NATIONAL director for the Pan African Positive Women’s Coalition-Zimbabwe (PAPWC-ZIM) Tendayi Westerhof says HIV and Aids programming in Zimbabwe has improved to the extent that stigmatisation of people that are infected has fallen drastically. Westerhof said there was meaningful involvement of people living with HIV (PLHIV) in policy-making processes on HIV response, as well as the inclusion of women living with the virus. She speaks to NewsDay reporter Vanessa Gonye .
ND: What challenges do people you represent face on a day-to-day basis?
TW: PLHIV are also affected by socio-economic challenges like everyone else, though they face the double portion because of their condition, which subjects them to stigma and discrimination.
Women living with HIV still bear the brunt of the HIV pandemic as they are caregivers, are exposed to gender-based violence, mostly in rural settings, and still walk very long distances to access treatment, including access to other health services such as sexual and reproductive health.
User fees at some public health institutions pose a challenge to PLHIV as they are a barrier to treatment access. Self-denial, self-stigma and fear of the unknown continue to limit one’s ability to live freely. Denial is the reason why some people do not go on treatment.
The community may be nasty. For example, some scholarships from Russia and China specifically say they will only take HIV negative people. Locally, for one to enrol in the army, it is the same. So, we face discrimination and hence, fail to achieve our dreams because some sectors don’t want us. There is also lack of employment for our children and yet we continue struggling for fees.
The over 50-year-olds that are living with HIV have experienced increased risks of contracting other non-communicable illnesses such as cancer, diabetes, high blood pressure and malnutrition. The other problem is that issues affecting PLHIV have not been that prominent since the onset of COVID-19.
Nothing has been put in place to see that HIV testing, tuberculosis (TB) screening, condom distribution and follow-ups on defaulters are carried out during the COVID-19 period and yet no one must be left behind to reach our goal of ending Aids by 2030. There is a danger of virtual meetings fatigue as these meetings are now so many and the cost of data bundles is not going down.
ND: COVID-19 has changed a lot of livelihoods, how has it impacted on PLHIV?
TW: COVID-19 caused a lot of changes on livelihoods and food security. Most of the people in our country are not formally employed and depend largely on informal trading, but cannot operate as usual because of the lockdown restrictions that we must all observe to curb the further spread of COVID-19. The pandemic has caused a lot of emotional distress, stress on PLHIV and they are emotionally traumatised because of uncertainty that if they contract COVID-19 they might not survive.
ND: What would you say is the best way to address those challenges?
TW: The national, provincial, district and community task forces must include PLHIV and community-based organisations in their programming. This could be another solution to ensure we address challenges as a result of COVID-19. We want to see more community volunteers who are also given a fee or allowance for their contribution.
PLHIV should be meaningfully involved by engaging them as COVID-19 champions to scale up mobilisation for more people to get vaccinated against the respiratory virus, awareness creation and counselling because they know their communities better as they live in them. COVID-19 vaccines are safe and efficient and PLHIV, who have taken the jab, can be great advocates for demand creation.
ND: Do you feel the government and responsible authorities are playing their role in ensuring that issues affecting PLHIV are prioritised regardless of being in a COVID-19 era (environment)?
TW: We complement efforts by government on a unique National Aids Trust Fund that was created out of an Act of Parliament and this saw the majority of PLHIV being enrolled on HIV treatment and other forms of mitigation of the pandemic. Yes, but still more needs to be done. HIV treatment is free for all regardless of status in society because it’s a disease that does not discriminate.
However, some public health institutions are still charging user-fees and this is against policy and creates a barrier to access to treatment for all. We talk about commitment to the Abuja declaration on Aids, the Southern African Development Community protocols, Convention on the Elimination of all Forms of Discrimination against Women, the human rights of people living with HIV and so on.
There is need for foreign currency allocation to ensure that we have sufficient ARV treatment for PLHIV at any given time. We have seen panic situations in the past, where certain ARVs were said to be in short-supply and on many occasions, PLHIV were affected as they could not be administered their full quantities of ARV supply.
ND: What has been the major challenge affecting your constituency, dating back to the days when HIV came into existence and has this been dealt with?
TW: The challenge dating back to the days when HIV came is the set-up of clinics in city councils, which is not the same as that in general hospitals, where you find that the clinics for PLHIV are a standalone branch. At clinics, these are inside another room and there is no privacy as others do not want to be seen and, as a result, they default treatment. Others end up not turning up for counselling sessions.
ND: Last year, during lockdown, some adolescents on ART were saying they encountered challenges in getting treatment, as we are in another lockdown, what is your organisation doing to address the challenge?
TW: This time concerning the issue of adolescents, we have created an adolescent clinic, which means that every last Saturday of every month they meet for their refill and viral load collection, for those who have gone for holidays, their guardians will come and collect the ARVs. If they do not come, we phone so that they come and collect them.
ND: What would you suggest could be done to help the people you represent, on stigma and discrimination among other social effects?
TW: The first and foremost thing as an individual is to accept your status and have full information about HIV and Aids. Educate all those around you about it and disclose your status to your immediate family members and tell them why you have disclosed.
In most instances, disclosure is done in order to protect yourself and your loved ones. Disclose your status to the outer world starting with your community because you want to deal with issues of stigma. The more you hide, the more people stigmatise you. You can also get support from your family members. Engage in all activities in your community and help those who are in need of your support when they test positive and act responsibly. Be a role model in your community in terms of positive living.
ND: Anything else you would like to add, vis-à-vis COVID-19 and HIV?
TW: COVID-19 might be still with us for a long time, but as a country we can beat the diseases. We are succeeding in halting the further spread of HIV and lessons from that response can be applied to beat COVID-19. The two diseases have similarities in the sense that you protect me and I protect you, and to prevent COVID-19, we need to take measures and observe the set guidelines just like with HIV, we preach correct and consistent condom use, and other measures for HIV. For COVID-19 as well, it is about prevention, prevention and prevention.