First contact with 19 year old Violet Njoki** not only reveals the warm and bubbly personality she possesses, but is the depiction of a focused teenager who unlike many of her peers already has well set dreams and aspirations. Violet’s radiance, infectious smile and laughter are a clear indication that she will not let her HIV status come in the way of her happiness. Violet recently completed high school and is awaiting admission to the University after scoring a B plain in her Kenya Certificate of Secondary School Education (KCSE) exam.
Violet was first diagnosed with HIV in 2004 at the age of nine (9) years after suffering various unexplainable ailments including wounds. Her mother, a single parent, had succumbed to HIV/AIDS related complications in 2001 leaving Violet under the care of her aunt. While she continued to take her medicine faithfully, it is not until 2006 that a health official disclosed her HIV status to her during one of her routine visits to the hospital. This is a revelation that obviously shook her, given that she had been taking her medication for two years believing that she was being treated for her recurring skin conditions. This was especially for the head sores which she had been treated for severally without success until she was tested for HIV in 2004. However, after a series of counselling sessions at Nyahururu District Hospital, she adjusted to the news that she was HIV-positive.
The plight of a HIV positive adolescent
Like many adolescents living with HIV, Violet is exposed to major challenges especially when in school. Stigma remains one of the most common challenges especially due to the negativity associated with HIV infection, with most peers associating a positive HIV status with promiscuity. Violet notes that she faced challenges when taking her medication because she would have to take them secretly to keep other students from discovering. Sometimes her schedule would collide with school activities and she often had to find an excuse to go for her medication.
Violet however considers herself lucky compared to some of her peers because she had support from her friends to whom she had disclosed her status. But why did she choose to disclose her status despite the possible stigma she was likely exposing herself to? Violet notes that keeping her status a secret felt like she was carrying a big burden, a burden that became significantly bearable once she decided to disclose her status.
CHS and facility staff at Nyahururu District Hospital played an imperative role in her decision to disclose her status to some of her friends. “As promised by the CHS staff who gave us a talk on disclosure, I felt quite relieved when I first disclosed my status and why I have to take drugs every day to a close friend of mine.” Violet eventually disclosed here status to four of her friends at school with whom they had formed a study group and life became much easier for her. “I no longer had to hide or lie when stepping out from the study group to take my medication and my friends completely understood and supported me. They even took up the role of reminding me to take my medication whenever it was time for me to do so. It was amazing to have a support group,” Violet says.
Dating is also a great challenge for adolescents as many are lost at the point of disclosure. Violet notes that she has found herself in compromising situations where suitors have approached her but as she cannot disclose her HIV status to just anyone, she does all she can to avoid them, a position that raises questions. This is a challenging period for many teenagers who are not only going through physical changes, but also wish to feel loved and appreciated. Violet is however delighted to have a boyfriend who is HIV negative and who has offered her significant moral support through her journey.
Dreams, aspirations and future plans
Violet, who is currently tutoring at private school as she awaits admission to University, aspires to be a banker. She is a role model to many students in her support group as she has proven that HIV should not limit one’s ambitions and aspirations. She also hopes to advance her education further than her degree course saying, “My dream is to add a title to my name…. like Doctor.” She likes to encourage others who are in her position to take life positively and dare to pursue their dreams. “Being HIV positive does not mean that one is disadvantaged in any way. Anything that a HIV negative person can do, a HIV positive person can do even better with determination and strong will.” She further advocates for disclosure and while she is not ready to go public about her status yet, she notes that having close friends and family who know her status has helped her live a more fulfilling life.
The role of psychosocial support
CHS recognises the plight of young people, their vulnerability to HIV infection and challenges in dealing with adherence. The 2009 Kenya Population and Housing Status indicated that there are 9.2 million young people between the ages of 10 and 19. Statistics further indicate that every hour, 30 adolescents (10-19 years) are infected with HIV. Adolescent care, treatment and psychosocial support therefore remain a major focus of CHS program work.
CHS currently supports 20 adolescent peer educators in Central Province to promote adherence among adolescents and provide them with psychosocial support. In addition, 30 health care workers (HCWs) have been trained on the care of adolescents living with HIV. Through training, mentorship and financial support from CHS, adolescent peer educators have acquired a great level of knowledge on HIV, medication, adherence and positive living that they utilise to provide support to adolescents living with HIV.
Violet acknowledges the role played by the CHS-led adolescent psychosocial support group at Nyahururu District Hospital in helping her live positively. Through the support group, Violet says she feels a sense of belonging when interacting with other teenagers living with HIV. Through such interaction and teachings from peer educators and health workers, she has greatly improved her self-confidence, is more aware about HIV/AIDS, adherence and positive living.
In collaboration with the peer educators, health care workers have managed to set up 49 adolescent psychosocial support groups reaching 759 adolescents. Besides psychosocial support, CHS also provides adolescent-friendly clinics to cater for unique needs of this age group. 1,309 adolescents are currently enrolled into HIV care programs at CHS supported facilities.
**Name changed to protect identity