Online Reporter
Robin Muchetu, Health and Gender Reporter
WHILE the introduction of Antiretrovirals (ARVs) in Zimbabwe marked a turning point in the fight against HIV and Aids in the early 2000s — saving thousands from premature death — an alarming case from Masvingo has raised fresh concerns.
An 18-year-old man, who successfully took ARVs for 15 years, has now abruptly refused treatment, with potentially deadly consequences.
Health officials are stunned by this sudden U-turn, which threatens not only his health but also public health efforts to curb HIV transmission.
ARVs are life-extending drugs prescribed to HIV-positive individuals, capable of suppressing the virus when taken consistently over a lifetime.
Mr Pascal Makuve, the Gutu District Aids Co-ordinator for the National Aids Council (NAC), recently shared the heart-breaking case of a young man who, after years of adherence, now refuses treatment for reasons that remain unclear.
The case underscores the complex challenges health workers face when offering ART to adolescents — individuals undergoing physical and emotional changes that can influence their judgment and medication adherence.
“The young man was raised by his grandmother, who is now very old. Initially, he was co-operating when we spoke to him about his treatment, but over time, he stopped taking his ARVs. We believe peer stigma at school may have contributed to his loss of interest, leading him to refuse treatment altogether. This is devastating, considering he was on therapy for years. His defaulting negatively impacts his immune system,” Mr Makuve said.
He said given his age and stage of development, there’s concern that he is entering a phase where he may start dating and engaging in sexual activities, increasing the risk of transmitting HIV to others.
“Instead of fighting HIV, this situation risks spreading it further, undermining our efforts,” added Mr Makuve.
In contrast, Gogo MaDube from Masvingo shared a positive story about her grandson, who she started taking care of when he was 18 months old and now is in Form Two and on ARVs without issues.
She recounted how she took custody of the child after his mother, who was HIV-positive, passed away. Through education and support programmes, she has been able to monitor his medication adherence effectively.
“Workshops and training on caring for HIV-positive children have helped me ensure he takes his medication regularly. Now, he’s in Form Two, and I keep a close eye on his treatment,” she said.
Monitoring adolescents on ART remains a challenge, but the NAC has introduced the Community Adolescent Treatment Supporter (CATS) programme. This peer-led initiative provides psychosocial support and encourages adherence among young people, leveraging their comfort with peers over adult healthcare workers.
Christine Made (not her real name), 21, a CATS member in Masvingo living with HIV, exemplifies this approach. She supports her peers by fostering understanding and patience around medication adherence.
“I work with other young people living with HIV, listening to their challenges and helping them stay on treatment. We’re trained to approach them gently because this is a difficult stage in their lives. It’s heartbreaking when someone refuses treatment, especially after we’ve worked so hard to get them to accept their diagnosis,” she said.
Catherine Mupfumba, a healthcare worker at a local hospital, emphasised the difficulties in managing adolescent HIV care.
“Since adopting the CATS strategy, we’ve seen improvements — out of 38 young people living with HIV at our facility, only one has a high viral load. We’ve tried following up with him at home, involving social welfare and NAC, but he remains resistant,” she said.
The 18-year-old recently told health officials that no amount of counselling could persuade him to resume his treatment. Some stakeholders speculate that he may have been taking ARVs unknowingly, possibly due to non-disclosure of his HIV status by his caregiver.
The case highlights the urgent need for targeted interventions to support adolescents in maintaining their treatment and understanding their health.
Bongani Ndlovu