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Fear of HIV Testing Among Zimbabwe’s Teens

In Zimbabwe, four out of 10 sexually active girls aged 15-19 reported taking an HIV test in the last 12 months. Credit: Jeffrey Moyo/IPS

HARARE, Nov 21 2013 (IPS) - Seventeen-year-old Natalie Mlambo* has two good reasons to get tested for HIV. She has two boyfriends and has unprotected sex with them. One is a high school classmate. The other is older, works in a bank, and can afford to give Mlambo small gifts and some money.

“Yes, I sleep with both,” Mlambo told IPS. And, since she has sex only with them, they have stopped using condoms, she explained.

But Mlambo is terrified of getting an HIV test. “I’m afraid,” she said. “It is better to stay in the dark than to know I’m facing death; treatment doesn’t eliminate the disease.”

Mlambo, a final year high school student from Harare’s Kuwadzana high density suburb, is not unique – neither in engaging in transactional sex and having multiple sexual partners, nor in fearing an HIV test.

Felicia Chingundu, an activist with Shingai-Batanai HIV/AIDS support group in Masvingo, a town 300 kms southeast from Harare, sees teen resistance daily.

Why Teens Don't Test

In neighbouring Zambia, girls aged 15-19 named the fears that prevent them from testing for HIV:

• Fear of learning the result (58 percent)
• Fear of depression and suicide (27 percent)
• Fear of stigma (24 percent)
• Fear of dying faster (24 percent)
• Not at risk of HIV (12 percent)

Source: Sexual Behaviour Survey 2010. Multiple choice allowed.

“Teenagers engage in risky sexual behaviour but you hardly see them at testing centres,” Chingundu told IPS.

Zimbabwe set up early and robust prevention programmes in the 1990s that are credited with bringing the prevalence rate down from 24 percent in 2001 – one of the highest in the world – to less than 15 percent in 2012, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). Although a series of political and economic crisis after 2000 clipped many programmes, AIDS awareness is widespread.

One result is that more than half of young people aged 15-24 have comprehensive knowledge about AIDS, according to the 2011 Demographic Health Survey (DHS), a figure higher than the regional average. However, knowledge does not necessarily translate into action.

The Ministry of Health has set up mobile testing facilities that visit schools and testing centres in clinics. But young people say the centres are not youth-friendly.

“Most teenagers stay away from these places, saying they are congested with adults,” said Mavis Chigara, coordinator of the Young People AIDS Network in Zimbabwe’s Mwenezi district, in Masvingo Province.

In 2012, her organisation surveyed 12,500 young people in the district; only five percent had tested for HIV. 

“Testing for HIV amounts to seeking a death warrant, and taking ARVs is a lifelong burden,” said 19-year-old Terrence Changara, from Harare’s low-income suburb of Highfield.

Stigma plays a role. In spite of a widespread epidemic and massive treatment programmes and information campaigns, pockets of discrimination remain.

“My two boyfriends speak mockingly about people who suffer from HIV/AIDS,” said Mlambo. Their attitude indicates they must be AIDS-free, she explained, or they would otherwise be kinder.

The 2011 DHS found prevalence rates of nearly four percent for young males and just over six percent for young females. Census data estimates 3.1 million youth aged 15-24 in the country.

 Benefits of testing

Testing can be scary, and disclosing to a counsellor that one engaged in risky sex may be embarrassing, but the advantages are many.

“It is important for young people to know their HIV status because it will enable them to start treatment early and improve their health,” said Judith Sherman, HIV/AIDS specialist for the U.N. Children’s Fund in Zimbabwe.

“For older adolescents, it will reduce the risk of passing on the virus to another person,” she added. “Finally, it helps adolescents who do not have HIV to keep themselves from being infected.”

In spite of fear, four out of 10 sexually active girls aged 15-19 reported taking an HIV test in the last 12 months, according to the DHS. But one frequent reason for testing is that the girls got pregnant and are attending antenatal clinics.

“Going for HIV testing is rare among teenagers,” said Mandy Chiwawa, an AIDS counsellor in Harare. “They really need support to get tested.”

Nonetheless, more people aged 15-24 are testing, compared to the 2006 DHS. The percentage of sexually active young males who have tested tripled to 23 percent, while females increased five-fold to 45 percent.  This is higher than the regional average of 22 per cent for females and 14 percent for males.

Still a long way to go, still many Mlambos who need help to overcome their fear, but the trend is encouraging.

*Not her real name

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