Members of Zimbabwe’s Khoisan tribe perform a traditional dance during an HIV/AIDS awareness campaign conducted by Tsoro-O-Tso San, a development trust that aids the tribe. Credit: Jeffrey Moyo/IPS

By Jeffrey Moyo
TSHOLOTSHO, Zimbabwe, Aug 31 2017 (IPS)

Sixty-seven-year-old Hloniphani Sidingo gives a broad smile while popping out through the gate of a clinic in her village, as she heads home clutching containers of anti-retroviral pills.

The first Bantu people to dwell in present-day Zimbabwe, the Khoisan, also known as the Bushmen or Basagwa, populate remote areas of southern Africa, particularly Angola, Botswana, Namibia, South Africa, Zambia and Zimbabwe.

Here, the Khoisan community is found in Matabeleland North’s Tsholotsho district, where many like Sidingo are domiciled. Other Khoisans live in Plumtree in this country’s Matabeleland South province.

Now, with the word spreading far and wide about AIDS awareness, many Khoisans like Sidingo have joined the fight against the disease. And thanks to the Zimbabwean government’s anti-retroviral initiative, she is still alive more than 16 years after she tested positive for HIV.

“I’m so happy. I’m happy I continue to receive my share of treatment pills from government and this keeps me going,” Sidingo told IPS.

“AIDS killed my husband and my children – five of them,” she said. “I’m not taking chances because I want to survive. My husband back in the days didn’t trust community health workers when they approached us urging us to embrace HIV/AIDS tests and get treatment if we have the disease. Ntungwa, my husband, actually thought health workers were up to no good and avoided them, resulting even in our children, who also later died of AIDS, doing like their father,” added Sidingo.

Meanwhile, organisations catering for the welfare of the Khoisan here say the dread and shame surrounding HIV/AIDS is fading among members of the tribe.

“The Khoisan now understand the existence of the (AIDS) virus and almost all who are infected are on ARVs,” Davy Ndlovu, Programmes Manager for Tsoro-O-Tso San, a development trust that aids Khoisan people in Zimbabwe, told IPS.

But while success stories are there to be told about the ancient tribe’s strides in combatting HIV/AIDS, a combination of poverty and ignorance has sometimes disrupted ARV treatment.

“As you might be aware, the San are a poor people and when the nursing staff here once told them not to take the medication on an empty stomach, this was interpreted in that when one had no food for that day, one would not take his or her medication. Due to this ignorance, a number of Khoisan people living with AIDS have lost their lives,” Ndlovu said.

While the tribe now embraces ARV medication, they still face the burden of having to walk long distances to access treatment, according to Tsoro-O-Tso San.

“The other issue has to do with reviews where people are expected to travel to the nearest hospital, which is about 15 to 20 kilometres away. When they fail to raise transport money, they just stay and miss the review,” said Ndlovu.

Despite such hurdles, for Khoisans living with HIV like Sidingo, fighting the disease has become top priority.

“I have learnt to adhere to taking my medication consistently. Many people in my community now understand the importance of getting tested for HIV,” Sidingo told IPS.

Ndlovu said like Sidingo, many Khoisans now live with HIV and are trying to cope with the virus like everybody else, in  a country where 1.2 million people are living with HIV/AIDS, according to UNAIDS.

To Ndlovu, “They (the Khoisan) are no longer discriminated against in the AIDS battle.”

Of the 2,500 Khoisan people domiciled in Zimbabwe, approximately 800 of them now live with HIV/AIDS, about a third of the population, according to Tsoro-O-Tso San.

Meanwhile, the rush to get tested for HIV/AIDS amongst Zimbabwe’s Khoisan tribe comes at a time the tribe stands accused of engaging in careless sex habits, exposing the tribe to the ravages of AIDS.

“The biggest threat is that the San still practice casual sex with no protection at all. Sex among the San is a pastime to be enjoyed and you still find people sharing girlfriends – young and old do this,” Ndlovu of the Tsoro-O-Tso San told IPS.

“Organisations like Medicine Sen Frontiers (MSF) have worked with the Khoisan tribe on issues related to HIV/AIDS. A number of the Khoisans, both male and female, the youths in particular, have been trained as peer HIV/AIDS educators with the intention to teach people issues related to HIV/AIDS prevention, safe sex, and treatment,” said Ndlovu.

The Zimbabwean government’s National Aids Council fosters also HIV/AIDS awareness campaigns amongst the country’s ancient tribe, according to Tsoro-O-Tso San.

To do this, NAC works in conjunction with the country’s Ministry of Health to provide anti-retroviral drugs to the minority tribe, a gesture that has put smiles on many HIV-positive Khoisans like Sidingo.

“Back in the years, as the Khoisan we thought our people were being bewitched as we saw them succumbing to AIDS, but thanks to the treatment, we have started to live on even with the virus,” Sidingo told IPS.

HIV has become the leading cause of death among adolescents in Africa. Credit: Sam Olukoya/IPS

By Sam Olukoya
LAGOS, Nigeria, Dec 15 2014 (IPS)

HIV among teenagers is devastating families in Nigeria and elsewhere in Africa, where AIDS has become the No. 1 killer of adolescents.

Africa accounts for more than 80 per cent of the 2.1 million adolescents living with HIV globally.

