Advocacy in action

You started your work with AIDS/HIV as a nurse with the Bahamas Ministry of Health. Can you tell us what sparked your interest in nursing and why AIDS/HIV in particular?
I graduated from high school and could not afford to go off to college like so many others. I wanted to work in health so I enrolled in the local college, which offered excellent financial aid for nursing students. I was blessed because this random choice led me to a career that I fell in love with, and it was a random assignment that got me working at the HIV/AIDS Centre. It grew into something that I loved.

Family and other colleagues always asked if I was scared to work in that area, but I knew I had nothing to fear. I was able to help people who so many others did not want to help. I met some of the most amazing people while working in this unit.

You then became the Acting Director of the country’s National AIDS/HIV Centre. What was the difference in the scope of your work, after shifting from nursing to management?
As a nurse working at the Centre, I had face-to-face contact with clients all day, every day. I learned who they were and what they were dealing with in their lives. I was able to be with many people when they first learned of their diagnosis or when they disclosed their status to loved ones.

Moving into management reduced my contact with clientele, something I truly missed. But I was able to have a bigger impact on PLHIV in this new position. I could advocate for more services to improve treatment and care; I could provide training and mentoring to healthcare workers which would also improve our services, and I was able to troubleshoot issues or challenges faced by clients so again, services would be more accessible for them.

You earned a MSc in Public Health from the University of London, which you studied via distance learning, graduating in 2016. What made you choose the course and what impact has it had on you professionally?
When I started to work at the HIV/AIDS Centre, my supervisor (and mentor) spoke about this programme, and she had completed her degree at LSHTM. I read about the MSc in Public Health and realised this was something that I wanted to do because it would make me more marketable in my career. I did play around the idea of a Master’s degree in Nursing, but I realised that would box me into only nursing careers, whereas with a MSc in PH, I’d remain in the health field with endless possibilities. I chose UoL because of its reputation. In addition to earning a globally-recognised degree, I was able to advance my education without having to take time off from work or having to leave my home, something I could not do at that time.

This degree is what led to my promotion at the HIV/AIDS Centre and it has led to me being accepted into a competitive fellowship programme in Zambia, as well as other job offers. Personally, it has instilled a sense of pride in me. I still drive by the building where I sat my exams and I smile and say to myself, “You did that, Branishka.” I am the first of my family to attend college and by extension the first to graduate with a Master’s degree.

You started your work in the mid-2000s and saw much progress when it came to reducing infection rates, mother-to-child-transmission, and mortality rates. What has that journey been like?
My journey has been filled with a lot of highs, dotted with a few lows. The lows were when we experienced AIDS related deaths, mainly from people not in care or who were diagnosed late. It has also been hopeful. I have watched women living with HIV deliver negative babies and I have watched those kids grow up. I have heard the stories of people that have been living with HIV for decades, since the early 1990s when medication was not available. And they give me hope because they are still here, and they are living!

I have seen the advancements in ARVs (antiretroviral drugs): less side effects, less pills and excellent at reducing viral loads. I have seen families, partners and friends support PLHIV. So I will say my journey has been a hopeful one, because I believe that we will get where we need to be.

Alongside the medical side of AIDS/HIV, is the policy and social side. What are some challenges you saw in your career, in terms of stigma surrounding AIDS/HIV education, and what did you and your colleagues do to combat that stigma?
Unfortunately, in 2021 there still exists stigma and discrimination towards PLHIV and this proves to be a barrier to accessing treatment and support. The biggest challenge is stigma and discrimination amongst healthcare workers, the people that are supposed to help. The best way to combat this is through education and consistent advocacy. My colleagues and I would never shy away when we encountered healthcare workers making discriminatory remarks or blatantly treating a PLHIV patient poorly. We also encouraged our clients to report those people because we need to know what is happening when we are not there.

In your professional experience, what have been some of the most significant breakthroughs – medical, social, policy – in AIDS/HIV?
The most significant breakthroughs have been in relation to ARVs. In The Bahamas, we have gone from only antibiotics to treat opportunistic infection, to ARVs only available to pregnant women and children, and now being available to free of cost to everyone. The drugs used now are not as toxic and the amount has decreased drastically with some people only taking one pill a day, which greatly improves adherence.

Recently, you saw a shift in your career from working in AIDS/HIV to doing work with the current pandemic. Given your experience, do you see any important parallels in both COVID-19 and AIDS/HIV from which we can learn?
The parallels between these two infections are so similar. We saw the fear of disclosure of status due to want to avoid being discriminated against, and we saw attacks and inflammatory remarks against certain groups of people believed to be ‘carriers’, or responsible for the infections being in our community. We saw fear in the general population because there was so little information available on this new disease.

Knowing all of this, we know how important it is to make sure the public receives accurate and factual information. We must be prepared to educate them, and dispel myths and misinformation.

Finally, what are your hopes for future developments in the fight against AIDS/HIV?
My hope is to reach that goal of ending the AIDS epidemic by 2030. I want us to get to a place where PLHIV are not afraid to disclose their diagnosis and they are not afraid to access services. Ultimately, I hope for a cure.

Read more about the MSc Public Health programme