A Safe Space for Teens at Mzuzu Health Center

It’s a Saturday morning at Mzuzu Health Center in Malawi. During the week the facility serves over 800 people a day, but today is different. The usually bustling heath center is silent except for the soft sound of children singing, a sign that Teen Club is in session. Following the voices, an outsider entering the room full of young people would think they were joining a party, full of smiles and children laughing. Despite the fun the children are having, today has a very important purpose: to teach young people living with HIV how to lead healthy lives.

Until 2015, Mzuzu Health Center did not have any HIV services directed toward their adolescent population. Young people growing up with HIV have unique medical, psychological and social challenges they must face every day. While AIDS-related deaths worldwide are decreasing for adults, they are increasing for young people and has become the leading cause of death among young people in Africa, (see video: Growing Up with HIV). Two years ago, Nurse Emily Manda was one of the first health care workers (HCWs) at the facility to attend a training on Teen Clubs, provided by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the African Network for Care of Children Affected by HIV/AIDS (ANECCA) with funding from the Children’s Investment Fund Foundation (CIFF). With support from CIFF and the United States Centers for Disease Control and Prevention (CDC), Mzuzu Health Center was able to introduce a club for adolescents living with HIV.

Nurse Emily is jovial. She throws her hands in the air to the beat of the song the children are singing, leading the 50 teens and HCWs attending today’s session. As the song dies down, Emily explains the rules of the club.

“Teen Club is a safe space, the discussions we have here do not leave this room, and the topics we share with one another are only between us,” she says.

Today Emily has chosen one of her most loyal and influential members, Joanna Gondwe*, to speak to EGPAF staff for this story.

Joanna’s father first told her to attend Teen Club three years ago when she was 11 years old. She had taken medication every day for as long as she could remember, but never understood why. When she arrived, Nurse Emily realized that Joanna had never had her HIV-positive status fully disclosed to her, and requested that her father attend a Teen Club meeting with Joanna so they could participate in a group counseling session.

The session, led by Emily, focused on explaining facts about HIV to both Joanna and her father. According to Emily, “Disclosure is a process,” and she knew Joanna would eventually be able to accept her status.

Today Joanna is seen as a leader at Teen Club. “Being HIV-positive isn’t the end of the life, I can still get an education and I can still get married, just like anyone. Teen Club has helped me know this,” she explains.

At the African Network for Care of Children Affected by HIV/AIDS (ANECCA) training, Emily learned how to use certain tools to assess the health of Teen Club members. Emily uses open-ended questions to approach uncomfortable topics when speaking to teenagers. Today she spoke with one teenage boy who disclosed having seven sexual partners, none of whom knew his HIV-positive status. Emily took the opportunity to give the boy condoms and referral slips for each of his partners, asking that they come to the health c enter for an HIV test. She counseled him on how to disclose his status to his partners, and about the importance of strict drug adherence to control his viral load and limit his chances of passing the virus to others. Emily now has the boy’s contact information and plans to follow up with him within the next couple of weeks.

Before closing, Emily leads the group in a discussion about the topics covered that day. When asked to raise their hands if they have ever experienced fear when disclosing their HIV status, nearly every young person raises his or her hand without hesitation. “Look around and remember, you are not alone,” Emily says, and the club is dismissed.

*Name has been changed for this story