The following interview was conducted with Eugenie Kenda, a peer navigator with Yerelon+ in Burkina Faso. Yerelon+ is a local civil society organization and implementing partner under the USAID- and PEPFAR-supported #EAWA project. #EAWA is a five-year project with the goal of accelerating progress toward epidemic control in the West Africa region by improving access to prevention, care, and treatment services, particularly among key population members. Peer navigators work full-time with the project as part of a case management team to assist HIV-positive key population members in enrolling in and accessing care and treatment services. This interview has been edited for length and clarity.
How did you get involved as a peer navigator, and what are your responsibilities?
Well, I was a peer educator in 2015. And after that the staff at Yerelon+ thought it would be good for me to become a navigator. That was in 2016. Now I have at least 55 people I support, and I visit them at home, at the hospital, and I help with adherence, too. And I also do outreach.
Can you explain what a day looks like for you?
When the testing is done, and if there is a case [new diagnosis] and it’s outside the clinic, I talk to the person to convince them to follow me to the clinic so that they can be given the treatment.
If they don’t come right away, I have to call the person to motivate them to ensure that they take the treatment. And when they do get the treatment, you have to follow up. If the person doesn’t call you and if you don’t follow up with the person, they risk abandoning [treatment].
Do you find any part of your work difficult?
All the work is difficult, eh? But when you like it, you find it easy. But as far as difficult goes, maybe it is putting them on ARVs, the adherence. That is what is a bit difficult. I’ll give an example. When you test someone, the beginning of treatment isn’t easy. You really have to follow up the person, sometimes I go to their house, so that the person adheres. And that’s not easy at all.
Is there an aspect of your work that you like the most?
Ahh, what I like the most is adherence, for the person to be adherent! Wooo! That makes me happy. And if you find out that the viral load is undetectable, ooh-la-la! Frankly, I sleep well. I love that.
Do a lot of people manage to be adherent?
Yes, a lot. Really, all the people I follow up, little by little, they are able to take their treatment well and really all of them are in good health. Frankly, the sex workers are very, very mobile. Often I can lose sight of them, but I know that the person is going to come back to me. Why? If the person has a little sore, they are going to call me. When they have a problem, they say, “Where are you?” I say, “Ah hah, so today you are calling me.” And the person starts to laugh. I say, “What area of town are you in?” and I go out to look for her.
Do the people start on treatment the same day as testing?
Yes, yes. If we test them at the clinic, it’s the same day. The same day they are given treatment. And often when the testing is done outside of the clinic, it’s when we go out, we go out from six to eight o’clock at night. And when it’s like that, the next morning, I do everything to make sure that the person comes to the clinic. But it’s rare that I speak and they refuse. It depends on how you talk to them. Talk with the person’s best interest in mind, not your own. And if the person knows that you don’t have anything to gain, the person is going to come. And often the person says, “What is going to happen if I don’t take the treatment?” But I tell them, “If you don’t come to get the treatment, whether you want it or not, know that something else is going to happen.” And the person asks me, “What is the something else that is going to happen?” And I say, “Just ask yourself that question. I am sick and I refuse to go on treatment.” “I am going to die?” I say, “Ah. You yourself answered the question. So, I am going to take you there [to the clinic].” That’s it. And when it goes like that, the person does it. Before we had the tendency to flatter the person. But me, I speak contrarily.
Could you talk to me about a time when you felt particularly proud of how you helped someone?
Many times. There was one day when we tested a sex worker, and unfortunately she was positive. And then she started to cry, and when she stopped crying, I said, “My dear, is this the first time that you have done the test, or did you know your status before?” Well she hadn’t known her status. And the next day [after the testing], when she came for services, she asked me this question, “What do you think? If I take the treatment, will the illness go away?” I said, “The treatment won’t make it go away. But if you don’t take the product, you are also going to die.” Ohhh, she didn’t say anything. She just started to cry. I let her cry, and when she was done, she asked, “Why did you say I’m going to die?” I said, “But don’t cry. If you start taking the treatment today”—I gave her an example—“If you take the treatment and they tell you to come back in 10 days and you flee, you come back in a month, the treatment is for sure not going to work.” She said, “Really?” I said, “Yes.” When I talked with her that day, she took in everything I said. She told me that every night before she went to bed, she heard me talking. So that motivated her to take the treatment. And now, today, her viral load is undetectable.
What does it mean for you to support the #EAWA project as a peer navigator? Why do you do it?
I hope that everyone who is not infected doesn’t get infected. And for those who are on ARVs to always be adherent, stay in care. And help EAWA persevere to… finish with HIV. It’s a lot of work, eh? Lots and lots and lots of work. You have to love what you do. Love the people that you follow up. When you see them in good health, that really makes me happy.
Do you have any advice to give someone who wants to be a peer navigator?
That the person first of all loves their work and that they be available. Being a peer navigator really takes commitment. And most of all, you have to know how to talk. You have to be able to give advice. And to speak with the best interests of the other person in mind, not your own best interests. It’s that more than anything. To really be available.
To learn more about the inspiring work of the #EAWA project’s peer educators and peer navigators in Burkina Faso, view this photo story.