Improving HIV care for teens in Kenya with virtual friendships

June 2, 2017 by Peter Abwao

New support groups use WhatsApp to help boost HIV treatment adherence among adolescents.

Improving HIV care for teens in Kenya with virtual friendships

Houphet Mahoya, a clinician at Kakamega County Referral Hospital with Purity (standing) and members of the youth support group. Photo: PATH/Peter Abwao.

Editor’s note: A wide-reaching project in Western Kenya is having a profound effect on the lives of children and adults by tackling a complicated web of health issues. The PATH-led APHIAplus Western, short for AIDS, Population, and Health Integrated Assistance Zone 1, is funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID).

Nineteen-year-old Purity wants to have a successful career in public finance and to possibly, one day, head up Kenya’s leading telecommunications company. The dreams of this second-year university student, however, nearly derailed two years ago when the reality of being HIV positive became too much for her to bear.

Purity learned of her HIV status when she was just nine years old. She had been a sickly child, and eventually she and her mother were tested for HIV. The test results were positive. At that age, nothing bothered her, other than she needed to take a lot of drugs she knew nothing about. She adhered to the treatment—even when she felt well.

A dream and future at risk

Purity was fine until two years ago when things took a turn for the worse. As she became a young adult, she started worrying if she could get married, have children, and live happily like all her friends. And when she got her first boyfriend, her fears intensified, as she believed the young man would leave her once she disclosed her HIV status. Which is exactly what happened when Purity finally gathered the courage to tell him that she was HIV positive.

“I could feel the world crumbling around me,” says Purity. “I feared that this would happen but somehow I had blocked myself from thinking about it.”

“I had no one to share my frustrations with,” she adds. “I was angry at everything.”

What followed was despair. Purity had no motivation to take her drugs. She also stopped going to the clinic for regular checkups.

A race to save peers

Six months later, a safety net through a project called APHIAplus Western found Purity and brought her back to treatment. Peer educators reach out to HIV-positive people who have stopped going to the clinics by calling them on the phone. If phone calls fail, educators use information in the patient locator forms to reach out in person. Community tracing is a joint process with the community peer educators and community health volunteers. This was how they found Purity.

When Purity came back in for treatment, laboratory test results that checked her viral load were alarming. Her viral load had shot from low detectable levels to more than 35,000 copies per milliliters, a sign that she was at risk of becoming susceptible to other illnesses.

WhatsApp brings peers together

Now Purity is one of the members of a WhatsApp group who attend the HIV clinic at the Kakamega County Referral Hospital. The group was created to help adolescents and young adults share information and experiences on treatment.

“Adherence to treatment was a major problem among the 13- to 22-year-old age group, but this has greatly improved with the WhatsApp group.”

Houphet Mahoya, a young clinician working with the APHIAplus Western project, proposed the formation of a youth-only WhatsApp group so teens and young adults could discuss issues common among this age group. The group is open to young people living with HIV aged between 13 and 22 years.

“Because most of these young people who come here for treatment are in training institutions scattered across the country, it was impossible to maintain regular meetings and visits to the facility,” says Mahoya.

He adds that besides being in school or college and unable to attend physical group meetings regularly, stigma is another major obstacle keeping most young people away from getting high-quality treatment.

Through the WhatsApp group, members share how they are coping with stigma, responding to treatment including suspected complications or treatment side effects, relationship issues, and openly discussing anxieties they may have, which can affect adherence to treatment. Houphet, the only clinician in the group, can also use his pager to remind clients of their clinic appointments and respond to treatment-related queries.

Says Mahoya, “Adherence to treatment was a major problem among this age group, but this has greatly improved with the WhatsApp group. It is like a 24-7 therapy room. The good thing is that I am a member of the group, so if there is anything that is technical, I give advice even in the middle of the night.”

Purity says that since she joined the WhatsApp group she enjoys her treatment and believes that her dreams of a successful career in finance and having a family can be realized one day.

With youth-friendly treatment centers like the one at Kakamega County Referral Hospital, hundreds of young people like Purity who are born HIV positive can access treatment, turn their anger and despair into renewed hope, and pursue their dreams again.

The AIDS, Population and Health Integrated Assistance (APHIAplus) program is funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID).