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
By Shawn Malone, Project Director, The Mpilo Project, PSI South Africa
As of February 2024, an estimated 95 percent of HIV-positive men in South Africa knew their viral status, but only 73 percent of those were on treatment. That’s one in four men who aren’t getting the treatment they need. Why? Because, for many, an HIV diagnosis triggers emotions like fear, anxiety, and shame. And since men are raised to believe they should “man up” and push those feelings down, many avoid dealing with HIV altogether. Social pressures make it hard for them to speak up and seek help.
Zama felt this fear when his girlfriend told him that she tested positive for HIV. He initially avoided getting tested himself, but then he started feeling sick and eventually decided to stop putting it off. When his test came back positive, the paralysis set in all over again. He hid his HIV status from his family and friends and avoided the clinic, afraid that he would be seen there and subjected to stigma and discrimination.
Fortunately a nurse suggested that he connect with a local men’s support group, and that’s when everything changed. Not only did the men in the group look healthy and strong, they also spoke openly and confidently about living with HIV and having the love and support of family and friends—something Zama never imagined was possible. His group supported him in overcoming two of his greatest fears—sharing his HIV status with his family and going to the clinic to start treatment. Within a short time, he began to feel hopeful that he could still have a good life with HIV.
Based on his own experience of support, Zama decided to become a coach under the Coach Mpilo program, helping other men overcome their fears about HIV testing and treatment.
Designed and implemented in collaboration with the National Department of Health, the Coach Mpilo model employs men who are thriving with HIV—not just clinically but also socially and emotionally—as mentors to newly diagnosed men, men who have stopped returning to the clinic, and men experiencing other barriers to treatment.
As men living with HIV, coaches understand from their own lived experience the barriers that men face upon an HIV diagnosis, and most men immediately find coaches to be a safe, relatable, and trustworthy source of support. In turn, being a coach can help men with HIV reframe their identity, find meaning and purpose, and regain their social status.
Piloted by PSI and Matchboxology in 2020, the Coach Mpilo model initially reached 3,848 men, of which 3,811 (99%) were linked or returned to care and 3,653 (96%) were still in care at the end of the pilot period. Since then, the model has been taken up by various other organizations, with 375 coaches currently supporting tens of thousands of men across South Africa.
Men like Zama are not indifferent about their health; the barriers they face in accessing care are just harder to see and harder to break through. But in pairing men who are thriving with HIV with men who are struggling, the Coach Mpilo model is giving men—both coaches and their mentees – — the right source of support for overcoming those barriers.
To hear more of Zama’s story, go to www.coachmpilo.co.za/videos
