On Tuesday’s plenary session at the International AIDS Conference, Phil Wilson of the Black AIDS Institute talked about the need for an “army of patient navigators,” people who provide the critical connection between HIV-affected individuals and life-saving health and social services.As a Peace Corps volunteer working in Northern Cameroon, I came to know a timid collection of youth who believed that their HIV diagnosis was a death sentence. In addition to facing the stigma surrounding HIV, they must overcome the burdens of poverty, limited literacy, and in most cases being a woman in a conservatively Muslim society. Under the shade of a neem tree, they questioned the possibility of their dreams. How long could they live? Should they invest in going to school? Could they ever hope to have a family someday?Antoinette, shy and tall, spoke of how her husband accused her of bringing HIV to their marriage and abandoned her.Yaya had been left to die in an isolated room of his family’s compound because his family did not know about life-saving drugs.Aïssatou is a widow and mother of three, struggling to provide for her children. Six years later: through education and empowerment, these young people and dozens more like them have been transformed into dynamic, awe-inspiring front line health workers! First, they gained the knowledge to manage their own health and live positively. Then, they received a comprehensive HIV peer education training, and became armed with communication and leadership skills to educate others in their communities about HIV and AIDS. Now these HIV-positive young people reach out to the most vulnerable in their communities. They are uniting in solidarity to face down stigma and providing home-based care as well as psychosocial and financial support to HIV-affected families. They are partnering with the Ministry of Health’s regional directorate and district-level health facilities to ensure that people living with HIV have good relationships with the doctors and nurses there in order to access higher quality preventive care, CD4 tests, and ARVs. Antoinette recently gave birth to an HIV-negative baby and works as a social worker to ensure that HIV-affected families access the government’s social protection programs. Yaya is now on ARVs and has been trained in gender-based violence. He works with men to consider their role in negotiating sexual partnerships and condom use to prevent HIV transmission. Aïssatou can now pay for her children to attend school because she is healthy. She was awarded a scholarship from UNFPA and promotes prevention of mother-to-child transmission in her community. She also travels over bumpy roads to the border town of Kousseri to train sex workers on how to get tested and become peer educators and promoters of safe sex. These peer educators are the missing link between communities and health care services. They are cost-effective and they promote social accountability. As so eloquently stated by the speakers at Tuesday’s session on health workers, these armies of patient navigators, peer educators, and front line health workers will play a key role in turning the tide on the AIDS epidemic. Full disclosure: I am the chair of the Board of Directors for Education Fights AIDS (EFA) International, the organization that provides the capacity-building services described.Photo 1 courtesy of Rachel Deussom. Photo 2: Peer educators Katerine, Aïssatou, and Doudou support their communities and each other in the fight against HIV and AIDS in Maroua, Cameroon. © Rachel Hoy Deussom/EFA International
June 27th is National HIV Testing Day in the United States.
Too many people don't know they have HIV. According to the US Centers of Disease Control and Prevention (CDC), in the United States, nearly 1.2 million people are living with HIV, and almost one in five don't know they are infected. This means that they are more likely to unknowingly pass HIV to others.
Getting tested is the first step to living a healthier life. If you have HIV, getting medical care and taking medicines regularly helps you live a longer, healthier life and also lowers the chances of passing HIV on to others.
The message for achieving an HIV-generation remains the same, whether in America, Africa or anywhere else in the world: "Take the test, take control."
This is exactly the message that EFA's peer educators are sharing throughout Northern Cameroon. We are striving to make sure that this message reaches everyone by increasing access to our HIV prevention peer education program. Since our Training of Trainers sessions in early 2012, EFA's Regional Office has consolidated the training modules so that they can be taught to all 150+ members of the EFA Youth Empowerment Network over the coming years. They will in turn be empowered with accurate information that is key for all community members, especially young people, to take charge of their lives by taking an HIV test.
The need for HIV prevention information in communities throughout Northern Cameroon is so high. EFA's technical assistants and peer educators are working very hard to meet this demand, but require additional resources to get the job done.
Consider supporting EFA's peer education program so that we may achieve an HIV-free generation. It starts with knowing that you have to "take the test to take control!"
