Living with HIV in Mali

Psycho-social support and counseling help fight discrimination and ensure continued treatment

Aissetta was thrown out of her home by in-laws who refused to have a person living with HIV under their roof.
“They told me they did not want to hear that word in their family.”

Thrown out of her home by in-laws who refused to have a person living with HIV under their roof, Aissetta Sagara had to leave her home town of Mopti in central Mali to seek refuge at the AFAS/AMAS*, an association providing assistance and support to people living with HIV in Bamako.

A patient receives advice at the AFAS/AMAS offices in Bamako.

For the past three months, she has been going to group therapy and counseling sessions with the association’s social workers through a project supported by UNDP with funding from the Global Fund.

Being surrounded by people who went through the same trials gave me the will to take care of myself and to continue my treatment,” she says.

Around hundred care centers and associations throughout the country provide psycho-social services to people living with HIV, accompanying them to the clinics to ensure continued treatment, offering group therapy and weekly common meals as well as personalized advice to better live with the disease.

Social workers of ARCAD-sida, one of the main community association fighting AIDS in Mali.

In 2016, nearly 100,000 people were living with HIV in Mali, around 1.1% of the population. But while 35% of them have access to antiretroviral (ARV) therapy, experience shows that this is not enough.

Doctors are often overwhelmed by the number of patients they have to attend to, they do not have the time to explain how to take the medication, how important it is not to skip treatment or when to come to the clinic,” explains Dr. Bagnou, Programme Manager for UNDP Mali. “Psycho-social follow-up is essential.

ARCAD-Sida screening offices in Bamako.

Regular exchange with social workers and with other patients sharing their experience of the difficulties they encounter are an important part of the treatment.

People come [to community meals] to eat together and talk to each other. It’s an educational moment … a form of conviviality that allows people to share their problems and hopes, ” says Dr. Banou.

Community meals provide an opportunity for patients to share experiences.

In addition to the difficulty of accepting their status, patients often have to face stigma. “Some patients leave their home for fear of discrimination. The related costs of moving and transportation sometimes weigh so heavily in the balance that they stop their treatment, which can prove fatal,” says Ali Djerma, Coordinator of the AFAS/AMAS in Bamako.

That’s what happened to Fatoumatou Remy. Diagnosed as HIV positive in 2002, she received ARV treatment which stopped the progression of her disease … until the day her husband left her and took their five children with him.

She was on the verge of depression and stopped taking her medications,” says Dr. Diarra, head of the Bamako health center. “It was only by talking and reasoning her that we managed to convince her to fight and continue her treatment to stay alive.”

A vehicle is rented to patients making a living as moto-taxi drivers.

To help women like Aissetta and Fatoumatou find work and become independent again, the centers offer vocational training in trades such as cooking, sewing or soap making.

Some use the center’s equipment to cook and sell meals outside. Others come to the workshop when they have orders. It’s a good way to regain financial independence,” says Ali.

A patient prepares food that she will sell on an improvised stand in front of the centre.

“Every month, we gather at least 12 patients to see if they are interested in starting an activity and assess whether it’s feasible. We can also give them a baseline to start,” says Awa Dicko, social worker at the Bamako ARCAD-Sida center.

Aissetta learned how to make soap. She now wants to work as a social worker for AIDS patients in Bamako, and provide the same advice and support that has kept her alive after her rejection of by her in-laws.

In 2016, in spite of the conflict and volatile political context, 37,000 people living with HIV had access to continuous ARV therapy and 141,000 people have received HIV counseling and testing since 2013.

  • Women’s Association of Assistance and Support to Widows and AIDS Orphans / Malian Association of Assistance and Support to People Living with HIV