Meeting the needs of increasing number of adolescents with HIV in care in Rwanda

WE-ACTx provides comprehensive medical and psychosocial care to HIV infected children and their families through an integrated service delivery model, informed by Rwandan partner associations. Rwandan psychologists, trauma counselors, doctors, nurses, and family peer advocates staff the program. Support groups for children, mothers and fathers, and grandmothers meet weekly in different locations, and individual counseling is available for children with more serious psychological problems. Each Sunday, 150-175 children gather at the Islamic Center for outdoor activities, arts and crafts, a nutritional meal. A growing number of adolescents receive care and participate in these activities, including over 60 girls and boys aged 14-20. Support groups and special activities are targeted to these teens. Computer and English classes for the adolescents are held weekly as well. A group for girls has been meeting weekly to discuss issues of disclosure, sexual abuse, parental loss, and school needs. Housing instability, familial violence, abandoning school an poverty are pressing issues for many of the teenagers. Follow up individual psychotherapy sessions often address depression, post traumatic stress, and rape. The youngsters find it very difficult to plan for their future, because of the stigma of HIV, concern about death, and few opportunities. Age appropriate group activities, development of a peer adolescent program and exchanges with teens in other countries (virtually and actually) are critical components of a model which may begin to address these difficult problems.