“I was always sick and tired. I could barely do anything,” Laurinda Emiliano tells us during an interview. Laurinda, 19, lives in the Bairro Cimento within the village of Zalala, Quelimane District, Zambézia Province.
Starting in 2014, Laurinda mysteriously began to get sick frequently. “I started getting sick and I did not know what I had. Since the illness would not go away, I started visiting traditional healers.” The young woman sought out the cause for her illness for more than three years, but her health was only getting worse.
Eventually, one of the traditional healers advised her to go to the clinic. She listened to his advice and went to the Zalala Health Post, where she tested positive for HIV. She began treatment, but she was not happy with the medical care she received. When a nurse scolded her too harshly for picking up her medication late, she abandoned her treatment program altogether.
In June 2017, the Male Engagement Strategy Program was introduced at the Zalala Health Post. The primary purpose of the intervention is to involve male partners of pregnant women enrolled in prenatal care in order to increase the uptake of couples HIV counseling and testing during the pregnancy. The strategy also aims to increase the uptake of ART and improve retention in care among HIV+ pregnant women. Male Champions are trained to work one-on-one with men to teach them how to be supportive of their partners. Men are encouraged to accompany their partners to medical visits and to be tested for HIV themselves.
Although Laurinda was not pregnant at the time, she was visited by a Male Champion with the specific purpose of bringing her back into care.
Twenty-six year old Arnaldo Felisberto is the Male Champion who, as a trained agent of community change, worked with Laurinda’s husband, Lobito, 20. Arnaldo encouraged Lobito to convince his wife to re-engage in care and to resume ART.
“The first time I went to Laurinda’s house she was not feeling well. I tried talking to her and her husband as friends. I knew I would be rejected if I jumped into talking about medication. First, I convinced the husband. The wife no longer cared [about ART]. The husband said ‘no problem. I will convince my wife,’” recalls Arnaldo. He adds, “strategies on how to convince people are taught to us during the [male champion] training.”
By using such strategies, the Male Champion was able to convince Laurinda to return to the Health Post. Laurinda was counseled and began taking her HIV treatment (ART) again. Her husband, Lobito, was also convinced to take the HIV test himself. Lobito knew his wife was HIV positive, and supported her return to treatment, but he hadn’t yet taken the test himself. “I never worried about taking the test because I had never become sick,” he confesses.
Lobito’s test was positive for HIV and he soon began treatment as well. Four months have now passed and the couple remains adherent to ART.
“I’m very strong now. I’m now able to do my work activities without any difficulties. I no longer feel as tired as I used to feel before,” Laurinda tells us happily. She smiles and her face beams with the happiness of someone living a healthy life with HIV. She is also pleased with the support she gets from her husband. “The day before yesterday, due to my farming work, my husband had to get my pills.”
According to Erasmo Caminho, the director of Zalala Health Post, without the interventions of the Male Engagement Strategy and Arnaldo, the Male Champion, the couple would not have returned to the Health Post. “Male Champions have helped a lot in this process because they were the ones who convinced Laurinda’s husband to take the test. The fact that he started taking medication has helped his partner not to give up,” emphasizes the Health Post Director. The couple provides encouragement to each other to remain in care and take their ART as prescribed. It is no longer something Laurinda must do on her own.
In September 2017, a total of 602 male partners of pregnant women were tested in the ANC compared to 397 male partners in June 2017.