Empowered to prioritize Sexual Reproductive Health amid COVID-19
Adolescent Girls and Young Women (AGYW) often find that they need support to empower them to take ownership of their own Sexual Reproductive Health (SRH), this is due to lack of information and fear of stigma from their communities and sometimes, even their own families.
This was the case with Naledi Yika; a 15-year-old adolescent girl from Finetown, South of Johannesburg. She lives in a government-subsidised house with her unemployed mother – a single parent - depending on the South African Governments child support grant and income through rent from tenants in their yard. Naledi was introduced to Zenzele Counselling Project by a friend from school.
Zenzele Counselling Project is a Community-Based Organization based in Finetown. In partnership with HIVSA and the Department of Social Development, the organization provides various services such as daily meals, homework assistance, HIV education programs, health referrals and support.
These services fall under the four PHVP (Preventing HIV/AIDS in Vulnerable Populations) pillars which aim to see that all beneficiaries are healthy, schooled, stable and safe. Under the health pillar, Naledi was tested for HIV and was found to be negative. She is currently a Grade 9 learner at Willowmead High School, and she receives educational support from the organization.
As part of the HIVSA partnership, Zenzele Counselling Project received a Choma Innovations café in 2016. The Choma Innovations Café (referred to as café) is a shipping container refurbished with internet-connected chrome books and decorated in a funky pink style. The Café provides a safe space for AGYW to access information on HIV, SRH, love and relationships, and other health-related information. A female mentor (Choma Champion) actively host sessions on health-related topics in the café and the use of the internet helps AGYW to have the most up to date information. Currently, the organization has a total of 3 515 beneficiaries, of which 1 987 are AGYW and 465 are children and adolescents living with HIV.
Naledi being the only child, had no one to talk to about the challenges she faces as a teenager. She was unable to talk to her mother whom she perceived to be very strict. Whilst sharing her challenges with a friend at school, her friend who is a PHVP beneficiary invited her for sessions in the Choma Innovation Café. Naledi found the sessions informative and she grew interested in the topics discussed. She was later enrolled on the PHVP program.
After a session on ‘Know your Status’ Naledi approached one of the Choma Champions and disclosed that she is sexually active and she is afraid that she might contract HIV. The Choma Champion encouraged her to use condoms and invited her to attend a community engagement meeting at the organisation where Pre-Exposure Prophylaxis (PrEP) would be one of the topics for the day.
Naledi and her mother attended the community engagement meeting as part of the community. Having heard about PrEP, the mother privately told the Choma Champion that she suspects Naledi might be sexually active and would appreciate it if the Choma Champion would encourage Naledi to take PrEP. Meanwhile, Naledi had actually voluntarily requested to be initiated on PrEP. It was then arranged that Naledi would be initiated on PrEP during school holidays as she was not available to go to the health facility during school days.
And then South Africa was faced with COVID19 and ordered to go into Lockdown. As an essential service, the Choma Champions continued to support AGYW during this difficult period using telephone case management providing girls with adherence support, SRH and COVID19 information. Naledi was one of them and through discussions, Naledi and her mother requested that Naledi still access PrEP.
The Choma Champion arranged with the facility and she was successfully initiated onto PrEP. When asked about how she feels about PrEP Naledi said,
"PrEP can help change the future of a girl child."
During a follow-up phone call with the Choma Champion, Naledi further requested contraceptives as she do not want to fall pregnant. The Choma Champion accompanied her to Stredford Clinic where she was successfully linked to contraceptives.
Outcomes
- Naledi was successfully initiated on PrEP on the 5th of May 2020 during the COVID 19 lockdown, she is one of 31 AGYW who have been initiated on PrEP On the 10th of June she received 3 months’ supply of PrEP and is adhering to her treatment.
- Naledi was also linked to family planning at Stredford clinic in Orange Farm.