Depression: Silent Killer for Young Girls & Women Living With HIV

PUBERTY is one stage associated with anxiety, joy and stress for young girls transitioning from childhood to adulthood. The hormonal and reproductive changes which include the bulging bust, widening of hips, protruding hindquarters and menstrual flows all just come too fast within a short space of time.

By Michael Gwarisa recently in Gweru

However, for adolescents and young girls living with HIV, this phase could be traumatic and heart rending in the absence of proper counselling and psychosocial support. Phyliss Mavushe (24), a young person living with HIV and also a Mentor at Africaid Zvandiri, believes counselling and psychosocial support should be prioritised in the HIV treatment and care package.

By any standard, Phyliss is an amazing young, intelligent and beautiful lady who could easily contest in any beauty contest and win. But beneath the splendor lies a story of a young and brave person who has managed to overcome societal barriers, stigma and depression associated with HIV.

Having been diagnosed with HIV at the age of 16, Phyliss maintains that disclosure is the most depressing part for any young girl living with HIV.

Disclosure is a very difficult issue to begin with. So maybe based on my experience and that of other girls, there is that fear that is attached with what will follow after one discloses their HIV status. There is that fear of rejection, stigma and discrimination once one discloses their status.

“Once you develop the stress, it ends up as depression if it goes unmanaged. Because their status now instead of being known to the people that they have disclosed to, ends up being known to other people, this causes depression. Just think about it, just being rejected because of your status, something that you have no control over,” said Phyllis.

She added that the puberty phase is one other depressing phase that could kill confidence and self-esteem in young girls living with HIV.

“Many young girls and women also have been orphaned and they lack that normal love and support that a child needs to develop a sense of belonging, self-worth and hopefulness. With depression, you feel helpless and as an orphan no one really understands you especially if there is inconsistent custodianship and eventually, you feel hopeless and leads to depression.

“The other thing also that’s very depressing is the effects of HIV on the body. Some of the effects cause stunted growth. Let’s say for example we are all 15 years and others are already showing their boobs and I don’t have, I have delayed puberty and others are celebrating their menstruation and nothing of that sort is happening, you wonder and begin to blame yourself, your parents or whatever caused you to be HIV positive,” said Phyliss.

She however bemoaned the lack of psychosocial and mental health support for young girls, women and people living with HIV in Zimbabwe.

“There is no psychosocial support for people living with HIV in Zimbabwe. Mental health is not talked about and is not recognised as something serious. Once we start talking about the “mental” part, people start associating it with psychosis or madness yet there are a lot of elements to mental health.

“There are a lot of things attached to mental health for example depression, stress anxiety among others. Mental health is also stigmatised just like HIV. We are not being given enough information on mental health. At times we take our medication and they cause mental health related disorders among other, no one tells us or informs us about these effects,” added Phyllis.

According to the National Aids Council (NAC), women constitute about 52 percent of people living with HIV in Zimbabwe. An estimated 740,000 women were living with HIV in Zimbabwe in 2017.

Director, Chilhood HIV and AIDS Zimbabwe, Ms Eunice Kapandura said there was no mental health or psychosocial support for women and people living with HIV in Zimbabwe.

Eunice Kapandura

“I don’t think there is enough support for young women living with HIV in the current interventions that are available in the country. There is need to scale up counseling services and other psychosocial support services to assist young girls and women.

“This includes exchange programs, recreational camps. We need something that young women and girls can actually look forward to, be it competitions be it something that occupies their mind so that learn to use to use their skills. As you know especially among children who were born with HIV, it really affects their level of consumption of new information which makes a child a slow leaner, said Mr Kapandura.

She added that there was need to increase awareness on interventions such as cervical cancer screening and even the new Dolutogravir (DTG) HIV drug in a bid to prepare the girls psychologically.

“There is need for mainstreaming for mental health programs in all Antiretroviral (ART) sites in order to have a one stop kind of service for young girls and women living with HIV.

“The best way is also to have feedback sessions where women who acquired the virus and a young age and those who were born with the virus but are doing well in life so that there can have a survival skills sharing meetings.”

Ms Chipo Chitongo (51) a woman living with HIV from Mrehwa said HIV drugs at times cause mental health issues such as nightmares and stress and service prioviders should explain the effects to people living with HIV.

“When I was switched to Tenolam E, I was not told of the side effects which include nightmares and anxiety. I went for a long time having nightmares, they ended last year.

“In the nightmares, at times I would hear someone telling that I had not taken my ARVs for a week and you are going to die. I would wake up get my bag and get my tablets. AT times I would end up taking my tablets twice due to the nightmares.”
She also said the issue of relationships also depresses women living with HIV due to the fact that men flee the moment a women discloses her HIV positive status.

UNAIDS Fast Track Advisor, Jane Batte told a Sexual Reproductive Health and Rights (SRHR) Workshop in Gweru that issues of mental health among women living with HIV were rampart and she would engage top decision makers in the organisation to ensure its put at the top of the agenda.

“Women have so many problems, we carry the burden of HIV. We are the care givers. You look after yourselves, your children and your husbands. I am going to Geneva and I am going to pursue issues of mental health for women and young girls living with HIV because that is an issue we have failed to address.

“Young girls and women living with HIV have no one to talk to because their families have rejected them. We can train some women living with HIV here in Zimbabwe to be mental health experts so that when somebody has a problem, they can talk to someone they are comfortable with,” said Batte.

She also added that many girls from the ages 15 to 25 living with HIV go through a lot and most end up communicating suicide because of mental health issues.

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