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Proactive HIV management key among adolescents



SOME 780 000 young women and girls are living positively with HIV in the country while an estimated 460 female adolescents get infected with the pandemic every day in the eastern and southern Africa regions, a UNAids report recently indicated.

The shocking revelation, which also claims that a total of 50 from the same demographic of 10-19 years succumb to HIV-related ailments daily, comes in the backdrop of an ongoing debate on whether minors, particularly those under the age of 18 years, should access sexual and reproductive health and rights (SRHR) services and education in schools.

Farisai Chingarava (42) is overwhelmed by pity every time she hears school-going children talking about SRHR issues because, according to her, they should not be in a position to know “too much” about sex.

For years now, Chingarava has remained resolute on her stance that it is taboo for adolescents to talk about the act although she is aware that some, who she brands as deviants, are already sexually active.

The mother of five from Mugaradziko in ward 12, Chingarava was part of the Rushinga district community elders who attended SAfAIDS’ launch of Tanaka Young 4 Real Clinic — an adolescent sexual reproductive health (ASHR) facility stationed at Rushinga Clinic, earlier this month, albeit by chance as she had come to collect family planning pills.

In this community, a considerable number of conservative adults still insist that availing SRH information and condoms serve as some sort of “encouragement” for minors to start engaging in sex.

“The best way is to tell them that they should abstain entirely, but those who want services like condoms can approach the clinics we have in this area because establishing exclusive facilities even in schools is some sort of encouragement for them to have sex,” Chingarava said.

She believes the old scare-tactics her generation grew up accustomed to could work better.

“This (ASRH) programme is too modern because it is simply giving them sex tools, but I think children should be instilled with fear,” she said, adding that she had reined in her Form 2 daughter by telling her that “‘all boys at her school had HIV’.”

Interestingly, her 25-year-old first born, now married, got impregnated when she was a teenager in an ironic demerit of applying fear as a measure to curb careless sexual activities among the youths.

Data presented by the National Aids Council (NAC) on Mashonaland Central province, where Rushinga is located, late last year, pointed at a 4,9% rise in the number of new STI cases compared to the previous year, with young people constituting a significant fraction of the number.

“There is an increased number of STIs (sexually transmitted infections) and that is how we know that adolescents are having sex out there, so we have to offer them sexual education concerning the use of contraceptives to prevent the risks,” Risaphael Zishiri, the sister-in-charge at Tanaka Clinic, said.

Growing calls for more SRH services in Rushinga are also coming from sections of this community, which is alive to the saddening reality and hence desperate to avert the consequences of laxity whose consequences include a rise in STIs and unwanted pregnancies.

Health organisations have joined hands with government departments to create safety nets for young people, particularly the girl child, through setting up health centres in response to the scourges.

“This is a rallying point for people and it’s a safe place, we also want to avoid putting young people at risk, where they may be scared or worried of being ambushed when they go there,” SAfAIDS executive director Lois Chingandu explained.

According to Chingandu, the ASHR clinic initiative is a response to young people’s calls for a stand-alone youth health institution to deal with sexual issues following the relative defects of adolescent corners in conventional clinics and youth centres.

“They (youths) have been telling us about the discomfort of sitting in the same queues with adults or being attended by adult service nurses who in their eyes look like their parents and often ask many questions and judge them,” Chingandu said.

A conflicted Chingarava ostensibly shared the same sentiments, admitting that an institution like Tanaka Clinic could help young people engaging in sex to open up about their health problems before it is too late.

“In most instances, children find it hard to talk to us as parents if they have an STI, but with this facility, they can be assisted because they are shy around us. For my daughters, even telling me about things like their monthly period is very hard,” she admitted.

Chingarava is also of the idea that SRH education should be followed up by mandatory testing and making the results of minors found HIV positive public to help curtail the spread of the disease and help “obedient” children to be more cautious before entertaining the idea of engaging in sex.

“Since our obedient children are given some this sort of encouragement, which makes them feel comfortable to have sex, they must be fully protected from evil partners who can persuade them to have unprotected sex or remove the condoms in the middle of the act,” she suggested.

This is despite the fact that she has personally vowed not to get tested.

SAfAIDS programme officer Tarisai Chibanda said they had exposed the material they use to parents in an effort to dispel the idea held by some parents in the community that “when a child is given SRH information, they are being encouraged to have sex”.

“Change is a process, so we will continuously engage the parents, but the greater challenge is on the girl child because it is not easy for parents to allow her to come. We continue to engage them and let them know the benefits of their child coming in to meet routinely with other children,” said Chibanda.

Furthermore, they have introduced a skills set programme where youths get vocational training in a bid to dismiss the idea that young people attend the programmes solely for sexuality information.

For parents like Chingarava, the ASRH is still a hard sell, but if horrendous STI statistics are constantly flashed in their faces, perhaps this fear of teach-children-about-sex can be turned into an intuition to assist the next generation in making informed decisions before relenting to sexual urges.

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