Women Making a Difference

Overcoming HIV Stigma at the Center of the AIDS Pandemic

	Zanele with her children, Phiwa and Nkosingphile, and her mother Alice. Source: Jon Hrusa/EPA

Just one year ago, Zanele was a young mother facing a precarious future in rural Swaziland.

She and her husband, Mfanzile, owned a tiny, one-room house at the top of a hill, in a small village about 50 kilometers east of the capital Mbabane. They lived there with their infant daughter, Phiwayinkhosi, whom they called Phiwa.

Life was hard; there was barely enough space for the three of them, and they earned very little money. Sometimes there was not even enough food to eat. And there was one more challenge for this young, struggling family: Both Zanele and Mfanzile were HIV positive.

“Despite all of these difficulties, we were happy,” said Zanele. “Mfanzile and I lived for Phiwa.”

Phiwa was born in 2008, HIV negative thanks to the health services that she and Zanele received at the Mkhulamini Clinic, supported by USAID and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).

Pregnant women bear the brunt of the HIV burden in Swaziland, a country with the highest HIV prevalence rate anywhere in the world. But because of the aggressive response of the country’s Ministry of Health – working with USAID and private implementing organizations like EGPAF – services for the prevention of mother-to-child transmission (PMTCT) of HIV have become widely available in clinics throughout the country. Now three out of four pregnant, HIV-positive women in Swaziland are receiving the medicines they need to protect their babies from the virus.

Unfortunately, some women and their children still slip through the cracks. Before Phiwa was born, Zanele and her first baby, Tema, was one of those cases.

After a then 20-year-old Zanele became dizzy during school exams and was taken to the hospital, she learned she was pregnant. It’s also when she made another life-altering discovery: She was HIV positive.

Zanele with her husband Mfanzile and her son Phiwa. Source: Jon Hrusa/EPA

She told Mfanzile about her HIV status, but he was unreceptive to the news and refused to get tested. Although all parts of Swazi society are affected by this disease, there are still high levels of stigma around HIV, particularly in rural areas.
Zanele dropped out of school and gave birth to a baby girl, Tema, but didn’t receive the medications needed to prevent passing on the virus to her daughter. Tema died shortly after turning 1 years old.

In 2007, HIV caught up with Mfanzile, and he became ill. He was finally tested for HIV and learned that he too was HIV positive. The couple started receiving antiretroviral treatment to control their HIV infections, and his health improved.

After receiving PMTCT services, Zanele gave birth to Phiwa in 2008. This should have been a happy ending for this young family, but things soon took a turn for the worse. Mfanzile’s HIV treatment began to fail, and in June 2010, he died from AIDS-related complications. At the time, Zanele was six months pregnant.

Despite being evicted from her home by Mfanzile’s family, Zanele continued to take her ARVs and go to the clinic for PMTCT services. Three months after Mfanzile’s death, Zanele gave birth to a baby boy, Nkosingphile. His name means “Gift from God.”  So far, he has tested HIV negative.

Zanele is now living in her home village with her mother, Alice, who is also HIV positive. Alice actively works to eliminate stigma around the disease in her own community.

Despite the hardships she’s faced, the future looks brighter for Zanele. Her children are living proof of the potential to eliminate pediatric AIDS, even in a high-prevalence country like Swaziland.

“I see a long life ahead for myself and my children,” Zanele said. “I believe that Mfanzile is looking down on us from somewhere, and he is smiling.”

Story provided by the Elizabeth Glaser Pediatric AIDS Foundation

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