Lusaka, Zambia — The mental health crisis in Africa is an acute challenge for young people living with HIV
Mental health is a cornerstone of overall health, especially for young people living with HIV. Yet, research reveals a hidden epidemic of the silent struggles with mental health that burden these children and adolescents. Many young people feel their future veiled in uncertainty. They carry the weight of a chronic illness and its impact on their lives while navigating a society full of stigma. Depression, anxiety, and isolation become constant companions. This is the harsh reality for far too many young people living with HIV.
Often, it goes unseen.
At the recent International Conference on Public Health in Africa (CPHIA) held in Lusaka, Zambia, allAfrica's Melody Chironda had the opportunity to speak with Paul Mavesere Ndhlovu, an International AIDS Society Young Leader, about the pressing issue of youth mental health in Africa.
Ndhlovu's advocacy journey began in 2016.
As a community adolescent treatment supporter (CATS) under the guidance of Zvandiri, he took on a vital role at the Highfield Satellite Clinic. There, he empowered young people living with HIV. He helped them accept their status, adhere to treatment, and provide knowledge to their caregivers. He organized support groups, facilitated meetings, and offered home visits and clinical assistance. This experience ignited a deeper passion within Ndhlovu. He soon joined Zvandiri's ranks as a Zvandiri Champion, coordinating the Zvandiri show. His eagerness for new challenges led him to his current role in the communications department in 2018.
Zvandiri means 'As I am' in the Shona language.
"My role isn't just local, it's global," says Ndhlovu, his voice filled with passion. "As a global HIV and public health advocate, my mission is to amplify the voices of young people in every aspect of the fight against HIV."
He explains, "Whether it's crafting standards, writing policy briefs, or shaping service delivery, I champion meaningful youth engagement. This isn't about tokenism - it's about treating young people as equal stakeholders, partners, and experts. I envision a future where young people aren't just clients, but consultants, service providers, sitting at the table, not just waiting for handouts, but actively shaping solutions."
Challenges faced by young people
"Imagine young adults living with HIV, navigating dating, love, and all that comes with it," Ndhlovu said. "Accepting your status is tough, and sharing it with someone else? That's a whole new hurdle."
"In this generation, secrecy isn't an option. People fall in love and propose, but when it's time to disclose, fear freezes them. That's the first challenge. The second? Mental health. Disclosure takes a toll, and without support, it's even harder. Then there's school. Not everyone wants to be open about living with HIV. It affects disclosure, adherence, and even access to support. Without peer counselors, it's a lonely battle."
"Medication alone isn't enough," said Ndhlovu. "You test someone, hand them pills, maybe an IV drip, and call it a day? No way. Accepting your HIV status is the bedrock. It's not easy taking daily medicines, but with acceptance, you find the strength."
That's where peer support comes in.
"Connecting young people living with HIV to peer counselors is crucial," he said. "At Zvandiri, our counselors are embedded in government clinics under the Ministry of Health, and ensure everyone gets tested and is supported, and empowered to accept their status. These counselors become their anchor, helping them adhere to treatment and overcome stigma. "
"Acceptance is powerful. When a young person embraces their HIV, they often transform from feeling ostracized to becoming an advocate, now sharing their story, challenging myths, and inspiring others to fight alongside them."
"But if you are in isolation without any peer support, without any support groups that you are attending, then you are prone to be affected by stigma or discrimination because you're not yet strong, or you're feeling like you're lonely. You don't have any sense of belonging. So peer support is key to addressing stigma, and discrimination and also to educating society," he added.
Current state of mental health in Africa
"In Zimbabwe at the moment, we are celebrating. We achieved the UN's 95-95-95 targets! Congratulations to us! We're one of the five countries that did, yet mental health is still lagging," Ndhlovu said.
But why?
"Look around! Organizations, and institutions, focus on providing medicines, monitoring viral loads, and optimizing treatment. But what about the psychosocial support? Life doesn't end with taking the medicines," he added.
"Young minds are bombarded with questions: 'Will I get a job? Find love? Have kids?' It's about going to school, navigating relationships, and facing societal pressures. These factors can cripple their mental health."
Ndhlovu added "Research is clear: mental health and viral load are intertwined. If young people's minds are struggling, their health suffers too. But currently, mental health is receiving less support in the global space."
Scaling up mental health for young people
Investing in mental health isn't just a feel-good thing, it's strategic. It's closing the gap, it's recognizing that a healthy mind is just as crucial as a healthy body.
"We need to scale up some models, they're game-changers. Organizations like Zvandiri, they're the ones who moulded me and showed me the way" he said. "We need models that are evidence-based and tools, tailored to young people like us, proven to work wonders.
