The role of faith communities in ending AIDS in children and adolescents
To counter this reality, UNAIDS and PEPFAR have co-published the Compendium of Promising Practices on the Role of African Faith Community Interventions to End Paediatric and Adolescent HIV, which goes a long way to addressing this dearth of information. The Compendium documents 41 promising practices that provide evidence of the core roles that faith communities have played in identifying undiagnosed children living with HIV, improving continuity of treatment, supporting adolescents to access psychosocial support, care and treatment, and enabling peer support groups to empower children and adolescents living with HIV. It also documents how faith leaders have driven advocacy to tackle stigma and discrimination and pushed governments for targets to be achieved.
The Compendium showcases the transformative impact of faith-based approaches, highlighting innovative strategies, programmes, and interventions that have saved lives and nurtured the well-being of young individuals. By combining the power of faith with evidence-based interventions, these organizations have created a synergy that reaches far beyond medical treatment. They have fostered a sense of belonging, love, and support, creating safe spaces where children and adolescents affected by HIV can find solace, guidance, and empowerment. This vital report brings together essential lessons from faith communities’ exceptional leadership in addressing the challenge of HIV in children.
It documents evidence from the core roles that faith communities have played in identifying undiagnosed children living with HIV, improving continuity of treatment, and supporting adherence to care and treatment. It also documents lessons from how faith leaders have driven advocacy to tackle stigma and discrimination and push for targets to be achieved. It will help faith communities, and those who support and partner with them, to advance a step change in progress towards the goal of ending AIDS in children by 2030. What is most fulfilling is that this report also shines the spotlight on Eswatini’s HIV succes story in that it documents best practices in different communities around the country as follows;
Faith Community HIV testing for children, adolescents, and adults
The Eswatini Church Forum works with the Ministry of Health in the country’s four regions to disseminate new HIV ‘Messages of Hope’ for men and children by religious leaders using places of worship, faith communities and social media to increase demand for HIV services. The increased awareness has been used to increase HIV testing of children, adolescents and adults, including using HIV self-testing, and those people identified as HIV positive are referred for ART treatment, as well as to other HIV services. In 2020, nearly 42 000 congregants heard messages of hope which focused on new choices (for testing), new timing (same day), new treatment (one pill), and new hope (undetectable = untransmittable).
Some 34 415 HIV self-testing kits were distributed to young people, adolescents and children, with distribution highest among youth (51.5%) and adolescents (48%), with children only 0.5%. Of the 403 referred for a confirmatory test, 360 (89%) were reported to have been linked to ART. Over 57% of eligible adolescents and youth were referred for preventive services. Although there is no quantitative data, the staff reported that at the start of the project there were many discriminatory statements from the congregants and fear about disclosing their HIV status.
However, as the project continued, with supportive supervision provided to the church members, there was an increase in the number of those who disclosed their HIV status and were free from self-perceived stigma and external stigma. One of the key success factors for the intervention was the training received by both faith leaders and community carers, who are selected from the churches and who receive a stipend.
Impact of intervention:
Although there are no quantitative data, the staff report that at the start of the project there were many discriminatory statements from the congregants and fear about disclosing their HIV status. As the project continued, with supportive supervision provided to the church members, there was an increase in the numbers of those who disclosed their HIV status and were free from self-perceived stigma and external stigma. These observations have been substantiated by verbal reports from faith leaders that attitudes have changed and the stigma related to HIV was reduced.
• There are encouraging signs that HIV incidence among children, adolescents and youth will be reduced based on data about the distribution of HIV self-testing kits to these age groups and their referrals for preventive and/or curative services.
• There has been increased number of children tested for HIV and accessing prevention and treatment services.
Shiselweni Community Home-Based Care
The Shiselweni Home Based Care (SHBC) is a faith-based organization that has four focal areas: home based care; early childhood development; supplying meals to orphans and vulnerable children; and supplying wheelchairs to those with disabilities. The key elements of the intervention involve community members visiting people who may be living with HIV, referring them to testing facilities and, if testing positive, supporting them to start and adhere to ART medication. Out of a total of 5500 clients, approximately 3000 are living with HIV, of whom around 300 are under the age of 19.
The clients are given holistic care and support, are visited regularly and supported emotionally to adhere to their ART regime. Some 400 children also receive daily meals at one of the nutrition depots. As people were encouraged to be tested for HIV and to start on ART, the mortality rate dropped annually and although the data from a detailed study in 2014 do not prove causality, there is a trend indicating a dramatic decline in overall client mortality (71.4%), from approximately one in three (32.2%) clients in 2007 to one in ten (9.2%) in 2011. The success of SHBC has been attributed in large part to the philosophy of volunteerism of community members, which ensures commitment to and sustainability of the programme.
Results of the intervention
SHBC’s data collection and reporting practices are very rigorous and distinguish it from many community-based initiatives. The organization has been able to track dramatic declines in client mortality, design data collection strategies to monitor and evaluate its services and develop targeted initiatives to address HIV health needs of clients and to assist its care supporters. Out of 5500 clients of which approximately 3000 are HIV positive, around 300 under the age of 19 are HIV positive (two-thirds of this group are over the age of 40). These people are given holistic care and support, are visited regularly and supported emotionally to adhere to their ART regime. Around 400 children also receive daily meals at one of the nutrition depots. It is expected that this number will rise to over 500 now that the COVID-19 is over and schools are allowed to function once again. The report is available for download on https://www.interfaith-health-platform.org/_files