ZAMBIA: Positive teens start talking about sex

Photo: UNICEF

Hearing other peers' experience provided healing

LUSAKA, 30 September 2009 (PlusNews) - How do you tell your boyfriend that you're a 20-year-old virgin living with HIV? Zambian Chanda Nsofwa was born infected and is now at an age where she has to deal with this and other ticklish questions about sex and HIV.

"We know that some of these children are already having sex or simply want to have it. They hear about sex from their friends and think its time they had it as well," said Dr Chipepo Kankasa, Head of Paediatrics at the University Teaching Hospital (UTH), one of the largest medical facilities in the capital, Lusaka.

The answers are available. The hospital has started a programme to help a generation of children born HIV-positive and reaching young adulthood find their way through the thickets of sex and sexuality among teenagers living with the virus.

"The hospital decided to start sessions where teenagers come together with their counsellors and share the concerns they have. The findings have been shocking - the children have a lot of things they want to know, and being given a platform here at the hospital has really helped them," Kankasa said.

She admitted that teenagers were not receiving adequate support at the adult clinic where they got their antiretroviral (ARV) drugs and had to return to the paediatric hospital for group counselling sessions. "So we have reorganized ourselves and opened up sessions for these children to speak about sex and sexuality among them."

The paediatric hospital decided to adopt the World Health Organization (WHO) definition of adolescents - people between the ages of 10 and 20 - and divided them into two groups: those aged 10 to 14, and those who were older.

"This helps us give the right kind of key messages around issues of sex and sexuality appropriate to each group ... We teach ... [the older ones] about unwanted pregnancies, opportunistic infections and sexually transmitted infections [STIs]," Kankasa said.

Coming to terms with HIV

Nsofwa knows the difficulties of living with HIV and dealing with it in relationships. "Every time I have met a guy I really like, I feel I have to tell him about my HIV status. It was difficult at first, but after sessions with my doctor I knew that was the right thing to do," she said.

"Many have pulled out of the relationships while others opt to just remain friends with me. I know there is Mr Right for me somewhere. When I find him, we shall have two beautiful children together."

Why should I be condemned to taking drugs for the rest of my life? I did not infect myself. I simply got the virus through mother to child transmission

Dr Manasseh Phiri, an HIV activist who has also treated children born with the virus, noted that HIV-positive teenagers could have a hard time coming to terms with their status, and sometimes even stopped taking their medication.

"The knowledge levels of HIV and AIDS are very high among these children. Unfortunately, they also know that one [mostly] gets HIV from sleeping around or, simply put, from illicit sex. They are also aware that they have not had sex; so, when they find out they have HIV, they go into a crisis ... They get angry with their mothers for infecting them."

Grace Tembo, 21, still finds it difficult to accept her status. "You know, I have been through a lot of things in my life and sometimes I felt like hitting back. Why should I be condemned to taking drugs for the rest of my life? I started ARVs when I was 9 years old," she said during a group session.

"I did not infect myself. I simply got the virus through mother-to-child transmission. I was sick most of my young life and ended up missing classes. I began to ask myself why my mother infected me with HIV and messed up my life."

Kankasa said the group sessions have begun to yield positive results. "We have had children who are very withdrawn, and we have seen them open up in these sessions and share their deepest fears and concerns. For most, hearing other peers' experience provided healing."

However, Phiri expressed concern about having the counselling sessions at the hospital, and urged health officials to introduce similar initiatives in the community.

"Hospitals are about ailments; HIV is multifaceted. We have, for instance, primary caregivers of these children, such as parents; we can trust them with the programme - they also are faced with tremendous challenges, and they also need to hear from these children, and each other."

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