Luanda, Angola—An innovative approach to ensuring follow-up care and treatment of Angolans who test positive for HIV is giving women and families the hope and means to lead healthy lives and protect their children from the virus.
In two provinces in Angola, Jhpiego has been working in partnership with the National AIDS Institute to strengthen the cascade of care: enabling more pregnant women to get tested for HIV during their first antenatal care visit; ensuring that those who test positive receive antiretrovirals (ARVs); promoting births at health facilities; and following up children exposed to HIV until they receive definitive results of their status. The President’s Emergency Plan for AIDS Relief, through the U.S. Agency for International Development, and UNICEF are supporting this intervention.
Integral to the success of this initiative has been training nurses to prescribe ARVs and enlisting HIV-positive activists from Huambo and Luanda provinces to serve as client advocates, who can share their personal experiences and facilitate the care and treatment of fellow Angolans newly diagnosed.
These activists bring real-life experience to their work. After years of battling discrimination and stigma, activists—such as Elizabeth Fernandes, 50, Francisco Pinto, 42, and Suzeth de Morais, 41, who learned of their HIV status over six years ago—are working in clinics and convincing pregnant women and their partners to get tested and counseled, and, if positive, enter treatment and protect their unborn children.
The activists are engaged in the lives of their clients, often going beyond their daily routines to help women and families struggling to cope with their newly learned status. Below are a few examples of the determined efforts of these activists to keep families together, healthy and thriving.
A Violent Outburst Becomes an Opportunity to Bring a Family into Care
Early one morning, Elizabeth receives a phone call from a client, a 36-year-old pregnant woman. She has been beaten by her husband after revealing her HIV status and needs medical attention. Elizabeth travels to the woman’s home, takes her to the hospital and then escorts the woman home. There she finds the husband’s relatives threatening to sell the family house and toss her pregnant client out on the street. Steadfast and calm, Elizabeth appeals to the family and they back down. She explains that HIV is not a death sentence, that she has been living successfully with the virus for more than a decade. Considering her earnest appeal, the husband eventually admits that he too has HIV and has had several partners. He then agrees that these women, whom he refers to as his other wives, and his four children all should be tested.
The husband’s partners test positive for HIV and begin on ARVs at a hospital close to home. The children’s tests are negative. Elizabeth’s client is thrilled, saying, “I am very happy to know that my children are all negative and the unborn one will have the chance to be born without HIV too.”
Working with HIV Clients Gives New Meaning to Health Activist’s Life
One day while Francisco is working at the KM 12 Health Center, a nurse reaches out to him to help comfort a pregnant mother of three. During her antenatal care visit, the woman learns she is HIV-positive and she can’t stop crying. She explains to Francisco that she has had only one partner in her whole life, adding, “I don’t deserve this.” Francisco shares his personal story of living with HIV and asks her to bring her husband to the health center. The couple arrives the next day and the husband agrees to a test. His result is positive too. The woman begins to accept the couple’s new reality, understanding that it is not the end of their life. She begins receiving treatment and months later gives birth at the center. With the help of health care providers, the mom learns how best to exclusively breastfeed her baby. The next time she sees Francisco, she tells him: “My baby is doing well, I am on a family planning method and I feel healthy.”
For Francisco, this is a very rewarding job: “I feel very useful and happy because I am helping others to walk the path I already walked. My wife died of AIDS, my daughter died in an accident this year and I still have a sense of being useful, which helps me recuperate from my sorrow. I feel I have helped all the women who have come to the KM 12 Health Center to not only accept their results but to keep having a life.”
A Couple with Different HIV Results Raises HIV-Free Children
After counseling a pregnant woman on her HIV-positive result, Suzeth is asked to help the woman break the news to her husband. The client, 30, and a mother of two, is fearful of his reaction. Suzeth meets with the husband the following week, who tells her that he has been tested through the urging of his boss and, thankfully, his results were negative. Suzeth encourages him to retake the test with his wife, saying, “If he was negative, probably the new test will be negative, but if it was not, he could receive treatment.” The husband was tested and his results were negative. Suzeth gently explains that his wife is not as fortunate. Upset by this news, the husband worries aloud if he can live with an HIV-positive woman.
Anticipating his concern for his children, Suzeth explains that she too is HIV-positive and the mother of four, HIV-negative children, saying, “I also explained that there are couples who are discordants (one HIV-positive, the other negative) but can continue to have sexual relations using a condom. I also encouraged him to please bring his children for testing.”
The father brings in his daughters who all test negative. After the birth of the new baby, she is tested at 15 months and is negative. Now two years old, the baby remains negative. The husband recently called Suzeth to tell her his wife is pregnant again, and “he thanked me for helping him find the meaning of life again.”