By Michael Gwarisa in Chinhoyi
For 21-year-old Joseph Mwashipe* from Cherima in Chinhoyi, Mashonaland West, living with HIV as a young person has presented him with a whole set of challenges. Even though he is studying towards an engineering program, he feels his dating life is currently weighing him down mentally.
“Ukangomuudza chete kuti uri HIV positive zvinobva zvadhakwa (The moment I disclose my HIV positive status, the girl disappears from the picture),” says Joseph.
“I don’t know whether I should continue disclosing or not because it seems the more I disclose, the more I lose out on good girls.”
Joseph discovered he was HV positive at the age of 15 when he accompanied his friend who wanted to get tested for HIV. On his first visit to the health facility, he tested negative.
Somehow I was not sure about my result so I went home and asked my mother to accompany me for testing. Still, I tested negative. However, when I went back for the third time, I tested positive and I have been on Antiretroviral Treatment since that day,” said Joseph.
Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. The burden most parents or caregivers have had over the years was breaking the news to their children that they were born with HIV. Now the tables have turned, it is the young people struggling with disclosure issues as they are faced with the realities of adolescence and adulthood.
According to a ZVANDIRI Implementation Brief, disclosure is the process of informing someone of his / her HIV status and is a key component of paediatric and adolescent HIV testing, treatment and care services. Although younger children may not yet be ready to be informed of their HIV status, it is now widely accepted that early disclosure for older children and adolescents which is conducted in a supportive, planned manner helps to promote HIV and ART literacy, adherence and psychological well-being among children, adolescents and young people living with HIV (CAYPLHIV).
For Hazel Zulu* (24) from Makonde District, disclosure is not much of a problem and she believes it allows her to be free and not hang on to relationships that were never meant to be.
“I don’t just disclose to everyone i meet. I first see where the relationship is taking is. I don’t struggle with disclosure. I have been married before to a man who would abuse me telling me that I was good for nothing and no one would love me as I am. Now that I am out of that marriage, I feel like disclosing has empowered me, I know if anyone stays now, they are for real,” said Hazel.
Several young people have gone underground and opted not to disclose their HIV status to anyone. Extensive research focusing on identifying barriers to disclosure identifies several factors preventing adolescents from disclosing their status to others. These include a lack of communication skills and self-efficacy, a lack of normalisation, fear of rejection or abandonment by peers and romantic partners, and fear of isolation among others.
Ms Irene Musarapasi, an HIV advocate from Makonde District in Mashonaland West, has lived with HIV for 28 years. She believes young people are not disclosing their statuses to each other in the dating phase.
“I think disclosure is one the most difficult things for young people. However, I encourage them to disclose as this will allow the person you are dating to choose whether they want to continue dating you or not. Encourage young people to make good choices that will help them have a better future,” said Ms Musarapasi.
HIV and AIDS remain a challenge in Zimbabwe, with a prevalence of 11.58 percent, translating into an estimated 1.3 million people living with HIV in 2021. Of these, about 72,100 were children 0 – 14 years and 77,300 adolescents aged 10 – 19. Failure by young people to disclose their status could however reverse gains made in the HIV response as more young will likely be infected.
Ms Madeline Dube, the National AIDS Council (NAC) Communications Director said young people should not disclose their status randomly to everyone they date.
“When you are dating, don’t get into a relationship because you want to have sex, no. The purpose of every relationship is to build a relationship and later on, get into marriage. This is the information we need to teach our young people living with HIV. Before you disclose, first establish if the relationship is serious enough and if it’s someone you would like to spend your life with then disclose,” said Ms Dube.
Meanwhile, national guidelines indicate that the timing and process of disclosure should be guided by the caregiver’s wishes, but that the best interests of the child should be considered at all times. These guidelines are based on the UN Convention of the Child and national Children’s Act which state that every child has the right to information about his/her own health and access to services which keep them safe from harm.
However, late disclosure of HIV status remains common; CAYPLHIV with the capacity to understand what is happening to them are being left with limited information about their own HIV status and treatment, resulting in poor mental health and limited ability to understand the importance of ART, adherence and retention.
NB// The identities of the Young People Living with HIV have altered to protect them
