Successful HIV Counseling Leaves No One Behind in Zambia

October 25th, 2018 | Story


Ruth Nyirenda, a fish trader from Central Province, Zambia, learned she was HIV positive when pregnant with her third child in 2017. While devastated with the news of her HIV status, she delivered her baby but refused to begin treatment. Ruth’s husband is also HIV-positive, but is on antiretroviral therapy (ART).

USAID SAFE: Supporting an AIDS-Free Era Community Health Volunteers (CHVs) visited Ruth in March 2018 and counselled her, but she still refused to be initiated on ART, claiming the drugs would do her more harm than good. During counselling, Ruth shared the pain of her HIV diagnosis as well as her fears for her 10-month-old child, who was still HIV negative. Despite the CHVs’ encouragement to visit a facility for treatment, Ruth remained adamant that she would not seek treatment.

SAFE CHVs visited Ruth and her family every month, each time unsure of the reception they would receive. However, they gently persisted and had conversations with her about HIV transmission from partner-to-partner and from mother-to-baby; the availability of short-term therapy; the effects of a high viral load due to no treatment; as well as how to address stigma and cope with self-stigma.

In October 2018, after several months of these counselling sessions, Ruth finally agreed to be tested and begin treatment. 

USAID SAFE collaborates with Zambia’s Ministry of Health to provide HIV testing, treatment, and integrated services to people in Central, Copperbelt, and Northwestern Provinces. CHVs and Professional Counsellors (PCs) are an integral part of the HIV care and treatment system. CHVs and PCs often work together – where one cannot break through to a client, their colleague comes in to support the counselling and try another approach. This teamwork is invaluable in ensuring every person who requires HIV testing services receives the help they need. CHVs and PCs also provide post-test counselling before referring the positive client to a clinician for initiation on treatment.

With its community-based services, USAID SAFE helps us in many ways. They come to our doorstep and meet with us. It really helped me,” said Ruth Nyirenda, Ngabwe, Central Province.

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