Wiedeman, Danielle

Public Health

MHS

Ethiopia

Ethiopia- Pediatric ART Youth Center Support

An estimated 72,945 children under the age of 15 are living with HIV in Ethiopia today. The introduction of Antiretroviral Therapy (ART) is transforming HIV from a life-ending diagnosis into a chronic disease. With this transition comes hope, but also a new set of challenges. HIV positive youth may struggle with shame, isolation, and depression. These feelings may be further exacerbated by the loss of one or both parents. Comprehensive care for HIV positive youth addresses these struggles and includes age-appropriate education, development of coping skills, and psycho-social support in addition to medical care. These skills can help improve quality of life, increase adherence, and curb disease transmission. Programs throughout Africa have successfully addressed these needs by establishing teen clubs or Youth Centers. We have started establishing Youth Centers at different hospitals in Addis Ababa and SNNPR region of Ethiopia to address the unique needs of HIV positive adolescents aged 10-16. The main gols of the Youth Centers are to provide psychosocial support to improve quality of life, to promote treatment adherence, and increase involvement of parents. Interns will work at these Youth Centers to help enhance comprehensive HIV care and assist with critical psychosocial support.

As a second year masters student focusing on child and adolescent health and development, I was very fortunate to be offered a position at The Technical Support for the Ethiopian HIV/AIDS Initiative (TSEHAI) in Addis Ababa, Ethiopia. An affiliate through Johns Hopkins, TSEHAI works to minimize morbidity and mortality among HIV infected individuals based on a widespread scale-up of anti-retroviral therapy. My role and responsibilities focused specifically on the adolescent population in establishing, strengthening and maintaining programs providing additional psychosocial support within health facilities. We concentrated on the psychological and social pressures that accompany HIV status disclosure via vertical transmission and recognized the overwhelming stigma and seclusion many face from society. Establishing youth centers around Ethiopia helped us to enhance comprehensive HIV care and treatment adherence through health education, while also curbing future transmission and alleviating common stressors affiliated with this chronic disease.

At first, I was somewhat taken aback with the overwhelming need of psychosocial support among this population. Understanding the great strides TSEHAI has made in providing anti-retroviral therapy to those in Ethiopia, it seemed simple to supplement this initiative by executing a program that taught the importance of health and empowered youth to be engaged in their treatment plan, while also supporting them psychologically in normalizing and accepting their HIV diagnosis. I learned very quickly though that once in the field, things aren’t as straightforward as you once envisioned them to be. But by spending time with these incredible adolescents, listening to their stories and getting to know almost all three hundred of them made it very easy for me to modify things according to their suggestions and create a guideline made up of topics and concerning issues they felt comfortable discussing amongst each other. Before I knew it, youth attendance had almost doubled, (maybe partially due to the added bonus of a foosball table) and we quickly began looking for ways in which to accommodate all youth seeking out our services. What I didn’t anticipate was the overwhelming encouragement we received from the healthcare professionals, who insisted in doing everything in their power to make these programs successful and effective. The sheer enthusiasm they brought to every youth meeting and the bonds they helped create between adolescents, gave every individual a sense of belonging they might not get anywhere else. Even now, I am confident they continue to work diligently towards increasing the quality of life among HIV youth, while shedding light on the fact that they have the control of possessing a long and healthy future.

This experience allowed me to create a vision and see it through. From writing proposals, to creating structured guidelines and collecting baseline data, we successfully built a strong foundation. Through training health professionals and empowering peer advisors, we are working towards maintaining program effectiveness, sustainability and future expansion. This opportunity has helped to reinforce my aspirations to continue working on child and adolescent health issues from an international perspective. Moving forward, I am interested in continuing down the path to program evaluations and possibly even a career pertaining to more research-focused responsibilities. I am intrigued by the essential components encompassing psychosocial support and hope to further explore this in the near future. If Ethiopia has taught me one thing, it’s the essence of teamwork. Being a part of a team that shares a common goal is an incredible feeling; especially knowing that common goal will one day influence the lives of thousands of youth across the country.

People

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program
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December 2019

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