“Once it sunk in that I was HIV positive, my thoughts went to my children. I decided I could not give up,” said Abaynesh Tafa, a 37-year-old mother of seven in Ethiopia.
Tafa’s first husband died when she had three children. She learned her HIV status during an antenatal visit to Echini Health Centre, after she got pregnant by her second husband. Since learning her status and receiving counseling and treatment she has turned her attention to a community HIV awareness programme.
During the third International Conference on Family Planning, Dr Yonas Getachew, who is a clinical advisor to Echini Health Centre and works for IPAS – an organisation focused on advancing women’s reproductive rights – said: “This centre in Oromia district, 60 kilometers north-east of Addis Ababa, is just like other health centres across the country, where women can access sexual and reproductive health services as well as HIV services all in one place. The Ethiopian government has had a policy of integrating services for around ten years and can this, at least in part, can be credited for the decreasing HIV rate in the country.”
Tafa said: “During my fourth pregnancy, I heard rumours that my husband was taking HIV drugs. I got tested and was later told that I needed to get counselling, after which I was told my results.
“I was prepared because of the rumours I used to hear about my husband. I sat down and thought about my children and started to imagine what would happen to them if I died, so I decided to live positively. However, I still wanted to get the truth from my husband about his HIV status.”
When Tafa approached her husband he readily admitted that he was taking antiretroviral medication (ARVs) and apologised for not having told her earlier because he feared he would lose her.
Tafa said: “I was disappointed and very angry. Life become very difficult for me, but later my thoughts turned to my three children. I started to think of them living without me. I imagined them without support and with a bleak future, so I decided to go to the health centre to receive further counselling and information.
“I started taking ARVs and I convinced my husband to seek further medical help. Although he knew of his status and did not tell me, after that we lived happily.”
Her husband later become unwell and was admitted to Echini Health Centre, where he died soon after the birth of her seventh child, who is now five years old. “I cared for him during his sickness and started to talk about HIV with my children and community, including the people who had told others about my husband being HIV positive,” Tafa said.
In her community education meetings, Tafa teaches people about the preventive measures they need to take. “I go to schools to teach about HIV,” she said. “And I take advantage of gatherings to tell my story. I urge all people to get tested before getting married and explain that those who want to engage in sex must always use condoms.”
Tafa decided to go into community education because she wants others to learn from her experiences, particularly young people. She explained: “It is my responsibility as a citizen. I am responsible for my children and I want others to learn from me. I talk about my challenges and experiences so that no one should go through what I have gone through.”
Integrating HIV and reproductive services
The need to encourage more people like Tafa to engage in community-based responses was one of the issues under the spotlight throughout the four-day international conference. There was also a big focus on youth, including a need for youth-friendly HIV and family planning services to increase uptake among those most at risk of HIV and unplanned pregnancies.
New research published at the conference shows nearly 20% of young people never make independent decisions regarding their sexual and reproductive health. This comes from a global survey carried out by Link Up, a project to reach one million young people in five countries including Ethiopia with integrated HIV and reproductive health services.
Ethiopia is already leading the way by integrating family planning to antiretroviral treatment sites, which not only saves lives but can also save $25 for every $1. But much of the international community needs to catch up and advocates continue to call for greater support of integration in the post 2015 development agenda.