The Integra Initiative was a five year research project that gathered evidence on the benefits and costs of a range of models for delivering integrated HIV and sexual and reproductive health (SRH) services in high and medium HIV prevalence settings, to reduce HIV infection (and associated stigma) and unintended pregnancies. IPPF is presenting its findings at the International Aids conference in Melbourne Tuesday 22 July.
Bomani*, a 15-year-old boy from Ntcheu District in Malawi, was diagnosed HIV positive when he was 12 years old.
Bomani was one of the beneficiaries and a success story of the Integra project 2008 - 2013 that was implemented by International Planned Parenthood Federation Member Association Family Planning Association of Malawi. This is his story.
“After a long time of getting sick and not receiving the right treatment, I made a resolve to find out what was ailing me. Since my symptoms were a classic case of someone who is HIV positive, I went to one of the clinics in Malawi and specifically asked them to test me for HIV. I didn’t tell anyone that I was going for an HIV test because at 12-years-old, nobody expected I knew what HIV was all about, let alone the value and need for testing.
“When I discovered that I was HIV positive, I got very worried because I knew what people in my school and in my community thought of people living with the disease. When I finally gathered the courage to talk about it, I told my mother. She did not say anything, but things in my family changed.
“My sister told some of my schoolmates about my status. They used to laugh at me and that would hurt me a lot. They isolated me. Nobody wanted to walk to school with me, or even play with me. They all said that they did not want to get infected with HIV by associating with me.
“I finally succumbed to all the hate and discrimination and stopped going to school. When a peer educator in the community heard about my situation, he invited me to join his support group. He was a member of Nzontheka, a support group in the community for young people living with HIV.
“The young people in the support group held monthly meetings to discuss issues affecting them and how to sensitize the community on HIV to enhance their understanding of the disease and acceptance with positive status.
“Joining Nzontheka changed my life, I felt loved and appreciated and for the first time felt that I was not the only one going through this. My healing process was however short-lived because I later developed a very bad skin problem. People distanced themselves from me in a misguided belief that they may contract the disease.
“I was forced to drop out of school for the second time.
“My support group and coordinator at the Family Planning Association of Malawi (FPAM) were not going to let this happen again. They took me through a lot of counselling and went as far as coming to school to sensitize the teachers and pupils about HIV.
“They provided the family with materials and information on HIV and educated them on how they can relate with me to provide a supportive environment. Later on, my mother took a test and was diagnosed with HIV. Empowering my family and the school on HIV was useful in providing accurate information and knowledge on the same.
“My situation at home, within the community and at school has since improved tremendously.
FPAM has also been very helpful to me. Besides ensuring that I stayed in school, they taught me a lot about HIV, provided counselling and gave me the confidence I needed to face the world, while sensitizing the community on HIV and other SRHR issues.
“The support I received from Nzontheka and FPAM inspired me to get involved with HIV programmes.
“I want to fight against discrimination of people living with HIV especially young people. The strategy is to reach out to people who discriminate against people who know their status and are living positively with the disease.”
The flagship Integra Initiative was managed by the International Planned Parenthood Federation (IPPF) in partnership with the London School of Hygiene and Tropical Medicine (LSHTM) and the Population Council and was funded by the Bill & Melinda Gates Foundation. It is the largest ever evaluation of different models of HIV and Sexual and Reproductive Health (SRH) integration. The research was embedded within the day-to-day activities of 42 government and IPPF health facilities studied in Kenya, Malawi and Swaziland. The research findings demonstrate that there are benefits to using integrated models of service delivery.