The Power of Sisterhood: HIV-Positive Women in Mozambique Stay Healthy Through Community Adherence

Lily Tivane poses with her daughters: Lucia, 14; Rudivania, 4; and Emilia, 9

Arsenio Manhice/EGPAF

Lily Tivane is a proud mother of three living in the Bairro 4 residential area of Chicumbane, which is about 10 kilometers from the Chicumbane Health Center in Mozambique. Although she is living with HIV, her two older daughters, Lucia, 14, and Emilia, 9, were born without the virus thanks to prevention of mother-to-child transmission (PMTCT) of HIV services. 

But Tivane sometimes struggled to maintain her therapy because of difficulties getting to her clinic regularly—resulting in her transmitting the virus to her youngest child, Rudivania, who is now 4 years old. Since then, however, Tivane has been a pioneer member of an HIV/AIDS community adherence support group, which ensures that she and young Rudivania take their antiretroviral medication (ARV) regularly.  

Tivane is a member of Grupos de Apoio a Adesão Comunitária (GAAC), which uses a community approach to collect and distribute ARVs to HIV-positive women. Based on a model established by Doctors Without Borders, the Elizabeth Glaser Pediatric Aids Foundation (EGPAF) has been implementing GAAC for the past two years in Mozambique’s Gaza province.

The GAAC program brings together as many as six individuals, usually women, living with HIV. They are joined through a common point of contact—perhaps they live in the same neighborhood, work in the same location, or attend the same church. Every month, one person from the group visits the local health center and picks up ARV’s for herself and the other members of the group. While she is at the facility, the designated group member will consult with her provider for her six-month check-up. Upon returning from the clinic, she then distributes the ARVs to her peers. Each month a different group member makes the trip to the health facility.

Since EGPAF’s program began in November 2011, more than 1,400 people have signed up for GAAC—and its members have shown a higher rate of ARV retention than patients who have not joined support groups. Tivane’s group—which consists of five women and Tivane’s husband—has never lost a member after more than 12 months of rotations. The program is successful because it helps group members save time and transportation costs.

“We decided to create this group once we understood how it works and its importance,” said Cristina Cuna, the group’s leader. “The time spent before on ARV pickup is now spent on other activities, such as farming, selling in the market, and sewing,” she said.

According to Cuna, her husband and other family members have been supportive, offering to collect the drugs for the group if a member is unable to do so during her turn. In addition to benefits to their own health, budgets, and schedules, group members say that they are pleased that GAAC helps them educate their neighbors about the importance of HIV testing and treatment.
“We want to thank EGPAF, which has been helping us all along,” said Tivane on behalf of the group.

EGPAF works to ensure that HIV-positive women throughout the world have access to critical HIV/AIDS care and treatment. To learn more about EGPAF’s work in Mozambique, click here.  

Arsenio Manhice is EGPAF’s Communications and  Advocacy Officer, based in Mozambique.