NELIE ERASMUS
>>nelie.observer@gmail.com
The province joined the rest of the world in commemorating World Aids Day last week. The latest official HIV/Aids statistics of studies being done every five years, describe South Africa as having the highest prevalence in the world, but the province’s prevalence, according to statistics of the Department of Health, are below the national average of 29,7% and declined between 2009 and 2013.
The statistics for the province, supplied upon request by the Department of Health are statistics of 2013 and according to that statistics the prevalence in all districts in the province are below the national average of 29,7%.
With national Aids Day behind us an in-depth investigation with the assistance of the Department of Health was done about the status of the disease in the province.
“The latest HIV Prevalence statistics is that of 2013 as the HIV prevalence statistic is released by the Minister of Health,” Derick Kganyago, Spokesperson for the Department of Health said.
Among the country’s 52 districts, Waterberg ranked at number 23 in the country, with a prevalence of 27,3% and Vhembe which ranked 6th in the country, have the lowest HIV prevalence in the province at 15%.
According to Kganyago the Province is showing a decline of HIV prevalence from 21, 4% to 20.3% in the five years from 2009 to 2013.
At risk
Sex workers and their clients are at the greatest risk to contract HIV as sex workers find themselves in a situation where their clients brutalise them and sometimes refuse to use condoms, according to Khganyago.
Men having sex with men if a condom is not used are at a high risk because the anal membrane is thin and get easily torn.
“Lesbian, gay, bisexual, transgender and intersex (LGBTI) people, due to stigma attached to these groups, do not come out and delay in seeking health services and sometimes are stigmatised when they go to health facilities. Drug users injecting themselves are also at a high risk as they have a tendency of sharing contaminated needles. Prisoners are also at a high risk as sexual behaviour between same sex group especially males is taking place and sometimes rape is reported in prisons. People who engage in risky sexual behaviour and truck and long distance drivers are tempted to obtain the services of sex workers any casual sexual relationship,” Kganyago said.
Vulnerable groups
According to Kganyago youth in institutions of high learning and also youth out of school are at a peak period of experimenting, and peer pressure, exposure to substance abuse and thinking irrational when drunk make them more vulnerable. Other vulnerable groups are orphans and vulnerable children, and older people are at risk as some take care of their children who are HIV positive and get exposed to all kinds of secretions and waste without gloves. Older people are also prone to be raped and they are ashamed to report it. If the perpetrator is HIV positive, the elderly get infected. Girls and young women, due to the imbalance of power in relationships where an older male have a relationship with a younger woman are more vulnerable. Other vulnerable groups include people who engage in risky sexual behaviour, having more than one partner, practising casual and unsafe sex, not using condoms or using it inconsistently and incorrectly, migrants and farm workers who are sometimes exploited by foremen. “A study conducted on Mpumalanga and Limpopo farms about six years ago indicated HIV prevalence of 40% and above, and that prompted government to come up with farm HIV programmes.” The outcomes of this programme have not yet been published.
HIV/Aids and crime
A study by Julian Naidoo on the impact of HIV/Aids on crime in South Africa based on research between 1994 and 2003 found evidence that those infected with HIV are also more likely to engage in other risky behaviour such as illegal drug use. Those infected with HIV may be more likely to engage in risky behaviour such as drug use and crime because their reduced life expectancy leads them to discount the future. Naidoo also found no evidence of HIV/Aids crowding-out police/law enforcement expenditure in favour of other government agency spending for the study period. The study found weak evidence of a negative correlation between HIV/Aids and some types of crime that are of a violent nature, possibly because HIV positive people become too sick to commit these types of crime. No specific study could be found relating particularly to the impact of HIV on crime in the province.
Exposure to HIV
Children born from HIV positive mothers are exposed during pregnancy, birth, and breast feeding. Pregnant women found to be HIV positive are urged to take treatment and take it correctly and consistently, thus increasing the chance for their babies not to contract HIV to more than 90%,” according to Kganyago. ”Health workers are also exposed to HIV if they prick themselves and should be tested should it happen, Other situations where people fight or condoms burst – condoms, if used correctly and all the time, are 98% effective, meaning that if 100 women have their partners use the male condom all the time and always use it perfectly, 2 women will become pregnant in a year.
Male circumcision
The impact or benefit of male medical circumcision (MMC) was investigated before adoption of the programme as one of the methods of HIV prevention in 2010. A study was conducted prior to 2010 in Uganda and South Africa and it was found that MMC reduce the risk of contracting HIV by 60% if well done and a circumcised person use condoms too. MMC reduce the risk of contracting HIV but does not prevent HIV. People engaging in risky sexual behaviour will contract HIV even if circumcised.
Success rate of campaigns
Asked about the success rate of awareness campaigns, Kganyago said “Through campaigns we as improve knowledge on HIV and other conditions which then assist communities to do the right things when coming to prevention and treatment and we are able to deal with myths and cultural and religious norms, engage traditional leaders, faith-based organisations and political principals to assist us to reach communities, sensitise them and make them aware of what should be done.”
The campaigns are successful because we are able to reach communities in their areas, sometimes in their homes, and we have noted that home testing acceptance is high and that there is disclosure when we do household or home testing. We tend to reach men when we do campaigns as compared to facility services. We are able to identify other ailments including psycho-social needs and through campaigns we provide services, educate, give information, create awareness and create a platform and opportunity to unite communities in the fight against HIV and Aids and show support to people living with HIV and families of those who passed on.
Successes in the province
“We have achieved HIV prevention targets (testing, prevention of mother to child transmission of HIV, condom distribution, medical male circumcision, post exposure prophylaxis and reaching the key population groups. Patients can now get medication at certain pharmacies and need not come specifically to hospitals, except for prescriptions.
When patients are found to be HIV positive we offer AR treatment, regardless of CD4 count. We are working on preventing HIV drug resistance, doubled on stock to prevent ARV stock-outs in the province and managed to recruit some peer educators to educate their peers. We have intensified sexually transmitted diseases (STIs) management because poor management of STIs make clients vulnerable to HIV infection and developed strong relationships with traditional leaders in managing traditional initiation schools to avert fatalities and serious MMC events.”