Education, in particular HIV/AIDS education, is the cornerstone of EFA’s strategy to improve the condition of life for the associations and members of our Youth Empowerment Network. Peace Corps Volunteer Caitlyn Bradburn paved the way when she created the Peer Education program. The Peer Education program was designed to give association members, regardless of previous education, monetary situation, or ability to read or write, the opportunity to not only educate themselves on HIV and AIDS, but to serve as educators for their peers also infected or affected by HIV and AIDS in their community. It sought to empower our members to not only live positively themselves,but to promote positive living and reduce stigma and discrimination in their communities. Caitlyn, Alim, and Amada served as the new program trainers.
When I arrived as the next Peace Corps Volunteer to serve with EFA International, it was clear this program was a huge success. Members felt empowered and attitudes and behaviors of both HIV-positive and HIV-negative people in the community were changing. I thought to myself: this is great, but how can it be better? I realized, the previous Volunteer had created this empowering and effective program, but now my role was to make it sustainable, to make it EFA’s program and not the Volunteer’s.
I approached Alim and Amada, the trusty and dedicated staff of the regional office in Cameroon with an idea... what if we trained existing motivated and talented Peer Educators as volunteer program trainers? Though they thought the task would be difficult, they were immediately on board. What better way to further empower EFA Youth Empowerment Network members? What better way to ensure that the program can and will exist without a Peace Corps Volunteer?
With the help of star Peer Educator/Trainer Pehlem Therese, whose excellence and passion for peer education had actually already secured her as a Peer Education trainer, I set off to design my project and with the support from a VAST/PEPFAR grant and contributions from EFA International, including those from Global Giving. My project began in late November 2011.
Candidates for the new trainer position underwent a preliminary application and testing process, from which we selected four Peer Educators to continue on to the training round. These four candidates then participated in an 8-day intensive Training of Trainers, which included identifying training needs, facilitation, and leadership techniques. Finally,all the candidates gained practical experience by serving as the lead trainers in an actual EFA Peer Education cycle for members of AJUBS Kousseri under my supervision and the supervision of Pehlem and Amada. Even though the project was long and difficult, watching the improvement of these four candidates from the initial interview process to the final trainings they delivered has beeninspiring. In addition, seeing Pehlem continue her personal and professional growth and rise to the challenge of being a leader has been one of the greatest highlights of my service. Not only have they all succeeded themselves, but they successfully trained 8 new peer educators in Kousseri, a training success rateof 80 percent with the highest average post-training test score of any PeerEducation cycle and EFA’s first post-test score of 100%!
I am so proud to announce EFA International Cameroon’s five volunteer Peer Education Trainers, who successfully completed their training and practical in March 2012:
Pehlem Therese, AJEPS MarouaAsta Madeline, AJEPS MarouaSalihou, ASSYSGOD GodolaAissatou Moussa, AJUBS KousseriHenriette Maidouwe, AJUBS Kousseri
Please join me in congratulating their hard work and welcoming them to the EFA team! This success is due not only to their hard work, but also to the generous support of Global Giving donors like you. Please help EFA to continue this positive momentum!
In the absence of a cure for HIV, for the past 30 years this question has been the center of debate. For those of us who have dedicated our lives to the fight against AIDS, recent research has given us a glimmer of hope—and may have finally ended this debate.
In May, the University of North Carolina at Chapel Hill released results from the HPTN 052 study which indicate that putting an HIV-positive person on treatment as soon as HIV infection was detected reduced the risk of them transmitting the virus to their sexual partners by 96%. Ninety-six percent. The evidence was so compelling that the trial was actually ended early and results published years before expected. For anyone who has worked in the uncertainty of research, this just doesn’t happen.
EFA’s beneficiaries have experienced these benefits first-hand. Since receiving treatment, their improved health status has empowered them to become HIV advocates, peer educators, and leaders in their communities, gaining the respect of those who once stigmatized them.
On World AIDS Day 2011 and every day, over 50 EFA peer educators conducted community-wide education events in over ten communities. Some members are sitting down with local religious and traditional leaders to explain how they can help achieve an AIDS-free generation. Others are going door-to-door, encouraging people to get tested for HIV at the local health center, and describing why an AIDS-free generation is important to their community.
We have the technology. For the first time ever we can actually see the way forward. We can envision an AIDS-free generation. Not a generation free of HIV, but free of AIDS.
So, forget the debate—treatment IS prevention. Putting people living with HIV on treatment early will not only extend their lives, but will also prevent new HIV infections among their HIV-negative sexual partners.
