49-year old HIV survivor defies odds amidst funding uncertainties
For 16 years, Angeline* lived with the HIV virus, building confidence, inspiration and belief, until an announcement about USAID funding cuts battered her hopes, but she made some progressive resolve
By Emmanuel Mandella
When 49-year old Angeline Severino (not her real name) received the test results from her doctor confirming she was HIV positive, she was devastated. She had lived for 33 years ‘free’. How could this have happened after all those years? she hurtfully wondered.
How was she going to handle the new life? What about her family, children? How were they going to go about it? Many questions crossed her mind. She was perturbed, but could not get answers at fingertips.
However, a counsellor came through, and after a few minutes of chit-chat, she found some balance.
“If I leave myself to die, I will be leaving my children and family behind. I must fight this virus for them and for myself,” she told herself, amid comfort and conviction from the counsellor.
Angeline* says she found out about her status in 2009 in Uganda.
Thereafter, she did not take long in the country before returning to her native South Sudan, where she began antiretroviral treatment (ARVs), a regimen she adhered to faithfully for 16 years.
But her journey has not been without setbacks. One day, she says, the clinic where she got her ARVs was closed without warning.
“My last tablet was the night before, and my drugs were locked inside,” she recalled. “We raised our voices until the government and the State AIDS Commission intervened.”
Her worries, alongside those of other patients at the facility, stemmed from the risks associated with missing HIV doses. According to medical sources, skipping doses makes it easier for HIV to change form, causing your medication to stop working, a situation referred to as drug resistance.
HIV can become resistant to your medication and to similar medications that you have not yet taken, limiting the options for successful HIV treatment.
In Western Equatoria State, where Angeline* hails from HIV prevalence has seen a notable decline, raising hopes in a region data has the leading prevalence rates in South Sudan.
Despite the incredible progress, officials warn that cuts to foreign aid are threatening to roll back hard-won gains in prevention and treatment.
Prevalence down, but support shrinking
Hon. Kenyi Henry Alex, Acting Chairperson of the Western Equatoria State HIV and AIDS Commission, says the HIV prevalence in the state has been through collaboration between government, chiefs, churches, and community leaders.
“Some years back, we had a high prevalence rate, but according to reports from Juba, there has been a notable drop. We have joined hands to fight this disease, and we are seeing results,” he said.
However, Kenyi warned that the withdrawal of USAID’s support towards combating the disease, once a major source of HIV program funding through ICAP and other donors, has left a significant gap in the state.
“USAID was doing great work here in Western Equatoria State, but with the cuts, we are facing it rough. We still need support for food, vocational skills, and farming tools for people living with HIV so they can sustain themselves,” he said.
The USAID program played a significant role in the global fight against HIV, particularly through the President’s Emergency Plan for AIDS Relief (PEPFAR), providing antiretroviral treatment, supporting prevention of mother-to-child transmission (PMTCT) programs, strengthening health systems, and funding research.
Frontline workers, the worst hit
Mr.Luka Baakia, a staff at one of the health facilities in the region, said supply chain delays are hitting rural communities the hardest.
“We are doing everything possible to ensure ARVs remain available, but some facilities go for weeks without fresh stock. This forces patients to travel far or miss doses, risking drug resistance,” Baakia explained.
Meanwhile, health advocates say the fight against HIV and AIDS in Western Equatoria has made progress in testing and treatment. Even though, major gaps remain particularly in partner notification, community engagement, and health infrastructure, says Lubang Simaya Jak, the State TBHRB field officer.
Simaya revealed to this publication that awareness and sensitization efforts across the state are still insufficient. He urged civil society organizations, AIDS Commission, and the Ministry of Health to intensify their work and seal the gaps.
“When I look at the HIV and TB activities, HIV testing is beginning to take shape, but we still face serious challenges especially in index testing, which targets the sexual partners and biological children of newly diagnosed individuals,” he explained.
“Most newly identified HIV-positive people fear telling their partners, and this leads to denial or outright refusal to bring them for testing.”
As of June, about 16,000 people living with HIV in Western Equatoria were on treatment, with new cases added each quarter. However, treatment interruption remains a recurring problem, especially in facilities handling large patient loads.
Disruption of services due to funding cuts
Simaya also pointed to the impact of the February 2025 suspension of a USAID-funded project in Tombura and Nagero counties, which supported community HIV activities through a local civil society organization.
“When the stop-work order came, HIV testing in the community dropped, treatment numbers went down, and viral load coverage and suppression rates also dropped in February and March,” he said.
Activities resumed after a waiver, but were integrated into the work of the main implementing partner.
He stressed that improving facility infrastructure is another top priority in tackling HIV. Basukangbi PHCC in Nzara County, he said, is a prime example of how local resources such as community-led construction can strengthen services.
“Many sites, especially remote HIV testing locations, lack proper designated structures for HIV activities, and this affects service delivery,” he noted.
“When communities contribute local resources like bricks and labor, it not only builds infrastructure but also reduces stigma and discrimination.”
Public awareness role and Vision 2030
With the state government and partners having launched a program to end new HIV infections by 2030, Simaya believes local leaders must play a central role.
“The community understands better when information comes from their own leaders,” he said.
“Through awareness campaigns and sensitization, they can help people see the importance of testing, adhering to treatment, and undergoing regular viral load checks.”
He cautioned that Western Equatoria State still lags in diagnosing all people living with HIV, retaining them in care, and ensuring consistent monitoring of treatment effectiveness.
“Let us check our HIV status regularly. If one is positive, start treatment immediately and stay in care. If medication is taken correctly, viral load will be suppressed, and HIV transmission can be stopped. That’s one of our greatest challenges and also one of our greatest opportunities,” Simaya advised.
National records
Nationally, South Sudan’s HIV prevalence is estimated at 2.4% (of population ages 15-49 ), with Western Equatoria region being among the most affected.
The national government through the Ministry of Health and the South Sudan HIV/AIDS Commission is committed to achieving the UNAIDS 95-95-95 targets by 2030: ensuring 95% of people living with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those on treatment achieve viral suppression.
In a one on one interview with the City Review, Madam Rose Obede Isaac, Director General at the State Ministry of Health, stressed the importance of sustaining the fight.
“We cannot allow the gains we have made to be reversed. Protecting the health and future of people living with HIV is not just a health priority, it is a national responsibility,” she said.
She said her ministry is now working to mobilize alternative funding, strengthen local drug procurement, and improve facility infrastructure to reduce patient travel distances.
A message of hope
For 49-year-old Angeline, who has braved 16 years with HIV, the message is simple and clear:
“Accept yourself the way you are. You can still live, work, and achieve your dreams with the virus inside your body. Sometimes you may even be healthier than those who don’t know their status. Just live responsibly and adhere to the ART guidelines.”
