngsters who’re all HIV-negative because of the prevention of mother-to-child transmission.

“I made positive that the mom was taking medication on time. The youngsters are wholesome,” Mwatamawenyu mentioned.

In the meantime, he mentioned these congregants who left him within the 2000s are returning, an indication that individuals at the moment are accepting him.

Even locally, he now holds totally different management positions.

Marginalised teams

Nonetheless, not everyone seems to be on board. And specialists say stigma and discrimination in the direction of sure teams are nonetheless rife.

In line with a current Stigma Index by the Zimbabwe Nationwide Community of Folks Residing with HIV (ZNNP+), a nationwide umbrella physique that represents and coordinates individuals dwelling with HIV, stigma and discrimination towards transgender individuals is at 97 p.c, intercourse employees at 77.7 p.c and males having intercourse with males at 62 p.c.

Hazel Zemura, director of All Girls Advocacy, an organisation representing intercourse employees in Zimbabwe, mentioned whereas strides like entry to condoms, pre and post-exposure prophylaxes and vaginal rings have been made to strengthen efforts to forestall HIV, intercourse employees nonetheless face important hurdles accessing providers.

“Intercourse employees usually expertise stigma and discrimination from healthcare suppliers in public well being amenities, resulting in concern and reluctance to hunt providers,” she informed Al Jazeera.

Jane Kalweo, a rustic director at UNAIDS, mentioned peer-led fashions and the promotion of community-led organisations to succeed in out to high-risk teams will improve attain.

“Group-led monitoring may also tackle boundaries to healthcare by troubleshooting the place there are bottlenecks when it comes to accessibility, appropriateness, affordability and timeliness of providers,” she mentioned.

“Social contracting of community-led organisations to supply providers that ought to usually come from [the] authorities may also bridge the hole in service provision,” she added.

Molokele, an opposition member of parliament, mentioned entry to well being providers for sexual minorities like intercourse employees and the LGBTQ group is lagging.

“We should be extra trustworthy and recognise the wants of all the important thing populations,” he mentioned.

“We can not finish AIDS by 2030 if we’re leaving among the key populations behind.”

Goal to finish AIDS by 2030

Zimbabwe, like different UN member states, has dedicated to ending AIDS by 2030.

Consultants consider the goal is bold and a scarcity of assets threatens it.

In 1999, Zimbabwe launched an AIDS levy whereby people, corporations and trusts are charged 3 p.c of earnings, which is then channelled in the direction of HIV/AIDS programmes.

However specialists say that isn’t sufficient because the World Fund, a partnership of worldwide humanitarian companies mobilising assets to battle HIV, AIDS, tuberculosis and malaria world wide, is supporting medication and diagnostic gear whereas authorities healthcare focuses on administration.

Funding to Zimbabwe’s well being sector fell in need of the Abuja Declaration, a dedication made by African leaders at a 2013 summit in Nigeria, which requires no less than 15 p.c of budgets to be allotted to well being. This has resulted in dysfunctional hospitals.

Olive Mutabeni, an govt director at Life Empowerment Help Group, a female-led activist group, mentioned for Zimbabwe to succeed in the 2030 goal, HIV consciousness programmes ought to proceed on the grassroots degree.

“Funding needs to be supplied to community-based organisations led by individuals dwelling with HIV to lift consciousness and proceed providing assist to their members,” she mentioned.

Some individuals dwelling with HIV and AIDS additionally undergo non-communicable illnesses and they’re requested to pay for checks and drugs which is past the attain of many dwelling in difficult financial situations.

Mlambo mentioned she struggles to pay for among the providers.

“HIV providers are at no cost, however we pay for remedy for different illnesses. I can not afford it,” she mentioned.

Mwatamawenyu is beginning to expertise frequent long-term results of HIV treatment like numbness – however he’s grateful to have lived a few years.

“Again in 2003, I by no means thought I might nonetheless be round. However right here I’m, match and wholesome,” he mentioned.