HIV & AIDS

A couple from Malawi receives counseling from a Community-Based Distribution Agent (CBDA)

In Kasungu District, Malawi, trained Community-Based Distribution Agents (CBDAs) gather for their final and perhaps most challenging training: couples counseling.

With HIV, couples often do not freely discuss issues and concerns. “Where communication has been a problem for couples, CBDAs in underserved areas will help in risk reduction,” explains Jane Ngwira, MSH’s Kasungu District Coordinator.

A Health Surveillance Assistant offers HIV-Testing and Counseling (HTC) in a Resthouse Room at Sombi

 

Picture trees, water, mountains, mud, birds and fish. This is Lake Chirwa -- the second largest of the five lakes in Malawi and the main habitat of small fish called Matemba. The lake offers a trading opportunity for fishermen from many walks of life.

Lying in the southern region of Malawi, Lake Chirwa is a wetland for people of three districts: Phalombe, Zomba and Machinga. All these people have frequent contact with Mozambique as they lie near the bordering frontiers. The lake lies some 50km from Zomba District Health Office.

Lucia Afiki and Esther Goodson are living positively with HIV. They are counselors for family planning and HIV & AIDS at Salima District Hospital in Malawi, where they openly tell their clients that they are HIV-positive. “When we are open with them about our status,” says Afiki, “people say, ‘Come closer, we want to learn from you.’” Goodson adds: “They say, ‘What should I do to look as good as you?’” The counselors tell them to visit a doctor and join a support group. This is an approach that saves lives. It also transforms social norms about health and gender.

Fatima preparing bean cakes for her business, Nigeria

 

HIV-positive women in Nigeria are the primary caregivers for their own families and other people living with HIV. This disproportionately high burden of care has detrimental effects not only on their health but also on their economic well-being.

The MSH-led, USAID-funded, Prevention Organization Systems AIDS Care and Treatment (ProACT) project in Nigeria has helped establish HIV support groups whose participants are 80 percent women. These groups have started providing income-generating opportunities for participants through savings and loan associations, registered with the Nigerian State Ministry of Commerce and Cooperative Societies.

Mary Umoh, colleague and friend -- and one of the winners of an internal MSH abstract contest for staff -- traveled from Nigeria to Rome to present her poster at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011).

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.

Lucy Sakala at the Salima District Hospital in Salima, Malawi (© Dominic Chavez)

 

Yesterday the results of HIV Prevention Trials Network (HPTN) 052, a clinical trial funded by the National Institutes for Health, offered definitive proof of what we have long suspected---that treating HIV infected persons substantially reduces the risk of transmitting HIV to uninfected persons.

This is FANTASTIC news and offers very convincing evidence that, at least for heterosexual discordant couples (the study was not able to enroll significant numbers of gay men), if the infected person is on ART, the uninfected partner is protected. And more broadly, it offers significant evidence that treatment is indeed highly effective in preventing transmission of HIV. This can reasonably be described as a “game changer” with respect to how we think about HIV prevention, care, and treatment. We used to talk about “treatment as prevention,” but now we can say “treatment IS prevention.”

Read the UNAIDS report here.

Cynthia Isioma, Nigeria

In the village of Owa Ofie, Nigeria, Cynthia Isioma, a young girl who has survived enormous odds reclaimed her dream of secondary education.

Cynthia lost both parents at the age of two and was left in the care of her grandmother who died three years later. Cynthia’s situation grew more challenging when she was then moved to her blind grandfather’s home at the age of five.

Rather than receive care, Cynthia had to take on the responsibility of caring for her grandfather who could not afford to send her to school.  Cynthia became a child caregiver, providing for herself and her grandpa. Her daily duties included going to the forest to collect cocoyam, palm nuts, snails, and waterleaves to sell and for household use.

Cynthia’s situation changed when she was 13 years old and Rural Linkage Network (RULIN), a community-based organization based in Boji Boji, visited Owa Ofie to identify orphans in need of support. RULIN is supported by the USAID-funded, MSH-led Community Support for OVC Project (CUBS).

This blog post originally appeared on the US Agency for International Development's IMPACT blog.

Yodit Assefa (center) and procurement colleagues from PEPFAR’s Supply Chain Management System (SCMS). Photo credit: SCMS

As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.

Well planned, strategic procurement is a smart investment. Our team helps save money by minimizing costly unplanned and emergency procurements and buying low-value and bulky products locally.

It’s common sense that a mother who is on treatment for AIDS, pregnant, has a sick child, and is accompanying a sister debilitated by Tuberculosis should not have to visit four separate service delivery points to receive care. Integrated health services not only make the world a healthier place, but also decrease the burden on health systems.

Integration is a comprehensive approach to service delivery. It is the transition from a vertical or horizontal approach to a diagonal, synergistic approach at all levels of a health system. Smart integration means coordinating disease specific programs (such as HIV and AIDS) with other health programs that have operated independently in the past (for example, family planning) to deliver services at the same time or, more importantly, with the same funding. Integration helps organizations maximize the impact of their health investments while allowing people, information, and funding to flow more easily among collaborating groups and stakeholders. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently---regardless of the initial reason a person seeks care.

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