"Imagine philanthropists, donors, governments, even the UN, all joining forces. They're supposed to invest in these pillar initiatives to ensure that the mental health of young people comes first because mental health is also a health issue. So investing in mental health is key to ensure that we address this gap."
Bringing voices to the airwaves
"At Zvandiri Radio we identify the community and health challenges that are being faced by young people living with HIV and turn these topics into radio shows to share information and to advocate for adolescent health," he said.
"Let me give you an example," Ndhlovu said.
"Imagine being a young person in a boarding school, grappling with HIV and medication adherence. You need to take your ARV medicines on time but everyone's awake at 9 pm. How do you take the medication when all your other peers are seeing it?"
"So we identified this challenge and turned it into a radio show called 'Life in Schools for Young People with HIV.' We invited the Ministry of Education, we invited those young voices themselves with lived experiences, and we create a space where their concerns echo loud and clear." "This is one of the moments that I'm proud of," he said.
Ndhlovu added that his selection as an International AIDS Society Young Leader was a deeply meaningful experience for him. He described it as "unbelievable" and a "motivation, " highlighting the immense talent and dedication of young people working in the HIV field.
"I can't explain it. Even the moment that you're told that you've been selected, it's like, unbelievable," he said. "Being selected doesn't mean you're the best. There are a lot of young people who are doing a lot of work, and every work is amazing."
"I'm a young leader passionate about making a difference. I've been recognized by the International AIDS Society, the United Nations, and Go Next Gen as a global citizen with the potential to create positive change. Go Next Gen trained me to be a global citizen, and I'm now using those skills, along with my experience in the UN Young Leaders Program and the International AIDS Society's programs, to contribute to the Sustainable Development Goals (SDGs)," he said.
"We often think of the SDGs as something for adults or governments, but I believe young people have a crucial role to play. The UN's program empowered me to advocate for and promote these goals. With the International AIDS Society, I helped design and curate the "Youth Hub" platform. This platform addresses the scattered landscape of opportunities and resources available to young people," he said. "Visit the site to join the movement! It's a one-stop-shop for mentorship, funding, reading materials, and more, connecting young people with the organizations and advocates they need to thrive."
Shaping a brighter future
"The World Health Organization says it loud and clear: countries need to prioritize mental health, especially for young people," Ndhlovu said.
"The World Health Organization's new guidelines urge countries to embrace and expand mental health and psychosocial support initiatives, especially those with broad appeal," he said. "Ignoring mental health will derail our entire goal of achieving universal health coverage."
"If we neglect mental health, young people living with HIV are going to be affected. But it doesn't stop there. Young people in general are drowning in a sea of stress, anxiety, and lack of support. We see it in the rise of substance abuse, risky behaviours, and social problems," he added. "Social, economic, and other factors all play a role in shaping young minds, and their mental health is intricately linked to these broader issues."
"And because of that, we need to ensure that we invest in supporting mental health initiatives, not only as a health issue, but as a social issue, and as well as an economic issue."
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
Youth call for action
"We understand the importance of quantifying public health statistics in Africa, and we appreciate the opportunity to contribute to this effort. We recently participated in the International Conference on Public Health in Africa (CPHIA) 2023 youth pre-conference and provided recommendations for the Africa CDC youth strategy. The strategy outlines five pillars, and we shared our perspectives on how to achieve meaningful engagement of young people.
However, it's not just about discussions, guidelines, or policies; the key lies in actual implementation. Action matters. It's what we're eager to witness - the translation of our recommendations into tangible reality.
This conference generated numerous recommendations and guided the youth strategy. Now, the exciting part is seeing these ideas put into action. We're advocating for governments, institutions, organizations, donors, and philanthropists to actively support what we, as young people, aspire for," Ndhlovu said.
Words of encouragement
"For other young people living with HIV, my message is clear: HIV does not define you," he said.
"You are not limited by your HIV status. Your hopes, dreams, and aspirations are still within reach. You can still achieve your dream job, pursue your passions, and find love. With Pre-Exposure Prophylaxis (PrEP) medication, you can prevent HIV transmission to your partner. And thanks to PMTCT (Prevention of Mother-to-Child Transmission) programs, you can have healthy, HIV-negative children," he added. "Remember, you are no different from anyone else. We are all human beings, and we are all capable of achieving our goals."
"To the youth of today, I want to emphasize that we possess brilliance and innovative ideas. Let's not succumb to the notion that this is solely the domain of our elders. We have the capability and the responsibility to shape our own futures. Within our communities, we each have a crucial role to play. Our contributions extend to the Sustainable Development Goals and Africa's Agenda 2063. Let us actively participate in shaping a global future that reflects our aspirations."
AllAfrica's reporting from CPHIA2023 is supported by the African Union and Africa CDC
