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May 13
Working at the coal-face of our HIV response

This week we will be profiling some our incredible staff who work at the coal-face of our HIV response.

Today we introduce Hlengiwe Masuku, Psychosocial Care Advisor in eThekwini.


“I provide support and counselling for clients who are newly diagnosed with HIV, as well as supporting youth clubs in peer education, and referring clients on to other government services like accessing childcare grants.


My role involves a lot of work with the youth on HIV, sexually transmitted infections (STIs) and teen pregnancies as well as HIV testing and treatment.


After the patients learn their status, I come in to do ‘deep counselling’, because most of the time, they are in shock. I ensure that by the time they leave the health facility, they have a clear understanding of what is going on and what is going to happen in their life. If they take treatment, they need to know all the side-effects. I also do follow-up to see how clients are getting along with their treatment − especially the youth, as they tend to be in denial about HIV.


Even if clients test negative for HIV, I still do health talks to tell them how to stay negative and how to protect themselves, and also educate them about STIs and pregnancy.


We face different challenges with different groups of clients: Men don’t like to test at all. They have a fear of knowing their status, a fear of stigma. Men really don’t like to come to health facilities because they say they are treated unfairly. They will come and test and be initiated on antiretroviral treatment, but then you never see them again. This means that their viral load will never be suppressed and they will continue to spread the virus.

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Even if they start treatment, it is difficult to get them to adhere to the regimen because they don’t want to be seen going to the clinic and coming back with a parcel of medication. They believe that everyone will say that they on ART, even if they are picking up pills for another chronic disease like diabetes.


One of the initiatives to assist our clients with this concern is the Chronic Central Medicines Dispensing and Distribution (CCMDD) programme, which enables patients who have been stable on their medication for 12 months to collect pre-packaged medication discreetly from a number of convenient pick-up points, including retail stores like Clicks. 


I’d say that about 80% of youth understand what HIV is. The problem is that knowledge does not protect them from the circumstances in which they find themselves. If a teenage girl lives in a home where there is no food, she will have transactional sex to get groceries. Those older men hold all the power, and make it clear that they will not buy groceries for the girls if they don’t have sex without a condom, so it’s difficult to say that these girls are making a choice. Do they let the family starve or do they put their own lives on the line? Others are attracted to older men because they want fancy things like weaves and cell-phones. They feel they will never find jobs anyway, so this is their only chance to get the things they see others having.


I find it very sad to see more teen pregnancies and HIV infections resulting from this trend.


The youth are also affected by the culture of crime and violence in South Africa. I had a young client who came from the rural areas and was totally lost. Her father had been quite a tough guy, who owned a shebeen. He was shot dead and after he passed, she went looking for men to play that protective role. She ended up with three children and being infected with HIV because she was looking for love which she was not getting from her mother at home. 


Many of our children have lost their parents in terrible conditions or have even been abandoned by their grannies. We need to remember that these children are orphaned, growing up without love or guidance, and then going on to repeat the cycle with their own children.


We must reach the 90-90-90 targets and ensure that 90% of HIV-positive people know their status and are adhering to treatment so that they become virally suppressed and can no longer pass on the virus.


I do this work because I want to make sure that young people have the opportunity to live full and healthy lives and leave a strong legacy of children who know their value in this world.”​

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