Reclaiming Their Futures: Three Adolescents With HIV Share the Importance of Accompaniment

Editor's note: This article was originally published in Spanish on Socios En Salud's website.

Alexander* remembers the moment with great clarity. As a health care professional explained that he had tested positive for HIV and syphilis, he felt as if his mind had disconnected from his body.

He answered yes when the doctor asked if he understood and nodded his head along as they spoke, but he wasn't listening. Alexander lived in a stunned haze for two months before returning to the clinic to ask the questions that he hadn't been able to formulate that day.

Isaac* had been thinking for weeks that he just had a persistent flu. He went from hospital to hospital, spent a month in bed, and one early morning ended up in the emergency room. He was studying software engineering and looking for a job to help support his family when he eventually received a positive HIV test result.

Isaac's first feeling wasn't fear of the virus. He was more afraid of his parents' reaction, who had never fully accepted his sexual orientation.

Onexis* arrived in Peru with an unexpected pregnancy. She had left her home in Venezuela as a teenager and, just three months after arriving in Peru, discovered she was going to be a mother. Two years later, she and her partner discovered they were HIV-positive. Frantic internet searches amplified her fear, and the immediate stigma made everything heavier.

These three stories are different, but they converge on the same reality. In Peru, nearly half of new HIV cases are registered among people aged 15 to 29. And, although treatment allows for a full life, many adolescents and young adults continue to abandon care due to fear, loneliness, or discrimination.

With them in mind, Socios En Salud, as Partners In Health (PIH) is known in Peru, partnered with Harvard Medical School to launch an intervention called PASEO, which provides accompaniment by community health workers to adolescents undergoing the transition from pediatric to adult HIV care.

When One Pill is Not Enough

PASEO, this project that supports treatment adherence for adolescents living with HIV, was initially framed around an uncomfortable question: if treatment exists, why are teenagers still dying from AIDS-related causes?

The answer doesn't lie in clinics or medication. It's in isolation, anxiety, stigma, and the lack of support after receiving a diagnosis that can erase any hope for the future.

Alexander is all too familiar with feeling lonely. He arrived from Venezuela at the age of fourteen, friendless and even afraid to walk around an unfamiliar city. Over time, he found work, studied to become a veterinary assistant, and decided that one day he would protect animals because "they have no voice to defend themselves," he says.

When he received the diagnosis, Alexander thought of his uncle who had lived with HIV and died after abandoning treatment. Then he considered his own medical history: diabetes, hypertension, arrhythmia, asthma. "I took it as just another stripe on the tiger," he recalls. But that strength took weeks to emerge.

A New Form of Treatment

The PASEO project means exactly what it says. In Spanish, paseo means to stroll or walk, typically with friends. The name also serves as an acronym for peer accompaniment, support, and education.

As part of the project, not all participants receive the same type of support. Some are randomly assigned to a mentoring group with a tutor who accompanies them to medical appointments, answers questions, coordinates visits, and facilitates access to mental health services. Others navigate the healthcare system on their own, as any young person would without a program to support them, so that the project can compare their experiences.

In the mentoring group, Isaac found something there he hadn't expected: people who understood what he was going through without needing lengthy, exhausting explanations. Between workshops and conversations, he learned about medication, labor rights, and self-care, but he also regained a sense of routine that had disappeared after his diagnosis.

The project psychologist spoke with Isaac's mother, father, and brother. She didn't resolve all the conflicts, but she helped transform fear into dialogue. Following this, Isaac was able to return to his studies at university and focus again on what he's truly passionate about: developing mobile applications.

Onexis also discovered that support can change how a person understands their diagnosis. In the mentorship meetings, Onexis asked questions she previously only searched for online and found answers shared by professionals and other young people with HIV.

"The company, the understanding, and the support," she summarizes, "were the most important things."

The Invisible Weight of Stigma

Discrimination doesn't always appear as an insult. Sometimes it hides in the look on someone's face or in different forms of isolation.

Alexander recently needed surgery for kidney stones and felt the treatment he received from the medical professionals caring for him changed immediately when they learned his diagnosis. He nearly cancelled the surgery because the clinic required him to buy his own materials that were beyond his means.

One of Onexis's worst experiences was facing the shame of her family. She had hidden her medication in a small, unlabeled bottle to keep them from learning about her diagnosis. However, while she was out, her mother found it, searched for a picture of it on Google, and discovered what it was for. That night, Onexis chose not to go home, but the next day, they had a constructive conversation that changed their relationship and helped Onexis be more open.

Isaac, on the other hand, still believes that his parents may never fully accept his sexual orientation. However, through PASEO, he no longer feels that he must face that reality alone.

For many young people, the biggest obstacle isn't the treatment. It's the fear of being defined solely by a diagnosis.

Reclaiming The Future

When asked about their futures, neither Alexander, Onexis, nor Isaac mention HIV first.

Alexander wants to study veterinary medicine, caring for the vulnerable. Isaac is about to graduate from university and dreams of specializing in mobile app development. And Onexis is thinking about raising her daughter with the peace she thought she had lost.

The project that brought them together didn't eliminate their problems, but it gave them back something equally important: the possibility of making plans for their future.

Perhaps that is the true meaning of PASEO. Not only to improve adherence to treatment or increase access to health services, but to demonstrate that a diagnosis should not interrupt or halt someone's life. With someone walking beside you, the future becomes a place worth reaching.

*Last name omitted by participant request