Johannesburg - Although South Africa has made meaningful progress in the fight against HIV/Aids in the past decade, more than 150 adolescent girls and young women are contracting the virus daily.
This is a source of concern for Mbulawa Mugabe, the South African country director for the UNAids.
Mugabe said vulnerable groups such as adolescent and young women, sex workers, men who slept with other men, transgender people and those who injected themselves with drugs, needed to be an area of focus for the next decade.
“It is important to point out there are many challenges and not everything is rosy. We have challenges around the high level of infection among adolescent girls and young women.
“More than 150 adolescent and young women acquire HIV everyday in South Africa, then there is also female sex workers, who are seven times more exposed than the general adult population to contract the virus,” he said.
For men, the challenge was encouraging them to get tested, and once tested, to remain on antiretroviral treatment.
He said data showed that there were more women testing and remaining on treatment than men.
Mugabe said South Africa had achieved one of its three 90-90-90 UNAids HIV/Aids targets, and that was the target in relation to testing, where coverage was at 92%.
Seventy-three percent had tested positive and needed to be on treatment, while 88% had a suppressed viral load.
“South Africa has made good progress over the years; there are 7.6 million people living with HIV and of those, over 5 million are on life-saving ART treatment.
“In terms of the number of people, that is quite good.
“When we look at new infections between 2010 and 2019, new infections are at 51%, compared to 23% on average in the whole world.
“If you look at Aids deaths, using the 2010 to 2019 comparison, the mortality rate declined by 60% in SA and the life expectancy has gone up considerably,” said Mugabe.
Although there was concern about the rate of infection for adolescent women and young women, more men needed to get tested and maintain their treatment if they tested positive.
“There are a lot of men who test and don't enrol for treatment. We need to fix that,” said Mugabe.
He said there were many gaps in the system that needed to be plugged, such as focusing on children, who were not coping as well when compared to adults. That areas was also of concern.
“We need to fix these gaps in the system and to do that we need to go back to the community.
“More importantly, there has been activism led by civil society and communities at the heart of the success. “Communities know their problems and what works, so we need to empower them.”
Mugabe said it was important for adolescent girls and young women to remain in school for as long as possible.
“The school system provides that protective layer. Staying in school longer also addresses the future challenges of inequality because if they go to school, they will be able to find their own independence through their own employment.
“We also need girls and women to have access to sexual reproductive health services. We need them to go to programmes that empower girls, so that they do not see the need to get money from sugar daddies or from macho men with money. This will make them less vulnerable.”
Mugabe said another way to protect young girls from infection would be if more men were tested and on treatment.
“Most people tested and treated are women. We need more men to test because when your load is suppressed you do not transmit.
“If we can get men into treatment, that will be good for protecting women, especially adolescent young girls.”
Mugabe said the UNAids was calling on countries to adopt a 95-95-95 strategy for the next 10 years.
“We want countries to raise the bar in a more targeted and nuanced manner. We want these targets for adolescent girls and young women, men who have sex with other men, the LGBTI+ community, we want all those population groups to reach those targets for service coverage in a more nuanced and deliberate manner at every district and metro, not just national,” he said.
Also key in meeting the 95-95-95 targets in the next decade, would be putting communities at the centre of the programmes.
“It is important to put communities front and centre and make funding available to community-based organisations because, at the end of the day, it is about behavioural change.
“We should also guard against complacency; there is complacency. We should also address the experience that people who seek service get and also work with these challenges.
“We need to go into health facilities and assess how people are experiencing service.
“We want to identify why people stop seeking service. We want services that treat people with dignity.”
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