Author: Kumbirai Tudor Mazaiwana is a social worker with the ACHIEVE project in Juba, South Sudan
In sub-Saharan Africa, six in seven new HIV infections among adolescents aged 15–19 years are among girls resulting in adolescent girls, and young women (AGYW) being disproportionately affected by HIV. In South Sudan, AGYW are often marginalized and face additional challenges to leading a full life due to social isolation, poverty, discriminatory cultural norms, orphanhood, and gender-based violence. Social workers like myself play a pivotal role in ensuring AGYW have access to equal health, social, educational, and employment opportunities.
I am originally from Zimbabwe, but today I work in Juba, South Sudan where I support vulnerable and at risk AGYW under the USAID-funded Adolescents and Children HIV Incidence Reduction Empowerment & Virus Elimination (ACHIEVE) project, through PEPFAR. Through my role as a social worker, I ensure that AGYW are enrolled in and meaningfully benefit from the PEPFAR DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership which includes the empowerment livelihoods for adolescents (ELA), life skills and economic strengthening package. The project supports and engages AGYW with risk and vulnerabilty factors such as being out of school or at a risk of dropping out, survivors of gender-based violence, multiple concurrent sexual partners, involvement in transactional sex, drug abuse, orphanhood, and a history of irregular or no condom use.
As a social worker with the ACHIEVE project, I focus on helping AGYW to be resilient and determined in the face of challenges that heighten their risk of HIV infection. My colleagues and I offer psycho-social support to restore their agency and self-esteem and help them gain knowledge and skills required to overcome any concerns they have about HIV by linking them to multiple DREAMS services such as HIV testing, Sexually Transmitted Infection (STI) screening and treatment, family planning, and psycho-social support.
I have worked with many AGYW, and orphans and vulnerable children, but the story of Kojo (not her real name) is one that stands out the most. Kojo was brought to Juba City, South Sudan, from Kajo Keji County in 2013 by her aunt. She was full of hope and looked forward to fulfilling her dream of attaining a quality education in the city. However, her dream slowly vanished when her aunt forced her to drop out of school. Soon after, Kojo was sexually assaulted. With the support of a different aunt, Kojo sought health care services at a local hospital and received post-exposure-prophylaxis for HIV. After six weeks, Kojo discovered that she was pregnant. Kojo kept the pregnancy and delivered her twin babies in 2018. She was 14 years old at the time. While her aunt continued to provide Kojo and her babies with food and shelter, Kojo was employed at menial jobs in order to earn money to pay for medical bills and buy clothing.
In October 2020, the DREAMS Partnership, with support from USAID and PEPFAR, launched in South Sudan and I led a team of colleagues to identify AGYW that would benefit from the program. Kojo was among the first AGYW to be enrolled. Kojo was initially hesitant to share her story, but during one of the ELA life skills modules, which involves learning how to deal with emotions, Kojo stood up and told her story to the group. Kojo was immediately referred to Juba Teaching Hospital One Stop Center for the secondary DREAMS support package: psychosocial support, free HIV Testing and STI screening, and family planning methods.
Today, Kojo is an active participant in the DREAMS program and has never missed a session. Kojo plans to enroll in the DREAMS long-term course in tailoring, which will allow her to make her own money to pay for food, her medical bills, and school fees for her children. “Knowing my HIV status makes me happy and gives me strength to stay safe until I find a suitable suitor,” she said. Kojo’s story is one of many. My drive to become a social worker stems from my own childhood experiences and growing up in a community with hardships and difficulties to make ends meet. As a young adult I saw the impact of social workers and advocates in my community. My career as a social worker gives me the opportunity to advocate for others, like other social workers had done for me.
Kojo’s story demonstrates the important role that social work plays in DREAMS programming and in preventing HIV among AGYW. We know that clinical care is only one step in preventing HIV, the comprehensive package of secondary services my social work colleagues and I provide are critical in the HIV response.