The tragedy is that this innovative and groundbreaking research comes at a time of declining levels of funding for HIV, of donor “fatigue” for financing national HIV programs, and of re-shifting priorities away from HIV strategies and towards broader health sector initiatives.
The United States government has taken a significant step. During a speech delivered by Secretary Clinton at the National Institutes of Health in November, she re-committed the U.S. government’s development efforts towards supporting the global AIDS response in achieving an AIDS-free generation. It is time for other governments to meet this call.
Through our Peer Education program our members learn the tools they need to stay healthy, live positively, and they receive education on antiretroviral drug adherence and strategies. Our peer education program trains members to go out into their communities and educate others about the basics of HIV transmission and prevention, and the importance of getting tested.
In 2011, our peer educators provided basic HIV education to over 20,000 people, and over 5,000 people were referred to their local health center to get an HIV test.
EFA is doing its part and we would like to graciously thank you for the support you’ve given us through Global Giving. We wouldn’t have made it this far without you, but we’ve still got a long way to go and count on your continued support.
We are together. Nous sommes ensemble.
modified from an EFA blog published in December 2011.
My husband died from a disease that we didn’t understand; after medical exams, the results showed that we had been infected [with HIV]. This was a huge shock for me; in addition my husband’s family began to treat me bad, insulting me, refusing to talk to me just because I was infected. I was not even allowed to eat with them anymore. To them, I had killed their son.
My husband’s family went as far as to forbid me to share and drink next to them, I could no longer use the same eating utensils as before – all this from fear that they would be infected. My life became impossible.
There was a young neighbor who had pity on me and defended me in front of my family in regards to this torture that I was living. He introduced me to a man who gave counseling, this man gave me a lot of advice and also showed me that I was not alone in this situation. He suggested that I leave my husband’s family to live with my parents.
I was extremely afraid of my parent’s reaction, but my father understood my situation and gave me a lot of examples of people in my condition that had been living for many years with this disease. He told me that I could live like the others.
Miss Oumarou, a medical counselor, talked to me about associations of people living with HIV and AIDS, at the time associations were typically for adults, but an association for youth had just been created by EFA. Thanks to EFA, I became a member of this association of youth living with HIV and AIDS. With AJEPS Mokolo [the association], I became a new person, like the others. Then the members of my association chose me to attend training on this disease and to become a peer educator. I had the taste of living a new life and I met a lot of other people living with HIV who lived in peace and at ease.
Thanks to my association I had the chance in my life to travel, eat well, and all while surrounded by a group of people who were HIV-positive and some people who were not. I even was able to sleep at a hotel during the training, this I could never have imagined; I was happy!
… After returning from the training, I became an active member of my association where I had the responsibility to buy and sell eggs for an income generating activity. Others in my association like me also bought and sold peanuts, which would help us enormously to balance our lives, to buy our medicines and to become healthy like the others.
Thanks to all these efforts, I could talk with people openly, I could even talk about my disease at church and explain to people in my local language the myths, realities and other things related to HIV and AIDS.
One day, my friend from training, Therese Pehlem, talked to me about a man in Maroua who was interested in me and who was also infected with HIV. I went to his house and I stayed there throughout all of his sickness. We still felt a lot of hope thanks to our associations, but unfortunately he did not survive. After his death the members of AJEPS Maroua [an EFA association in Maroua] asked me to integrate into their association; I was truly honored and I accepted.
Today, I am respected, I have friends, I manage the selling of water which is the income generating activity of my new association, I sleep well, I eat well and I can even help people who are in need, either for advice or for support.
The greatest thing that has touched me to this day is the exchange of ideas, the dialogue, and the friendship within the associations and during the trainings. This gives us more than hope; we have found again the will to live.
My wish today, is to see EFA International continue what they have started and with us help to save the other people who are in my situation. My last words to say are thank you to all who have had the courage to help us and to help those that we have helped.
To date, EFA International has helped create 10 associations (with another 2 currently in development) of youth infected and affected by HIV and AIDS throughout the Far North region of Cameroon. Through education, empowerment and enterprise, EFA International strives to improve the condition of life for these youth and their families. Though positive living and positive prevention, EFA International and our associations work to reduce stigma and discrimination, help others living with HIV or AIDS, and promote the prevention of HIV infection within their communities.
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EFA Country Representative
Extreme North Province