As we celebrate Women's Month, South African girls and women face the reality of being among the world's highest risk populations for HIV infection - but HIV prevention and support services offer real hope for a better future.
These young women are especially vulnerable to unprotected sex, HIV infection, gender-based violence, and unplanned pregnancies, but there is hope thanks to public health facilities' free, discreet medical services and community-based interventions that enable women to take charge of their futures.
A UNaids report on women and girls and HIV identifies warning signs that a girl or young woman may be at risk of contracting HIV:
- When a girl lives in poverty and is financially dependent on men, she may lose her free will because she is dependent on a man.
- A young woman, who has a partner who is five or more years her senior, may have a power imbalance in the relationship, making it difficult to negotiate condom use, among others.
The USAID-led DREAMS programme is one particularly effective project that offers this kind of support. In collaboration with the National Department of Health and implementing partners like BroadReach Health Development, the DREAMS programme — which stands for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe; supports high-risk young women and girls across the nation.
According to Dr Veni Naidu, the HIV Community Services Lead at BroadReach Health Development, young women encounter multiple obstacles to HIV prevention. "A young girl may not have the power to negotiate condom use if she engages in sexual activity or has been the victim of assault. She might not have the necessary resources or understanding to use PrEP (Pre-exposure Prophylaxis) to prevent HIV infection or to use contraception to prevent unwanted pregnancies.
Unfortunately, insufficient information and knowledge on PrEP can lead to misunderstandings about the significance of this critical intervention. That is why it is important to educate not only girls, but also their guardians, partners, and communities about how women can protect themselves from HIV infection, says Naidu.
A priority is screening young women for risk factors and putting in place measures to support them both socially and medically. Interventions could include offering the HIV prevention medication PrEP to protect them from infection.
If a girl is already HIV-positive, she is given interventions such as antiretrovirals (ARVs) to help her stay virally suppressed and avoid developing Aids.
In cases where young women have been exposed to HIV through unprotected sex or rape, the DREAMS programme offers post-exposure prophylaxis (PEP), a medication that should be taken within 72 hours of HIV exposure, according to Naidu.
Following that, at-risk women may wish to switch to PrEP to maintain their protection and prevent HIV transmission.
“It is now within our reach to create an Aids-free generation. We just need to embrace the interventions that exist. Now that there is access, there is hope, and the power lies in every woman’s hands,” says Naidu.
The DREAMS programme offers additional clinical treatments for girls, such as treatment for various Sexually Transmitted Infections (STIs). In order to help the girls in the programme overcome their challenges and pursue better futures, they also closely collaborate with affiliated organisations to offer gender-based violence support services, post-violence care, family planning, and mentorship on life skills and employment options.
USAID has started a peer-mentorship ambassador programme to create a supportive, non-judgmental and empowered community. “We have instances where a girl might have been exposed to an incident of abuse, intimate partner violence or gender-based violence, and through the support of programmes such as this, is able to garner support, counselling and advice from others with similar experiences”.
“In turn, many of the girls use their newfound strength to support other girls going through something similar. They support each other in reporting violence, getting the help and services they need, and going to court. They become each other’s champions and support system,” conveys Naidu.
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