Drivers of HIV infection among adolescents include scarce information about sexual reproductive health and HIV, unprotected sex and sexual violence.

Between 2005 and 2012 the global AIDS death toll fell by 30 percent but increased by 50 percent among adolescents, according to the United Nations Joint Programme on HIV/AIDS (UNAIDS).

Late HIV diagnosis, fear of discrimination, low enrolment and adherence to antiretroviral treatment, and absence of specialized health services for HIV positive youths are some of the factors responsible for AIDS related deaths among adolescents in Africa.

As AIDS becomes the leading cause of death of adolescents in Africa, empowering youth – especially girls - to make safe life choices and avoid HIV is crucial. Credit: Mercedes Sayagues

By Sam Olukoya
LAGOS, Nigeria, Nov 21 2014 (IPS)

Two years ago, Shola* was kicked out of the family house in Abeokuta, in southwestern Nigeria, after testing HIV-positive at age 13. He was living with his father, his stepmother and their seven children.

“The stepmother insisted that Shola must go because he is likely to infect her children,” Tayo Akinpelu, programme director of Youth’s Future Savers Initiative, told IPS.

“Shola felt as an outcast,” says Akinpelu. Eventually, Shola’s grandparents took him in.

HIV among teenagers is devastating families in Nigeria and elsewhere in Africa, where AIDS has become the leading cause of death among adolescents.

“This is absolutely unacceptable,” says Craig McClure, chief of HIV programmes with the United Nations Children’s Fund (UNICEF), in New York. “What’s more, AIDS-related deaths are decreasing for all age groups except adolescents.”

The global AIDS death toll fell by 30 percent between 2005 and 2012 but increased by 50 percent among adolescents, says a UNICEF report.

Fear of seeking help

One reason for this shocking teen death toll, says Dr. Arjan de Wagt, chief of HIV/AIDS with UNICEF in Abuja, is the low number of adolescents on antiretroviral treatment (ART).

Of the 3.1 million Nigerians living with HIV, half are under 24 years. But only two out of ten HIV positive youth over 15 and just one out of ten under 15 received the lifesaving drugs in 2013, de Wagt told IPS.

Rejection by family and society, as happened to Shola, or fear of rejection, prevents adolescents from seeking help.

“Many HIV positive adolescents are dying in silence because they are too ashamed to access treatment,”’ Blessing Uju, a Lagos-based youth counsellor, told IPS.

“The shame is even bigger for the girls. In Nigeria, if you are HIV positive, the impression is that you are a commercial sex worker,” she says.

Sally* did not tell her parents or siblings when she tested HIV positive four years ago, at age 19.

“At the family level, there is a lot of stigma,” she told IPS.

Although aware of the danger of not taking her medication regularly, Sally often skipped it to avoid being seen with pills at home.

“As a young person, you need a confidant. If you are not strong, you might end up taking your life,” she says.

Teenagers need family help to stay on ART, says Akinpelu.

Shola’s grandparents would normally cook the first meal for the day in the afternoon until Akinpelu explained to them that the pills can cause nausea on an empty stomach and Shola needed a hearty meal earlier.

Uju says that treatment fatigue hits adolescents hard. “Some say they prefer to die than to continue taking their drugs,” she says.

High death toll

Of the 2.1 million adolescents living with HIV worldwide in 2012, more than 80 per cent are in sub-Saharan Africa, according to the United Nations Joint Programme on HIV/AIDS (UNAIDS).

Malawi, with 93,000 HIV positive teenagers, has 6,900 annual AIDS-related adolescent deaths.

The death toll is linked to late diagnosis and starting ART too late, explains Judith Sherman, of UNICEF in Lilongwe.

Malawi’s policy is that all children seen in health facilities should be offered an HIV test. “Unfortunately, this does not happen routinely,” she says.

Teenagers’ adherence to ART is lower than adults, says Sherman, “for a range of reasons like treatment fatigue, depression, fear of stigma, denial and unstable family relationships.”

Tanzania’s estimated 165,000 adolescents living with HIV face similar challenges as their peers in Nigeria and Malawi. (see sidebar)

Allison Jenkins, chief of HIV/AIDS with UNICEF in Tanzania, says that one effective way to help teenagers are clubs.

“Teen clubs improve adherence to treatment, especially among members who attend regularly,” she told IPS.

HIV among teen girls

Alarmingly, adolescent HIV prevalence is highly gendered, with teen girls showing infection rates that UNAIDS calls ”unacceptably high”.

Teen girls aged 15-19 in Mozambique have a prevalence of seven per cent, more than double the boys of the same age. Botswana presents a similar scenario.

Lucy Attah, of the Lagos-based Women and Children Living with HIV & AIDS, blames poverty.

“Girls have to trade sex for money to sustain themselves,” she says. “The pressure for money is higher in the cities where teenage girls compete to get the best mobile phones and clothes.”

Adolescents become sexually active, try drugs and alcohol, feel invulnerable, and experience the social and economic pressures of becoming an adult. HIV and the lack of youth-friendly health services compound the problem, says the UNICEF report.

 “We must do more and do it well, focusing on sub-Saharan Africa and on adolescent girls, where the heaviest burden lies,” says McClure.

*names changed to protect privacy

Edited by Mercedes Sayagues