By Selma Shiwaya
Self-introspection and responsibility are what 47-year-old retired sex worker Scholastica Goagoses needed to adhere to HIV treatment and become virally suppressed.
Scholastica is a mother of four children who works as a Case Manager under the USAID-funded Key Populations - Strengthening Technical Assistance and Response for Sustainable HIV Prevention and Treatment (KP-STAR) project implemented under the leadership of IntraHealth Namibia.
Previously, Scholastica engaged in sex work for a living to provide for her family, particularly her children. In 2007 she tested HIV positive and resorted to drug and alcohol abuse. When she was initiated on HIV treatment, she did not adhere to treatment which weakened her immune system.
“My HIV positive diagnose result was the most difficult news at the time due to fear, limited information, stigma, and discrimination. I feared dying and started abusing alcohol and drugs. My body was weak, and I was diagnosed with Tuberculosis (TB) with a body weight of 27kg in 2010,” Scholastica recalls.
Whenever Scholastica defaulted on treatment she would change to a different facility and pretend to be a client testing for the first time and initiated on treatment.
“My struggle with treatment adherence continued. I moved from one health facility to the other and always registered myself as a newly diagnosed HIV positive patient”, she narrates.
Scholastica’s life, however, took a turn in May 2020, when she was recruited as a Case Manager in Gobabis under the KP-STAR project. Her role is to ensure that clients who test HIV positive are linked and enrolled into antiretroviral treatment (ART) ideally until they are virally suppressed. She also ensures that clients who test HIV negative and are at high risk of acquiring HIV transmission are initiated on Pre-Exposure Prophylaxis (PrEP). She also links clients to other health and social support services they may require.
She stated that the Case Manager’s role has been a life changer for her. “Considering my defaulting history, I first had to evaluate myself. I took a very important step in my treatment adherence journey to request for a transfer from Katutura Health Center in Windhoek to Epako clinic in Gobabis. “At the time of my transfer, my viral load was very high. But with the support of the Epako clinic staff, and through the USAID funded KP-STAR project I became a ‘star’ ART patient. I am now virally suppressed, and I’m proud because I cannot transmit the virus to anyone” says Scholastica.
Scholastica has become a role model for many people living with HIV and an advocate for the Undetectable = Untransmissible (U=U) campaign for KP-STAR project. As a Case Manager, Scholastica is committed to helping Female Sex Workers living with HIV to lead happy, healthy, safe and fulfilled lives. Scholastica also helps clients that are HIV negative to protect themselves from acquiring HIV. Currently, she has 139 clients on ART and 51 PrEP clients under her case management.
“I enjoy case management a lot and knowing that I have helped many people that is enough to have made a difference in people’s lives,” she concludes.
Ms. Fayonce Van Wyk, Omaheke Regional Coordinator for IntraHealth Namibia, asserts that the fact that Scholastica is open about her HIV status makes it easier for her to carry out her work.
“Scholastica has received case management training from IntraHealth Namibia, and she is also a certified Rapid Tester. She knows all her clients as well as their file numbers by heart which shows high level of commitment towards her work,” says Ms. Fayonce.
Scholastica is a living testimony of how a person can change and influence others to fully benefit from services provided by the Ministry of Health and Social Services in collaboration with projects such as the IntraHealth Namibia-led USAID supported KP-STAR project. She is also a good example of how to remain healthy while living positively with HIV.
