Clinical Officer makes strides with adolescent HIV support groups

Meshack Murto is 36 years old and has worked for 11 years as an AMPATH clinical officer. Murto has been with AMPATH long enough to witness some of the "good" and some of the "bad." The good is that far fewer babies are presenting with HIV in the AMPATH clinics. That is a product of a successful prevention of mother-to-child transmission program. The bad relates to the large number of HIV-infected babies and toddlers originally served that are now becoming adolescents. 

It would surprise no one that nothing can be more difficult than managing an HIV-infected adolescent. Many of these children have lost one or both of their parents. In addition, many are unaware that they have HIV. They have been told a variety of stories by parents or guardians over the years to entice them to take the daily (unknown to them) HIV antiretroviral drugs. However, without disclosure of their HIV status, one cannot expect to sustain this facade as the child approaches teenage years. Yet with disclosure comes all of the pain and self-doubt of realizing that one has HIV, making it understandable why caregivers are reluctant to inform the adolescent about his or her status. Add that burden to the normal challenges of the teen years—so much is already going on in one's body and so much relates to relationships with peers. Successful disclosure, however, promises better adherence to medication, a suppressed virus, and normal health. Failure to manage disclosure properly can become a key component of a downhill spiral and death.

Murto developed a keen interest in the issues around disclosure five years ago as he began to assist parents, guardians, and his patients toward disclosure of the HIV status of the child. About one year ago, Murto decided to create a support group targeting adolescents. He knew that disclosure alone would not be enough. The teenagers needed to realize they were not alone. Their endless questions all had answers. They could gain strength and confidence from each other. The invitation got out to every HIV-infected adolescent he could find at his clinic and only three patients showed up for the first meeting. Murto is not easily discouraged. He encouraged his colleagues in the clinic to make one day a week an adolescent clinic day. Today, he now has enrolled 223 teenagers. The teenagers that come to the support group are broken up into groups of ten to have maximum interaction with peers and the staff leader.
The group picture above represents the first effort to have as many teens as possible come on a day that school is out. And it was a success, filled with songs, dancing, and clear evidence that Murto's children are not alone and they indeed have a limitless future.

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