An interview with Mahawa Sylla, independent activist and humanitarian affairs officer at Médecins Sans Frontières (MSF), Guinea

Mahawa is an activist working with people living with HIV networks and MSF to scale up differentiated service delivery approaches in Guinea. 

Can you tell us about your work and why you decided to pursue a career in the HIV field?

My name is Mahawa Sylla and I am an independent HIV community activist and counsellor based in Conakry, Guinea. I also work at Médecins Sans Frontières as a Humanitarian Affairs Officer. I decided to put HIV at the centre of my activities because, as a person directly affected by HIV, I feel that I must actively participate in improving the quality of life of all people living with HIV. It is important for me to take an active role in HIV-related decision making and ensuring that the voices of people living with HIV are represented.  

Can you tell us more about your work with community organizations and people living with HIV networks?

My main tasks are providing psychosocial support to people living with HIV (face to face and online), supporting the community observatory (including gathering information about the availability of HIV drugs and commodities), providing community-level HIV prevention and testing services, and advocating for quality HIV care.

Regarding my role as an HIV activist, I am a founding member of VIE+ (an association of people living with and affected by HIV), established in 2006. VIE+ is a member of REGAP+, the national Guinean Network of Associations of People Living with HIV.

What are the advantages of engaging community organizations and people living with HIV networks in the development and delivery of differentiated service delivery models?

Through the involvement of people living with HIV networks in the development and delivery of differentiated service delivery (DSD) models, we are able to provide a larger range of care and support options, including psychosocial support, to clients seeking care. These models also allow clients to access care closer to home and develop a sense of responsibility for their HIV management.

Looking at service delivery, ranging from HIV testing and treatment initiation to care and support, what do you see as a priority investment in your country?

Community-based testing and quality psychosocial care still have to be strengthened in Guinea. For those who are at risk of becoming lost to follow up, it is important to provide home visits, which, in my view, are small efforts when compared with the potential outcome. There are still people whose lives can be saved thanks to a home visit.

In addition, many clients fear HIV-related stigma through the presence of implementing partners in the community whose logos and cars are associated with HIV. For this reason, many clients prefer receiving purely community-based services. To provide community-based services, including home visits, at a larger scale, we need to review the current HIV service delivery strategy.

Lastly, we need to do better in promoting and correctly performing viral load tests for every person living with HIV when they need it.

From the perspective of people living with HIV in Guinea, what has to change to better respond to their HIV service needs?

Several things have to change. First and foremost, the meaningful engagement of people living with HIV in the provision of HIV care and discussions is key for services to better respond to their needs. In relation to this, the current law regulating HIV prevention, treatment and epidemic control in Guinea dates from 2009 and should be updated to more appropriately reflect the rights and needs of people living with HIV.

Looking at service provision, there is a lot to be done to improve supply chain management. We also need to get better in providing biological examinations before people are put on treatment. In addition, those prescribing HIV drugs need to be monitored well by those responsible for the provision of HIV services.