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Beating HIV requires focusing on most vulnerable group – teenage girls

With the aim of overcoming barriers to HIV treatment and care, the race is on to end the HIV/Aids epidemic by 2030.

In conjunction with World Aids Day last week, a webinar hosted by BroadReach Group – a team of social impact businesses focused on harnessing innovation – saw experts in the field agreeing that Africa could overcome HIV by 2030 if vulnerable groups were prioritised.

This could be done by focusing on priority populations and supporting them through lifelong treatment.

The focus should be on identifying the remaining “last mile” barriers and on the needs of the vulnerable populations, including the most affected population of all – teenage girls.

Young girls most at risk

According to the recent joint United Nations Programme on HIV and Aids (UNAids) “In Danger” report, women and girls accounted for 63% of all new HIV infections in sub-Saharan Africa and six out of seven of those with new infections among 15 to 19-year-olds in the region were girls.

BroadReach health development’s acting district director of Gert Sibande in Mpumalanga, Nkosikhona Tshabalala, said a barrier to HIV care was to move away from the “tyranny of the aggregate”.

Also Read: Why we’re losing the fight against the HIV epidemic

Tshabalala said that, working with the US Agency for International Development (USAid) and the department of health, they believe the best approach is not to look at general HIV numbers and adopt a “one size-fits-all” method of prevention and care, but focus was required on the specific communities with the highest HIV prevalence.

“We must determine what we can do for them in a human-centric, caring way to address their specific health needs so that they can reach viral suppression.

“This is the key to stopping further transmission of HIV in society by 2030,” he said.

GBV and economic factors play major roles

As girls were at greater risk if they engaged in sexual intercourse at a very young age, had no power to negotiate protection use, had multiple sexual partners or repressed by patriarchal culture and gender-based violence, these were all symptoms of the current economic environment.

BroadReach Health Development’s “Dreams” programme for young women is overseen by Dr Veni Naidu, who said adolescent girls and young women were disproportionately vulnerable to HIV infection due to their socio-economic circumstances.

“Orphanhood is also a risk factor, because of a lack of guidance and higher risk of GBV [gender-based violence]. Girls are often reluctant to get tested or treated for HIV as they fear judgment from their parents, caregivers, peers and health workers.”

Also Read: HIV injection can be made affordable if licences given to African producers

Dreams programme ambassador Sukoluhle Nhlabathi said she decided to engage with girls under the programme because she wanted to bring about effective change in her community.

“Young girls are being raped and don’t even know who to speak to,” she said.

“I speak to girls between 15 and 20 years old. I try to have a talk with them and also my peers, advise them to go the clinic so they can acquire more information.”

Nhlabathi added that the programme was important especially in guiding young girls on how to carry themselves and who to consult when faced with challenges.

“A safe space is needed for young girls,” she said.

Work needed to reach men

People Living with HIV civil society leader Thanduxolo Doro said it was often practically challenging or embarrassing for men to attend clinics for HIV testing, treatment and care.

UNAids reported an estimated 2.46 million adult men (aged 15 and above) were living with HIV in SA and adult men comprise 37% of all adults living with HIV in the country.

Doro, who also leads USAids’s Mina (“me in IsiZulu) initiative focused on reaching men at risk, said cultural context was important to consider.

“African men often feel pressure to be virile, strong, respected providers and protectors, and clinics can be stressful spaces,” he said.

“They may feel stripped of their power, patronised by one-directional counselling with terminology they don’t understand. We have to work from a point of empathy and inclusivity.”

Doro added he was living proof of this. “I am living proof of this message of hope.

“I have lived with HIV for 33 years, not only surviving but thriving, with a happy, virally suppressed life with my HIV-negative family. It is possible,” he said.

– lungas@citizen.co.za

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