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Facing the HIV Triple Threat


Mery

Mery Mwansobe, a teen from Tanzania’s southern highlands, is confronting a trio of life circumstances—her age, gender and, notably, her address—that place her at a staggeringly high risk of HIV infection.

Ages 15 through 24 are an incredibly dangerous time for women, the Joint United Nations Program on HIV/AIDS (UNAIDS) warns. And, of the more than 1,000 young women every day who became newly infected with HIV in 2015, the vast majority live in sub-Saharan Africa.

Stats like those don’t bode well for Mery. But the 18-year-old tested negative earlier this year for the virus that causes AIDS. Not only does she intend to maintain that status, she insists, but she will also encourage other young women to join her in the struggle for good health.

A key, Mery says, has been taking part in activities sponsored by the Sauti Project, a combined HIV prevention and family planning program funded by the U.S. President’s Emergency Plan for AIDS Relief through the U.S. Agency for International Development, in cooperation with the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children.

Sauti is led by Jhpiego in partnership with EngenderHealth, Pact and the National Institute for Medical Research-Mwanza. The project has reached more than 20,000 young women and adolescents with HIV counseling and testing services since it began in 2015. Mery was introduced to the Sauti project in July 2015 when a peer educator invited her to attend social and behavior change communication group education sessions. Mery gained confidence among the supportive group of young women and began sharing ideas in addition to learning from them.

“My parents could not afford to send me to (secondary) school,” she explains, adding that after finishing primary school in 2013, she filled her days with visits to friends and household chores.

Mery lives with her parents and three siblings in Ntandala village off the main road in Kyela District. Although her community appears to be close knit—with its local brew huts that attract a highly mobile workforce of daily wage employees from surrounding small-scale farms—it is a reputed hotspot for HIV high-risk behaviors.

Data from studies in six locations within eastern and southern Africa reveal that in southern Africa, girls aged 15–19 accounted for 90 percent of all new HIV infections among 10- to 19-year-olds, and more than 74 percent in eastern Africa where Mery lives, according to a new UNAIDS report. “Young women are facing a triple threat,” UNAIDS Executive Director Michel Sidibé observes. “They are at high risk of HIV infection, have low rates of HIV testing and have poor adherence to treatment.”

During the Sauti-sponsored sessions, Mery heard about how to protect herself from HIV, sexually transmitted infections and unwanted pregnancies. She was also linked to health services for HIV testing and counseling.

“I value what I learned because men try things with me and want to engage with me,” she says. “Now I know what to do and protect myself against this risky behavior. Learning gender roles has taught me about empowerment and that I don’t have to do what an older male tells me to.”

Mery also has benefited from one of the project’s potent HIV preventives: financial empowerment.

She joined WORTH+, a Sauti-led savings and loan group based in her community. Emboldened by other young women who were launching small laundry and tailoring enterprises, she has started growing her own business selling vegetables. Through Sauti, more than 15,000 teens and young women are active in these economic empowerment groups.

Mery is inspired to help others avoid the all-too-common trap of transactional sex, which puts them at high risk of contracting HIV.

“It is easy to get lost and off track, to have unprotected sex for money, to put oneself at risk,” she insists. “Knowledge is a gift. I will mentor younger girls as I have been mentored.”

Haeli Gustafson served as a Community Health Advisor for the Tanzania Sauti Project and Maryalice Yakutchik is a senior communications manager at Jhpiego.