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Teenage mothers, Children Living with HIV

Triumphing Over Teenage Pregnancy, HIV and Stigma: Janesten’s Journey to Preventing Mother-to-Child Transmission of HIV

In the remote village of Kasipodo, Osukuru Sub County, Tororo District, Eastern Uganda, Janesten (pseudonym) has been quietly battling the odds, overcoming not only the challenges of being an HIV-positive teenager but also the harsh realities of both HIV/AIDS stigma and teenage pregnancy to achieve safe motherhood.

A Childhood Marked by Loss

Janesten was born with HIV/AIDS and began her life’s journey without the nurturing presence of her mother, who died of HIV when Janesten was just a year old. Raised by her stepmother and father, life took a challenging turn when, at the age of 15, her father searched for better opportunities in Kampala, leaving Janesten in the care of her stepmother.

In the hands of an unsupportive stepmother, Janesten’s life became tough as she lacked basic needs. She moved from one relative’s house to another, facing instability that disrupted her life, health and education, missing clinic appointments and struggling with poor ART adherence. At just 16 years old, Janesten faced an additional challenge: teenage pregnancy.

The Turning Point
In September 2022, Janesten’s viral load test revealed 16,500 copies/ml, and she tested positive for Tuberculosis (TB). Determined social workers and para-social workers stepped in to closely monitor her ART adherence and TB treatment. During their interactions, Janesten courageously shared the stigmatization she endured while on TB drugs. She described a situation where she was denied food, her cups and plates were separated, and she had to care for her child without a stable income. Her stepmother, burdened by their presence, provided little support.
This dire situation prompted Janesten to take a bold step for her and her child’s wellbeing. On March 15, 2023, she left her father’s home and sought refuge with her paternal aunt in Kasipodo.

The Journey to Restoration
Janesten’s viral load remained unsuppressed even when she had completed her TB treatment largely due to missed ART appointments. It was soon discovered that the primary reason for these lapses was the lack of transport and the considerable distance to the healthcare facility, a 22-kilometre trip. Thanks to the USAID OVC NE Activity intervention, which facilitated transport for Janesten, she gained access to vital services. In collaboration with the clinical team, the Activity provided intensive adherence counselling, viral load testing, ART refills, and a second PCR test for Janesten and her child, who were due for their appointments.
The team of both Social and Para-social workers provided unwavering encouragement and counselling to the young mother, emphasizing the critical importance of adherence to her medication to prevent mother-to-child transmission. Simultaneously, they offered vital support to the caregiver, recognizing the significance of her role in achieving better treatment outcomes for both Janesten and her child.

A suppressed viral load
These collective efforts bore fruit on July 10, 2023, when Janesten received the long-awaited news: her viral load results came back as “Not Detected,” and her baby’s results from the second PCR test were negative.
This remarkable milestone served as a powerful motivation for Janesten to continue adhering to treatment, ensuring not only her suppression but also preventing any possibility of mother-to-child transmission. With determination and resilience, she is breaking free from the shackles of teenage pregnancy, HIV, and stigma.
The collaborative interventions and support from various stakeholders, including the dedicated clinical team, the OVC partner, and household beneficiaries, have lit the path towards positive change. Together, they are working tirelessly to achieve the desired goal of viral load suppression and zero new infections by the year 2030, reaffirming the transformative impact of collective efforts in the fight against HIV/AIDS.

Agnes Tumuheire

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