HIV PreventionThe prevention group LoveLife launched South Africa's largest prevention campaign in 1999. Targeting young people, the goal was to decrease HIV, sexually transmitted diseases, and teen pregnancies. The group launched support hotlines, HIV clinics, youth centers and health clinics. For those hard-to-reach populations in rural areas or outside the education system, LoveLife traveled to them to deliver their HIV message.
Yet, LoveLife has been criticized for poor implementation of education programs, poor choices of who to target with their education, and failing to address identified weaknesses in their programs. In fact, their largest funding source, The Global Fund, pulled its funding from the program in 2005.
Like many countries with an out-of-control HIV problem, South Africa's economic, racial, and ethnic diversity makes prevention and HIV education very difficult. With limited resources, both financial and professional, choosing which populations to target and how exactly to get the prevention message across is a daunting task. But there are some programs in place:
- Voluntary HIV testing sites have gone up all over South Africa. Unfortunately, perceptions among South African citizens has made widespread testing difficult. For example, many more women than men are accessing the testing sites. Men feel that learning their HIV status is a burden that has no real benefit. That, combined with concerns of confidentiality and HIV stigma, keeps them away from the testing sites.
- As mentioned earlier, homosexuality is more acceptable now than at any other time in South African history. Yet, significant discrimination and stigma remains at an individual and institutional level. A counseling and medical service called the Triangle Project sets up shop in gay bars and clubs in hopes of providing a safe haven for gay men; allowing them to access the educational and medical services they need. Yet the lack of consistent education and prevention efforts is evident, fueling a rising infection rate among gay men.
- Prevention, testing, and education requires financial and human resources. Unfortunately, there is a shortage of both. Health-care workers, testing professionals, and HIV educators are lacking. Ironically, the shortage of these professionals is due in large part to high death rates from the hands of the very disease they are trying to stop.
HIV Treatment and CareThe sad fact is that most infected South Africans do not get the HIV care they need. For most, their only chance at care is through publicly funded. Only 20 percent of South Africans have private insurance or access to privately funded care. As a result, the public clinics are short-staffed, have long lines, are poorly equipped and maintained, and sadly there is little government initiative to address the problem.
Among the lucky few who get publicly funded care, it is inconsistent, most often without access to even the most basic services and HIV medications. Among the 80 percent that rely on public health care, the feeling is that society doesn't care and has alienated them from the rest of South Africa because of their disease.
The Treatment Action Campaign (TAC) was started by Zackie Achmat, an HIV positive man who recognized the importance of regular HIV care and medications. His organization has put tremendous pressure on the South African government in hopes of persuading them to provide basic HIV medications and HIV care to those in need.
In what was thought to be a huge positive step, South Africa's High Court agreed with him and ordered the government to make the HIV medication Nevirapine available in all state hospitals and clinics. The benefits of Nevirapine and its success in lowering the risk of mother-to-child transmission has been proven by scientists around the world. Yet, the government has been slow to follow the Court's order, citing concerns over the safety and effectiveness of Nevirapine. They went as far as making the distribution of Nevirapine a crime, punishable by jail time and dismissal from the medical community.
Sadly, many feel that with the right political commitment, HIV medications like Nevirapine could be universally available in as little as five years. But the reality is that while the government drags its feet, babies continue to be infected by their mothers and South Africans continue to die.
- Bureau of African Affairs. United States. Department of State. Background Notes: South Africa.01 Oct 2006.
- Hjort, L.; "Sexism, Youth, and HIV in South Africa"; 11 Apr 2006. Alternatives. 01 Mar 2007.
- NetPao, M."Q & A: Access to HIV/AIDS Care in South Africa." 19 Apr 2006. National Public Radio Online. 01 Mar 2007.
- Pembrey, G."HIV/AIDS in South Africa." 01 Dec 2006. Avert.org. 01 Mar 2007.
- Riviere, P."South Africa's AIDS Apartheid." LeMonde diplomatique. 01 Aug 2002.
- Unicef."Prevention of Parent-to-Child Transmission of HIV/AIDS." 01 Feb 2007. . 01 Mar 2007.