How MdL helps prepare young adults affected by HIV in Honduras to lead happy, healthy lives.
By Chris Ratcliff, Montaña de Luz Board Member and former Long Term Volunteer
This is the third installment of a series of blog posts entitled “Building a Future.” We will highlight the role of Montaña de Luz in building a better future for families affected by HIV in Honduras.
Research has shown that it is impossible for a person living with HIV who has a suppressed viral load to transmit the virus. Two famous examples are the “Partner Study”, in which no transmissions were recorded among 900 couples where one partner was HIV+ and the “Swiss Statement” which reports absolutely no documented cases of transmission from a person with a suppressed viral load. Someone is considered to have a suppressed viral load when the antiretroviral treatment (ART) reduces the HIV virus to an undetectable level. The reality that the virus can be controlled with available medicine is an enormous source of hope.
Yet in Honduras, only 39% of people living with HIV have suppressed viral loads. There are many reasons for this statistic as there are many circumstances that can lead to families struggling to achieve consistent access to medication. But one issue that must not be overlooked are the unique challenges faced by children and youth living with HIV who represent not only the most vulnerable to stigma and depression but also the most power potential advocates in the fight to control the virus.
To understand this, it is critical that we put ourselves in the shoes of a child living with HIV. I am not a parent, but for those of you who are, I’m sure this will sound all too familiar. I remember being a kid and I remember often fighting my parents over taking medicine. I hated taking pills, it tasted bad, I was in a bad mood – whatever the reason I clearly remember that it could be a struggle. But I only had to take medicine infrequently, and rarely for long stretches of time.
Youth living with HIV at MdL have had to take medicine at least twice a day, every single day of their lives, since before they can remember. When they miss a dose, they don’t even feel any different. In fact it can be years before the effects of stopping taking the medicine can affect an individual. This is why education and empowerment are central to MdL’s approach to this complicated issue. From an early age MdL staff strive to teach the children about their medication and empower them to the greatest extent possible to take charge of their own health. To do this our staff, including our nurse and nurse’s assistant, our psychologist, our social worker, our homeschool teacher, and our tias and tios (caretakers) develop comprehensive plans for each child. In a group home, it is absolutely critical that every adult working with every child be on the same page as to the child’s progress, understanding, and autonomy regarding their treatment.
Yet as we all know, the health of a child does not stop with their individual physical health but extends to their psychological health: their connections to their peers, family, community and their ability to envision a future for themselves in their society at large. This is represented schematically by a concept known as the social-ecological model of health. In this regard, one of the greatest challenges to HIV-positive youth is stigma. Many of our children have experienced or are at risk of experiencing stigma, which is unfortunately still very much a problem all over the world, including Honduras.
Once again, I am reminded of being a child and of how sensitive children can be to their perceived differences with their peers. How they need acceptance for their healthy development and therefore how HIV-positive youth are especially susceptible to depression and low self esteem. It is so easy to understand that the easiest way for a child to try to forget that they have this virus that makes them feel different from everyone else is to ignore their medication.
This is why MdL strives to work with a model that address their interpersonal well-being, and the way in which they see themselves within their community and society. One way in which we do this is through the Luz Program; an HIV educational program led by the children of MdL. The children lead service teams and groups from in and around their own communities in an educational program in which they are able to become advocates for better understanding of the virus and reduced stigma.
Youth development programs such as these which focus on assets and strengths and that are led and coordinated by the youth themselves are powerful pieces of successful youth treatment. This kind of programming is buoyed by services teams such as the Youth Across Borders group which brings HIV advocates from the United States to share experiences in solidarity with the children.
The care of MdL’s children extends further still into their education and skills toward future careers and healthy positions in society. MdL has a homeschool program for youth who either struggle in a normal classroom setting or for children who, due to no fault of their own, may not have had access to schools before arriving at MdL. MdL further provides opportunities for the children of MdL to attend trade school in Tegucigalpa, to learn electricity, maintenance, and agriculture from employees at MdL as mentors.
The ultimate goal is to provide the children the care they need to be autonomous in their personal health care, that they have positive and safe relationships with their friends and family, and that they feel that they belong in their community. They face serious and varying challenges that no child should have to face. But we believe in them and we believe that with support they can overcome these challenges, achieve their dreams and become powerful agents for change for the HIV community in Honduras.