Empowering young women in the fight against HIV

FACT Malawi, or Forum for AIDS Counseling and Training Malawi, is a youth-led organization that advocates for adolescent girls and young women by providing sexual and reproductive health (SRH) services, which include HIV testing, prevention and treatment Sexually transmitted diseases include infections (STIs). Madalitso Juwayeyi is a program manager at FACT-Malawi and presented research at AIDS 2024 on the Let Girls Shine program for disadvantaged adolescent girls and young women: “Mitigating HIV Transmission Risks From Young/Teen Mothers to Children: Lessons From the Let Girls.” Shine Program for Disadvantaged Adolescent Girls and Young Women (AGYW).”

This transcript has been edited for clarity.

Transcript

Can you tell us about the founding of FACT Malawi and the services you offer?

Our work focuses on improving access to sexual and reproductive health and HIV prevention services with the aim of finding solutions to problems of high HIV prevalence among young people, particularly adolescent girls and young women; termination of unwanted pregnancies; finding solutions to sexual and gender-based violence; as well as to [help] Poor girls who have no education complete their education. We also want to empower the youth.

Our organization was founded in 2017 and has been operating since then. In order to focus more on projects we have carried out in and around HIV, we have carried out projects primarily focused on addressing the need of young people, particularly young girls and young women, to seek HIV prevention services. This also includes HIV testing and access to PrEP [preexposure prophylaxis]and also condoms. Because of the issues raised by young people we work with in 2020 – not having access to youth-friendly services, being reluctant to use the services, not being able to discuss sexual health issues, Because It is considered taboo in our culture for parents and children to have this conversation, so we have opened a youth-friendly health center.

We have a youth-friendly health center that is entirely focused on young people, a clear, innovative youth-friendly center, from one young person to another. At the youth center, we offer HIV testing, provide HIV prevention services such as condoms and PrEP, and also provide SRH services such as family planning. We conduct training, counsel, provide spaces for victims and survivors of sexual reproductive health, and pretty much everything. This can empower young people to be the best citizens they can be.

Our goal in the future is to ensure that our center not only provides services, but can also offer treatment options for young people. We have a program called Comfort Corner that focuses on young people living with HIV. We also see that although we have Comfort Corners where young people living with HIV can come and interact with us if they want treatment at the same time, they still need to look elsewhere where it is available are older people. That's why we received complaints about this. That's why we want to ensure that our center expands and can become an important youth clinic where people can get tested and also treated for HIV, sexually transmitted diseases and everything related to their sexual reproductive health.

Can you describe the Let Girls Shine program and its importance in reducing HIV risk among young women and teen mothers?

I have been working with young people for six years, especially with the education of girls and young women, and in our center we have a lot to do with young people, especially young girls. Let Girls Shine, the term was originally intended for a different project. But due to the success of this project, we thought we could continue using the name and introduce other programs.

Specifically, it says that adolescent girls and young women in Malawi, 29% of them, are pregnant before their 18th birthday, [and HIV is 7 times more prevalent] than their male colleagues. And there's a lot of maternal health happening, 10% of it coming from adolescent girls and young women. So I saw a gap in that. Why are adolescent girls dying from sexual and reproductive health problems, and what can we do to help?

Through Comfort Corner, we also happen to have teen mothers who are mothers but also living with HIV. So we had a conversation with them to see what was going on, what was happening, and through that research, where we got case studies and stories from people, we found that a lot of adolescent girls and young women are changing because of intergenerational relationships infected with HIV. Due to poverty issues, they enter into relationships with men older than them for money, and the power dynamics in these relationships make it difficult for them to negotiate safe sex. They end up having planned sex, becoming pregnant and becoming infected with HIV in the process.

Our project is designed to empower them to negotiate safe sex while ensuring that if they test negative at the time of their baby's birth, they do not transmit the virus to their child in the years they are breastfeeding. But even if they tested positive and their baby tested negative upon discharge, that means they also need to make sure they don't transmit the virus. And if both are negative, it is also necessary to ensure that there is no transmission of HIV during the two years that the mother is breastfeeding. Because there were cases where teenage girls were discharged even though they were negative, but in the process they became infected with HIV because it was now their baby and they needed resources to take care of the child. Maybe the husband is no longer in the picture, or they return and contract HIV. And because they don't even believe they can become infected with HIV, they forego a test and give it to their baby instead.

So we set out to find the implementation on our own. We want to make sure that we have centers that are specifically for teenage mothers where they can come, talk to each other, bring their babies for testing and just have a user friendly environment where they feel comfortable and from which you can learn.