As the country enters its final month in 2020, Mzansi can marvel at how far it has come in terms of keeping the novel Corona Virus at bay. While provinces such as the Eastern Cape and Western Cape show surging numbers in positive cases, the country also observes its first pandemic, HIV/AIDS.
South Africa has the highest number of people living with HIV in the world. While the statistics show a staggering 7.7 million people in the country diagnosed with the virus, according to Avert, the country also has the world’s most extensive antiretroviral treatment (ART) programme. Boasting, as one of the most developed countries in Africa, the country also has high inequality rates. Plagued by poverty and inadequate healthcare, the pandemic of HIV/AIDS in SA continues to be an issue for many.
While little is known regarding the impact Corona has on individuals with HIV, the worry turns more to those who are not taking ART’s due to it being inaccessible or the inability to accept the diagnosis emotionally and mentally. Out of the 7.8 million, South Africans are living with HIV – five million are on ART, and a further three million remain unaccounted for, which according to University of Cape Town’s (UCT) Professor Linda-Gail Bekker is a difficult hurdle to cross. According to UNAIDS, in 2019, women accounted for most new infections in the country – further highlighting the inequalities and many barriers which existing for women’s health, education, and rights. Of all adults aged 15 years and over living with HIV, 62% were on treatment, while 63% of children aged 0–14 years living with HIV were on treatment.
“The UNAIDS goal states that The 90–90–90 targets envision that, by 2020, 90% of people living with HIV will know their HIV status, 90% of people who know their HIV-positive status will be accessing treatment and 90% of people on treatment will have suppressed viral loads. According to Avert, in 2018, 90% of people living with HIV were aware of their status, of which 68% were on treatment. Of those diagnosed and on treatment, 87% were virally suppressed. This equates to 62% of all people living with HIV in South Africa on treatment and 54% virally suppressed.”
Professor Gail Bekker adds that the country has seen improvements in the mortality rate of AIDS. The country’s AIDS-related deaths dropped in half – from 30.6% in 2002 to 15% in 2020. These numbers prove that the country’s ART programme is working exceptionally well, yet the Prof states that more can be done when the unaccounted-for 3 million can be catered to. To do that, an effective treatment plan needs to be enforced to ensure that while ART is made available, individuals also adhere to the treatment plan.
The Country’s High rates
Regarding the country’s high numbers of infections, it begs the question – why does the country carry such high infection numbers if it is one of the most economically advanced nations on the continent? The HIV prevalence rates amongst young adults, (15–49 years) was 20.4%. According to the CSIC, the reasons for this are both biological and social. The high rates of teenage pregnancy, the Gender-Based Violence epidemic that the country faces and the socio-economic issues of poverty which include unemployment and low education levels all contribute to the high number that the state is faced with. It was also observed that High rates of sexually transmitted infections (STIs) increase the risk of HIV acquisition, and mental health issues can lead to risky behaviours.
Emphasis has been put on men, who compared to women, hardly visit health care professionals. It was observed that where women go to the clinic regularly either for themselves or for their children, men hardly visit the clinic, which suggests they either don’t find out about their status or don’t receive regular treatment. In many communities, it also considered weak for men to seek healthcare, further probing the question if healthcare gender-neutral. The reality that many faces in terms of unemployment and poverty often overtakes the prevalence of HIV/AIDS – the problems are many, and the inability to curb the one usually affects the other.
While PrEP reduces vulnerability to infection by 99 per cent, the roll-out of PrEP in the country has been somewhat slow. The stigma which exists around the virus also means fewer people are willing to disclose their status and take treatment for it. The high poverty rates mean that many have to travel far to receive their treatment or cannot afford the healthy lifestyle required to stay healthy. And as mentioned above, other socio-economic issues in some cases outweigh the importance of treating the virus. The miseducation, and in many cases, the lack of, is also a significant issue that can be attributed to a particular behaviour. Not only do schools carry responsibility but other stakeholders.
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