” Today, 20 years since her diagnosis, Thembi is healthy with no detectable virus in her body. She began HIV antiretroviral treatment – a daily cocktail of three separate drugs – and slowly her health and her strength returned. Today, more than 20 years since her diagnosis, Thembi is healthy, with no detectable virus in her body. She is also the mother of two boys, both of whom are HIV-free.
Hope in the Epicenter of the EpidemicEswatini, a small kingdom in Southern Africa, was once on the brink of destruction due to HIV. Thembi, an HIV advocate, lives in a rural area of Eswatini. In 1999, before treatment was widely available, she was diagnosed with HIV. Thembi’s Journey On an early Tuesday morning in 1999, Thembi made the 20-mile trip from her home nestled in the rural hills of the tiny kingdom of Eswatini to the nearest health clinic to get tested for HIV. Her husband had exhibited symptoms of the disease and she was afraid she may have contracted the potentially deadly virus.
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Ryan. “It shows how a country with such severity of burden can achieve success through determination, collaboration and an aggressive data-driven approach to treating and preventing HIV. ” But challenges remain – for people like Thembi living with the disease and for the country as a whole. In 2018, nearly 8, 000 adults in this small, landlocked Southern African country were newly infected with HIV and almost 3, 000 people died from an AIDS-related illness – a staggering number considering the population is less than 1.
She spoke with the nurse about her risk, she sat through counseling, she even provided a sample, but she was afraid of what came next. So afraid, in fact, that she didn’t wait for the nurse to return with the results. Her fear was understandable. These were the early, dark days of HIV in Eswatini. A time where stigma and fear around the disease prevailed – even more so than it does today. Few people had access to treatment and a positive diagnosis was almost certainly a death sentence. Once back at home, Thembi only became sicker. She began exhibiting symptoms of the virus. Then she contracted tuberculosis (TB) – a ravaging disease that often attacks those with HIV because of their weakened immune systems. In fact, TB is the number one killer of those living with HIV.
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5 million. And despite the prevalence of the disease in the country, stigma remains pervasive. Left: Today, Thembi is a peer supporter for others in her community, like Thuli**, who was recently diagnosed with HIV. She is supporting Thuli to get and stay on treatment so that she can become virally suppressed.
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Shortly after this, she developed pneumonia and became so ill she was bedridden for more than a year and a half. Then, she lapsed into a coma. Her family, her doctors, they all believed she would never recover. But after two weeks, miraculously, she woke up from the coma, and learned the hard news: she was, indeed HIV positive. By this time, she was determined to fight. “For those two weeks, I was like a dead person, ” she recalls, “but when I came back from the coma I realized, yes, I want to live.
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“Back then, people in Eswatini often had to decide which funeral to go to on any given day, ” recalls CDC-Eswatini Country Director Caroline Ryan M. D., “those were very dark days. ” Then, the Government of Eswatini declared HIV a national emergency. With the support of PEPFAR* and CDC, the country engaged in an accelerated, multi-sectoral emergency response to ensure effective HIV treatment and prevention to all citizens who needed it. “Under the leadership of the King, with the full support of PEPFAR and with CDC’s technical expertise on the ground, we were able to launch a comprehensive response that helped transform our approach to this epidemic, ” says Rejoice Nkambule, Deputy Director of Health Services in the Eswatini Ministry of Health.
Top Right: At this CDC-supported clinic, Thuli will receive the range of HIV treatment services that has helped pave the way for epidemic control in Eswatini. Bottom Right: Thembi meets her client at her home in the hills of rural Eswatini – and will travel with her to a clinic several communities away to recieve HIV treatment and care. CommLink – CDC’s Peer Linkage Program On this day, Thembi is providing peer support as an expert client for Thuli** — a 28-year-old woman who has just learned, a few weeks earlier, that she is HIV positive. She tells a heart-rending story of having recently left her partner who threatened her with bodily harm if she ever became HIV positive.
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