Women living with HIV caring for each other

HIV-positive women in Botswana have created an innovative support network through which newly diagnosed women receive individual care and companionship from other women living with the virus. Traditional care programmes often focused on treatment and counselling services, without taking into account something as simple as support in the form of friendship, delegates attending the 13th International Conference on AIDS and STIs in Africa (ICASA) heard on Monday. Botswana’s Coping Centre for People living with HIV/AIDS (COCEPWA) initially started the "Buddy Programme" for 12 women in the capital, Gaborone, who requested peer support after discovering their status. The project has now been extended to other parts of Botswana, including the villages of Serowe and Molepolole. HIV-positive men will also become involved in the project, COCEPWA said. COCEPWA national coordinator Regina Lesole, told delegates that "buddies" were exactly that. "They are not counsellors, health care aides, baby sitters or a taxi service. They are positive role models who bring their own experiences and help their clients adjust to living with HIV," she said. The programme also targeted HIV-positive pregnant women who were planning to begin a treatment regimen, people who were failing to adhere to antiretroviral therapy, as well as those who were not responding to treatment. To become a buddy, COCEPWA coordinators select a healthy HIV-positive member who undergoes a week’s training course on: effective communication skills, the basics of the disease, medicines, nutrition, dealing with violence and alcohol abuse and positive living. Buddies are then linked up with their "clients" for a period of up to six months and are required to maintain regular contact with them - up to three times a week. But the programme is not one-sided. "Buddies also need counseling, they carry heavy loads, so they need time to heal. They have their own regular support group meetings for this," Lesole pointed out. They also receive a stipend to allow them to call and travel to visit their partners. The relationship between a buddy and her partner is meant to be an equal and open friendship. "The client has a right to her own opinion and should be treated with respect. If she makes mistakes, she should be comfortable enough to talk about them," Lesole explained. There are some ground rules, however, that both parties have to follow. The buddy cannot share medication or use drugs or alcohol with the client. They are both not permitted to have a sexual relationship or live together. "This is an intense relationship already, once you become involved or add another dimension to it, it becomes difficult to control," Lesole explained. But Shaun Mellors, a South African delegate, warned against adopting a didactic and heavy-handed approach. "People living with HIV/AIDS fall in and out of love too, does the project make allowances for [the buddy and the client] if this happens?" he asked. As the programme is expanded to include men, these are some of the challenges it will have to address. According to Lesole, both buddies and clients have benefited from the project. Being a buddy has had a positive impact on their mental health and self-esteem. "They feel important – they are doing something worthwhile and the client feels like she matters to someone," Lesole said. There was also a significant improvement in levels of disclosure among bothparties, she added. And clients also showed an increased capacity for self-care. "That is the main aim – we train our clients to become independent. You cannot depend on any man or anyone, you have to stand up for yourself," Lesole added.