World Aids Day 2017

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“We live in fragile times, where gains can be easily reversed. The biggest challenge to moving forward is complacency.”

 

Michel Sidibé, Executive Director of UNAIDS

A Mother sits alongside her 13-year-old son. The pair are part of an innovative new programme helping mothers disclose their HIV status to children.

This sentence seems a very apt response to my observations during my recent trip to South Africa. I can tell you the good news and I can tell you the bad news. I make no excuses for writing an article about HIV/Aids but it is still with us; 36.7 million people are living with HIV globally and it is still little spoken of. It still carries stigma and shame wherever you come from and 30% don’t know their status. The highest prevalence of HIV/Aids is in South Africa.

I will not reel off a series of statistics but mention what I was aware of. The good news: What I did not see were the groups of emaciated dying men talking together in pyjamas outside of the hospital, a frequent sight during my first visit in 2001. The number of babies born HIV positive has been almost eliminated thanks to screening of pregnant women and treatment to prevent mother to child transmission to and more people are stepping forward to be tested. Those who are found to be HIV positive are living well on Anti-retroviral drugs which are now freely available to those that need it.

South Africa has the largest ART drugs programme in the world and this money is coming largely from the governments’ social fund.

The fact that treatment is seen to be available may be a double edged sword though. The medical advances to keep people alive are now being threatened by the resistance to drugs and having readily available therapies is not the answer to end the pandemic.

It is young people in South Africa who are the largest group being infected with HIV. What is most worrying for the country is the gender abuse which results in so many young women and girls becoming HIV positive and the vulnerability of children and young people in their communities.

Despite educational programmes and local availability of counselling these messages do not always reach their target. School programmes are not always well taught even if the teenagers they are aimed at are receiving education. The child headed families are the most vulnerable as the least likely to attend school regularly and most open to abuse by older men. Life goes on and we must continue to celebrate life and all that is positive in a community but despite the fact that within the community I visited these dire facts were mainly hidden, we must not ignore them

An article in the Mail and Guardian 27th October 2017, reported how difficult parents found disclosing to their children that they are living with HIV.

Parents living with HIV are more prone to depression and anxiety and these feelings are picked up by the children. Much more research in recent years has focused on the effects of death and illness within the family particularly on young children and programmes to encourage open communication are beginning to happen. The one described in this article is called Amagugu and supports the parents in their communication. The study was carried out in Kwazulu-Natal but this and other initiatives need to become available more widely to counter the stigma that continues to isolate the most vulnerable within communities.

The UNAIDS Fast-Track strategy to end the epidemic by 2030 was launched in 2014 and sets targets for prevention, treatment and human rights.

The Fast-Track treatment targets are known as the 90-90-90 targets:

90% of all those living with HIV will know their status

90% of all those with HIV will have anti retroviral therapy

90% of all those with HIV will have viral suppression

It is through education that the hard messages have to be delivered but without the protection of the vulnerable young people there is a real battle to be won in the UNAIDS targets.

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