In 2021, when Muupakange Nghukwete was just 12 years old, he was diagnosed with HIV. An orphan living in the province of Cunene in southern Angola, Muupakange faced many challenges in adhering to his antiretroviral therapy (ART).
With the help of the Reaching Impact, Saturation, and Epidemic Control (RISE) program, young people like Muupakange are getting a second chance – at a healthy life and future.
Supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID), RISE Angola supports continuity in HIV care by reducing interruption in treatment and ultimately helps people living with HIV achieve viral suppression, among other aims.
Muupakange suffered from skin lesions that were difficult to treat, leaving visible scars on his face and body. He became a victim of bullying at school and by some family members due to his scars. He stopped going to school, church, and even ART appointments.
In May 2024, Muupakange was referred to a RISE HIV counselor who recognized that he needed specialized medical care and additional support continuing his HIV treatment. The RISE Angola team carried out a plan to send Muupakange to a provincial hospital in a nearby province, Huila, where he could get the specialized care he needed. Since the hospital was 381 km from Ondjiva, where Muupakange normally receives care, the RISE program collaborated with HIV focal points in Cunene, Huila, and Ondijva hospitals to mobilize financial resources to ensure that Muupakange’s travel and living costs were covered.
“It is absolutely crucial that we support young people to maintain consistent antiretroviral treatment,” said Ruth Bernadeth, a provincial officer for the RISE Angola program. “We must especially protect vulnerable young people, including orphans, who are more susceptible to mortality with early interruptions of treatment. Our goal is to really put the patient first and try to understand what factors may be influencing their challenges to treatment adherence.”
By July 2024, specialists at the Huila provincial hospital were able to remove the lesions covering Muupakange’s face and upper body. Today, Muupakange reports that he is no longer the target of bullying, he re-enrolled in the 2024-2025 school year, and he has reinitiated ART.
Eighteen percent of patients who start ART at Cunene are between 10 and 24 years of age. There are currently 600 young people receiving ART in the province, of whom 375 receive it at the provincial hospital in Ondijva, where Muupakange is enrolled. Like Muupakange, many of these young people face barriers to continuity in their HIV treatment.
The RISE program mobilizes resources – often in partnership with local civil organizations and other government authorities – to support people like Muupakange living with HIV to overcome challenges in maintaining treatment, whether through the purchase of food baskets to supplement a family’s nutritional needs, supporting rent payments, providing temporary shelter for those whose family members have rejected them, or providing transportation to and from health facilities.
RISE Angola also supports youth peer counselors known colloquially in Angola as “Kamba,” or “friend,” who work directly with youth who have interrupted or have yet to initiate treatment to better understand their HIV status. Youth peer counselors, who are living with HIV, work with youth to develop plans for disclosing their HIV status to trusted loved ones. In addition, in adherence support groups run by youth peer counselors, youth have a safe space to socialize, discuss their health, and even engage in games and other activities – to ensure they can focus on being kids again.
“Stigma and discrimination against people living with HIV often prevent young people from seeking or adhering to treatment,” said Luisa Chauca, RISE Angola chief of party. “The RISE Angola program is both working to support youth living with HIV but also engaging and integrating youth perspectives into HIV program development and implementation. This strategy is essential for closing gaps among young populations.”
About ICAP
A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu