An interview with Shanine Mushonga, Community Adolescent Treatment Supporter at Africaid Zvandiri, Harare, Zimbabwe

Shanine is an International AIDS Society (IAS) Differentiated Care Youth Champion and provides psychosocial support to adolescents and young people living with HIV as part of Zimbabwe’s differentiated service delivery approach for adolescents. 

We had the opportunity to speak with Shanine about her reflections on the 9th IAS Conference on HIV Science (IAS 2017) and to find out more about differentiated care for adolescents and young people.

What was the highlight of IAS 2017 for you?

Two things stood out for me. First, adolescents were a focus of the conference. There were so many sessions focusing on young people and HIV, but what was even better was that adolescents and young people were involved in leading these sessions.

Second, the wide range of sessions on differentiated care were such a highlight. Some sessions were high level, like the ones led by the World Health Organization (WHO) and the IAS. This symposia showcased how differentiated care, or differentiated service delivery (DSD), has been adopted for adolescents and young key populations in global guidance and was exciting for me as I was involved in developing this guidance. But there were also many other sessions that demonstrated how different countries have adopted DSD and workshops showing how DSD is important for adolescents and young people.

How did you first get involved with differentiated care?

I have been working as a Community Adolescent Treatment Supporter (CATS) for three years in Harare. CATS work together with the Ministry of Health and Child Care to provide additional counselling and support for children and adolescents living with HIV in their homes and clinics. I’ve been committed for some time to ensuring that the specific needs of my peers are responded to. In 2016, l gave a presentation at the 21st International AIDS Conference (AIDS 2016) in Durban, South Africa with WHO and, after that, I was selected by the IAS to be a Differentiated Care Youth Champion.

How important are peers in differentiated care models for young people?

Young people are diverse; they are not a homogenous group. Their needs are changing all the time as they grow and develop. So differentiated care is a great approach for young people as it recognizes that services need to adapt to individual’s needs. The main thing is that as young people, we understand each other. As a young person living with HIV, I know and understand the experiences of my peers living with HIV. We can relate to one another. They know I understand how and what they have gone through even though we have encountered different problems.

What improvements to the delivery of HIV care would you like to see for young people living with HIV?

I would like the voices of young people to be amplified and when heard, what they want to be done. I want adequate HIV services to be given to all young people living with HIV while recognizing their diversity.

Can you tell us about your role as an IAS Differentiated Care Youth Champion?

My role was to develop a detailed understanding of the differentiated care needs of adolescents living with HIV in Zimbabwe and document, disseminate and advocate for these needs. As a Youth Champion, l conducted focused discussions, documented and disseminated the voices of adolescents living with HIV through multi-media platforms.

I had the privilege of hearing from such diverse communities of young people in different parts of Zimbabwe. I met with young people with disabilities, young sex workers, young LGBTI [Lesbian, Gay, Bisexual, Transgender and Intersex], and those living in mobile communities – and I’m now advocating for what they need. Although the discussions around DSD have often focused on where ARVs are provided, what young people repeatedly told me was more about how services are provided. I also trained and mentored health care workers on differentiated care and advocated for differentiated care for adolescents living with HIV in Zimbabwe regionally and internationally.

What do you want people to know about differentiated care for youth and young people in Zimbabwe?

Differentiated care for youth and young people in Zimbabwe is innovative in the sense that it takes services to the doorstep of young people. The previous “one-size-fits-all approach” to HIV treatment was problematic because young people are not a homogenous group. Young people are quite diverse.

A differentiated care approach recognizes that everyone is different. This is particularly important for young people who are growing and developing and many psychosocial issues influence their lives. They are increasingly independent, yet still reliant on others in so many ways. Since these issues are affecting adherence and retention, we need to address them. So let’s keep listening to adolescents as we roll out DSD models and ensure young people are involved in the way services are planned and delivered.

For more information:

Details on the Africaid Zvandiri Community Adolescent Treatment Supporters

Policy brief on the IAS Youth Champions, Young Lives, New Solutions

The power of peers #IASYouthVoices film, featuring Shanine Mushonga

Operational and service delivery manual for the prevention, care and treatment of HIV in Zimbabwe (2017), Ministry of Health and Child Care, Zimbabwe