Leaving shame in the past
PEPFAR PROMOTES RETURN TO TREATMENT FOR ART DEFAULTERS
For two years Clive Tonderai Amisi defaulted on his Anti-Retroviral Treatment (ART) program because he was too ashamed to be seen queuing at the clinic for medication.
In 2019, after a mobile testing program visited his home area of Nyabira, Tonderai was tested and diagnosed HIV positive. He was immediately enrolled into the ART program at a nearby clinic.
“To get my tablets, I would send a friend to pick them up for me. I was too ashamed to be seen queuing up for medication. What would people say once they realized I was positive?”
“My friend soon got tired of picking up my medication for me. ‘Get them yourself,’ he said to me.”
“So, rather than go to the clinic myself, I stopped taking tablets in 2020. I also went back to my old habits and behaviors. At that time, I just could not accept my status and this new lifestyle of having to take tablets all the time.”
“I was sick quite often after I stopped my tablets. It would be things like severe headaches, flu, and diarrhea. My body felt weak and tired most of the time.”
Clinical evidence shows that ART improves the health-related quality of life for people living positively. Non-adherence to the prescribed ART regimen has detrimental consequences that include HIV resistance to antiretrovirals (ARVs), increased risk of disease progression, and the development of opportunistic infections.
In 2021, Tonderai returned to his home in Nyabira. Shortly after Tonderai received a visit from PEPFAR supported ART community champions.
“The PEPFAR ART champions visited my home and had a chat with me about my status. They were people from my community that I already knew. They explained to me that they were working with the clinic to trace people who had defaulted on their treatment so that they could assist them get back onto the program”.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is a U.S. Government funded initiative to address HIV/AIDS globally. Since its inception in 2003, PEPFAR has invested over $100 billion in the global HIV/AIDS response, saved 21 million lives, prevented millions of HIV infections, and supported several countries to achieve HIV epidemic control. In Zimbabwe, one of PEPFAR’s strategies is to encourage the identification and return to treatment for defaulters of ART who are lost or unknown to the health care system. Key to the success of this strategy is the engagement of ART champions who are local community members that can identify and influence their peers to return to treatment.
After the visit from the ART community champions, Tonderai recommitted to the ART program.
“I was the first person in line at the clinic the following day after they visited me. I didn’t even have my [health record] book – I had burnt it some time ago to hide evidence of my HIV status. But the clinic still had my records. It was easy to get back onto the program.”
“When I went back on treatment, I found the courage to tell my family of my status. I had been afraid that they wouldn’t accept me once they knew, but they were very supportive, and this has really helped me become stronger physically and mentally. My body is stronger. My mind is stronger. I have less health problems than I used to have. I’m hoping to find a job soon – maybe I’ll even become an ART champion and share my experiences with others. This time I will stay on medication and make sure that I don’t allow the shame to kill me instead.”