How SNS initiative brings hope in Mbeya… Nicholas’ success story in HIV testing, counselling
MBEYA: HE is a hero and a beacon of hope with a heart of gold. These are just a few of the words that describe Erasto Nicholas, a nurse at Uyole Hospital in Mbeya Region, who has profoundly impacted the lives of many.
As a counsellor at the HIV/AIDS testing centre at Uyole Hospital, Mr Nicholas is not only a skilled nurse but also a trusted confidant. Colleagues say he has a gift for healing, with a warm smile and welcoming demeanor that put patients at ease from the moment they meet him.
They say with the best equipped hospitals or best buildings without doctors and nurses, patients won’t be able to get required health services.
Being in the frontline in offering health advice and education to at-risk patients so that they can test for HIV and control transmission, Mr Nicholas said for the period he has been working in the area, he can not mention any success without acknowledging the introduction of Social Network Strategy (SNS).
SNS is an evidence-supported approach to identify, engage and motivate people with undiagnosed HIV infection to accept HIV testing.
SNS is based on the underlying principles that people in the same social network share the same behaviours that increase the chances of getting or transmitting HIV, and, in addition, that people in the same social network know and trust each other.
SNS was for the first time introduced in Mbeya Region by the HJF Medical Research International, making it easier for both service providers and the clients to access HIV testing services in a conducive and friendly environment. HJFMRI offered intensive training on SNS to health service providers and support them with all required means of applying the strategy effectively.
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Mr Nicholas says the strategy enables him to reach many people within a short period of time since it assures privacy and thus minimise levels of stigmatisation.
He narrates that with training from HJFMRI and other support, he has been able to make calls, visit clients and conduct HIV testing exercise effectively.
SNS covers special groups of people, whose activities expose them to HIV infections. Female Sex Workers (FSWs) long distance drivers, drug addicts, mineral miners and adolescents are among targeted groups for testing HIV through SNS.
SNS have been effective in increasing new HIV diagnoses, have high acceptability for HIV partner services and are feasible for implementation across multiple income settings. Mr Nicholas uses invitation cards to bring in clients for testing.
After testing one client, he provides him/her some invitation cards to be supplied to friends, partners or whoever is close to him/ her.
The coupon contains the name of the testing centre, service provider mobile number, coupon number and the location of the testing centre. “I sometimes receives calls from various regions apart from Mbeya, people are calling me asking for testing procedures and counselling, I advise them accordingly,” says Mr Nicholas.
According to Mr Nicholas, under the SNS, people have developed trust and confidence of testing for HIV since the whole process involves the client and the service provider.
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It is all about trust and good approach by service providers. Through SNS coupon, the clients are free to make calls to service providers any time and arrange for appointment, this gives them comfortability since they do not feel exposed to many people.
The meeting followed with counselling, advises and testing for HIV, those who are found positive are advised to take medication.
“I sometimes reach to my clients after working hours, it happens some clients ask me to follow them at their homes or meet them somewhere, I always rush for them whenever they call me, this job is a call to me, I feel happy and satisfied to serve my fellow Tanzanians, SNS has enabled me and other service providers to save lives of many people,” says Mr Nicholas.
He added: “It happens I talk with clients for up to 6 hours, they open up and tell everything, and it is through this trust, people are comfortable to reaching out to HIV at-risk peers from their social or sexual networks,”. One of the clients *David Jackson (not his real name) who tested HIV positive says if he hadn’t been given an invitation coupon by his friend, he wouldn’t have been able to know his health status. He said a friend of him passed him the card and some few information regarding testing. “I felt comfortable to reach Mr Nicholas on phone after a friend of mine gave me the coupon, I met the service provider somewhere and we were only two, I felt comfortable and confident to tell him everything about my past relationships, he later advised me to test and the result came out positive,” said Mr Jackson.
He added: “I immediately started taking medication as per the service provider instructions. I also took some coupons, which I provided to my friends and partners, I hope they have reached him at their convenient times,” Mr Nicholas says with the introduction of SNS, the whole testing process counts successes, unlike before, nowadays his phone keeps ringing and when he receives, he serves one soul!
Mr Nicholas says with SNS in place, the response is satisfying. From January to August 8, this year, he provided a total of 659 and 632 brought clients in for testing.
According to the Tanzania HIV Impact Survey 2022-2023 (THIS 2022- 2023) the percentage of people living with HIV, known as HIV prevalence, is 4.4 per cent among people aged 15 years and older (4.5 per cent in mainland Tanzania and 0.4 per cent in Zanzibar) and varies by residence (5.0 per cent in urban areas and 4.0 per cent in rural areas.
The July 2023 World Health Organisation (WHO) key facts show that HIV remains a major global public health issue, having claimed 40.4 million lives so far with ongoing transmission in all countries globally; with some countries reporting increasing trends in new infections when previously on the decline.
There were an estimated 39.0 million people living with HIV at the end of 2022, two thirds of whom (25.6 million) are in the WHO African Region. In 2022, 630,000 people died from HIV-related causes and 1.3 million people acquired HIV.
There is no cure for HIV infection. However, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
