HIV Prevention and Treatment
“People are talking about HIV, accessing treatment, increasingly becoming open about their status, having children being born HIV-free, supporting their families and living their life with hope.”
– Jo Musonda, Country Director, PCI/Zambia
PCI has been active in HIV prevention and response since the early 1990s, empowering communities to modify risk behavior, adopt healthy preventative behaviors, and access and utilize HIV testing, counseling, and treatment services. PCI’s HIV work is comprehensive, community-driven, child-focused, youth-focused, and family-focused.
Our current portfolio leverages relationships and funding to engage, mobilize, and create community ownership, build sustainability of programs, and create linkages between HIV/AIDS prevention, care, treatment, and support services and other relevant intervention areas such as food, nutrition, and livelihoods in many countries around the world, including three in sub-Saharan Africa.
PCI’s overarching approach to our HIV/AIDS programs is to leverage our community-based programming platform across different technical areas as an entry point to promoting effective approaches and improving service uptake. PCI also addresses root causes by facilitating community conversations while embarking on systems strengthening, including technical and management capacity building, especially for civil society organizations. Gender considerations have remained central to all our programs.
Some of PCI’s key approaches include:
- Peer-based education on prevention of HIV and AIDS;
- Community outreach and home-based prevention, treatment, and support;
- Support to orphans and vulnerable children (OVC) through protection mechanisms, providing developmental interventions, building capacity of OVC and their caregivers to take care of themselves and their families, leveraging platforms for providing support services, and supporting older OVCs and caregivers of OVC through self-help groups and income-generation activities;
- Anti-retroviral therapy;
- Increasing access to nutritional foods;
- Household economic empowerment activities and self-care skills training;
- Support groups for HIV-affected families;
- Addressing social drivers of the HIV/AIDS epidemic, including gender inequality and gender-based violence, stigma, and poverty/economic empowerment; and
- Local capacity building of governments, networks, community-based organizations, non-profit organizations, and faith-based organizations.
The Impact of HIV and AIDS in Africa
The HIV and AIDS epidemic in Africa has had a devastating impact on communities across the continent. The epidemic continues to be a major global health issue. Since the start of the epidemic, an estimated 78 million people have become infected with HIV and 35 million people have died of AIDS-related illnesses. In 2016, 1 million people died of AIDS-related illnesses. The vast majority of people living with HIV – an estimated 25.5 million – are located in sub-Saharan Africa.
For vulnerable communities with a high prevalence of HIV/AIDS, the epidemic has caused severe damage to social relations and economic structures, exacerbating social and economic inequities. HIV and AIDS have taken a terrible toll particularly on children and their families. During the past 30 years, an estimated 17 million children lost one or both parents due to AIDS, and 90% of these children live in sub-Saharan Africa. In addition, 3.4 million children under age 15 are living with HIV. Without HIV/AIDS treatment and support for HIV-affected households, parents struggle to support their households and care for their families. Children often cannot attend school because they were infected with HIV or were caring for a family member who was.
For vulnerable communities with a high prevalence of HIV/AIDS, the epidemic has caused severe damage to social relations and economic structures, exacerbating social and economic inequities. HIV and AIDS have taken a terrible toll particularly on children and their families. During the past 30 years, an estimated 17 million children lost one or both parents due to AIDS, and 90% of these children live in sub-Saharan Africa. In addition, 3.4 million children under age 15 are living with HIV.
Without HIV/AIDS treatment and support for HIV-affected households, parents struggle to support their households and care for their families. Children often cannot attend school because they were infected with HIV or were caring for a family member who was.
The vast majority of those infected with the virus are people in the prime of life, whose income and roles as parents are critical to the survival of families and society. The loss of so many parents has left hundreds of thousands of children orphaned. Even when extended family members will take them in, many of these children are at risk for neglect and often turn to the streets to support themselves and their families.
Thato, a nine-year-old girl from Botswana, is a survivor of such a situation. During a routine home visit, a PCI partner and local peer educator trained on how to spot child abuse, gender-based violence, and exploitation observed Thato’s extreme health condition and took her immediately to a clinic.
Thato weighed only 38 pounds and was severely malnourished. She was referred to a hospital where she stayed for two weeks and was eventually diagnosed with HIV and a gastrointestinal disease. Thato’s HIV-positive mother is a single parent who struggled to provide food and other basic needs for her five children. She relied on her oldest daughter, who also had HIV, to care for the younger children.
Weak and unable to fight sickness, Thato didn’t have the energy to attend school before receiving treatment. With proper Antiretroviral Therapy (ART), care and time, Thato’s health improved. She received support from a social worker and is receiving a food basket from the government. Today, she’s back in the classroom where she’s learning, growing, and thriving.
