Africa: An Enduring Commitment

Stigma, discrimination, and lack of knowledge on HIV/AIDS are all major challenges facing the success of HIV/AIDS treatment and the prevention of mother-to-child transmission in developing countries, including Malawi. To increase the rates of patient follow up, teach communities about mother-to-child transmission, and to encourage testing for more children, the Clinton Health Access Initiative (CHAI) uses a peer-to-peer education approach in Malawi through its Expert Client Initiative. Expert Clients, women who are HIV positive themselves, are helping to lessen stigma and improve HIV/AIDS awareness by sharing their personal stories and openly disclosing their status during clinic "Health Talks." CHAI has trained 50 Expert Clients that are supporting 21 Health Care Facilities where they complement the work of the clinical teams.

Expert Clients offer comprehensive counseling to their clients to reduce treatment default rates and help keep mothers and children on antiretroviral therapy. Counseling and psychosocial support from peers can help people live long, healthy lives, improve the health and well being of the whole family and help decrease stigma and discrimination contributing to a higher quality life for infected individuals, affected families and entire communities. Additionally, Expert Clients keep track of their clients’ next appointment dates and work with health center staff and trained community health workers to follow-up patients in the community.

In the past year, Expert Clients conducted more than 8,000 one-on-one counseling sessions with HIV positive pregnant women, HIV positive mothers, and HIV positive children and their caregivers. In the last year, 2,500 children of clients seen by Expert Clients have received HIV testing, including over 750 who were tested at 6 weeks of age through accessing Early Infant Diagnosis services.

In Machinga, Malawi, Expert Clients are encouraging women who test positive for HIV during pregnancy to bring their children in for testing. Sakina an Expert Client in the Pediatric Ward of the Machinga District Hospital said, "Just yesterday I helped five women get their children tested for HIV. Four of the children were positive so then I walked them straight to the ART clinic to get ART group counseling and start treatment."

Ewa Skowronska is a CHAI staff member in Malawi.