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Engaging Communities in HIV/AIDS Prevention and Treatment
PCI has worked hard to fight HIV/AIDS in countries like Botswana, Ethiopia, Malawi, South Africa, and Zambia. Every country and community has different needs and resources, and the first step in sustainable development is to listen to the people. PCI has developed particular expertise in mobilizing and building the capacity of communities to address root causes of the challenges they face and develop their own solutions, resulting in impact that is more likely to last and grow to scale. From there, PCI builds out programs that empower communities to enhance health, end hunger, and overcome hardship.
Peer education is the basis for much of PCI’s HIV and AIDS prevention work. One way we’ve connected vulnerable groups with HIV/AIDS services is by partnering with the Defense Forces and religious groups in Botswana, Malawi, and Zambia. We’ve collaborated with these groups to design and implement peer education programs that use theater, music, and workshops to share important messages about preventing and treating HIV/AIDS. We also empower community leaders, such as senior military officials and chaplains, to be a part of these programs and use their roles to support HIV/AIDS education and services.
All of these touch points are opportunities to provide not only education, but also referrals for testing, treatment, and additional care such as psychosocial support or nutrition services if needed.
Violence against women has become a prevalent and devastating contributor to the increased risk for female HIV infection. PCI’s USAID-funded program in South Africa, Prevention in Action, designed a social mobilization campaign using mass media to change social norms, attitudes, and beliefs about and create and sustain a shift in response to violence against women (VAW). Between 2008-2012, the project worked collaboratively with communities, civil society organizations, and public sector actors to empower individuals to take actions to stop VAW. In ZwaZulu-Natal, as well as local communities in the Western Cape, Prevention in Action crews filmed over 100 authentic stories of actions taken to prevent VAW. These videos were shared with the communities as a part of PCI’s tireless efforts through Prevention in Action to help establish Violence Free Zones that are community owned and led.
Bringing services to where they are needed
Getting HIV testing, treatment, and care is challenging if you live in a poor, rural area. PCI has helped bring these services to more people under our Department of Defense HIV/AIDS Prevention Program (DHAPP). We support the Defense Forces in Malawi, Zambia, and Botswana by providing technical assistance to implement, manage, and evaluate comprehensive HIV/AIDS prevention, treatment, and care and support programs among uniformed personnel.
In Zambia, PCI is conducting integrated mobile HIV testing and counseling, rapid diagnostic testing, and gonorrhea and chlamydia screening and treatment services. We also worked with Zambia Defense Force (ZDF) to integrate a cervical cancer screening, treatment, and referral program into their mobile home- and community-based treatment program, using an already existing platform to expand access to vital healthcare services among vulnerable women.
Building the capacity of local organizations and health workers
PCI empowers local organizations to keep their communities healthy long after we leave. Some of our capacity building work has included:
- Offering training, technical assistance, and systems building support to organizations in Botswana to address gaps in their capacity to provide HIV services;
- Training, mentoring, and supervising health workers in Zambia to enhance Prevention of Mother to Child Transmission (PMTCT) services; and
- Building the capacity of 12 Ethiopian organizations to provide holistic care and support to 60,000 orphans, street youth, and children who have been made vulnerable due to HIV/AIDS.
Community Care for People Living with HIV/AIDS
PCI is giving many who have lost hope a reason to believe in life again by providing family-centered care and support to thousands of people living with HIV/AIDS.
For example, the Malawi Department of Defense HIV/AIDS Prevention Program, which began in 2009, has reached over 28,000 people with prevention messaging and almost 12,000 people with HIV testing. The program supports the upgrade of ART, PMTCT, and male circumcision clinics and laboratories, while also engaging chaplains for disseminating HIV prevention messages to youth and couples using the True Love Waits/True Love Stays methodology. The program develops leadership capacity among officers and their spouses, supports self-help groups for PLHIV, and trains HIV-positive military personnel as peer educators. PCI also supports income-generating activities for PLHIV in Malawi to empower them with the funds to care for themselves and their families.
Under USAID-funded Orphans and Vulnerable Child and Gender program (2011-2016) and Comprehensive Care and Support for Orphans and Vulnerable Children (2016-2021) in Botswana, PCI addresses a number of the country’s challenges in meeting the needs of vulnerable children, women and their families/households. PCI and its partners continue to mobilize communities to:
- Improve livelihoods through skills training and household economic strengthening
- Improve integrated early childhood development interventions for vulnerable children
- Provide prevention education, social support, and life skills training to adolescents and young mothers
- Link HIV-affected households to services they need using the Comprehensive Family Care (CFC) approach
- Improve development, implementation, and coordination of national frameworks and policies that address the needs of women and children.
By utilizing a network of dedicated volunteers and strengthening community-based organizations, PCI is ensuring vital care is reaching those who need it most. We believe in a future where HIV prevention work leads to an AIDS-free Africa.
Zambia has one of the highest HIV prevalence rates in [...]