PRETORIA, 28 January 2020 – The South African National AIDS Council (SANAC) welcomes the latest South African Health Review 2019 (SAHR) report released by the Health Systems Trust (HST). The data on HIV and TB in the report is not divergent from recent data published by other institutions such as the HSRC and the MRC, which has guided SANAC and its stakeholders in programme design and implementation.
The SAHR report has indeed shared data that re-confirms what we know about the epidemic and supports the priority activities and recommendations prioritized by SANAC towards the full implementation of the National Strategic Plan (NSP) for HIV, TB and STIs (2017-2022). Goal 3 of the NSP outlines customized and targeted interventions for key and vulnerable populations, including adolescent girls and young women. Goal 4 of the NSP further guides efforts to reduce the vulnerability of adolescent girls and young women by addressing the social and structural drivers of the epidemic.
The SAHR notes the 5.8% HIV prevalence among adolescent girls and young women compared with only 4.8% of their male peers; a gendered trend that we have become familiar with over the past decade. The mid-term review of the National Strategic Plan completes this picture by also showing that new HIV infections are reducing amongst both males and females aged 15-24 years old (26% and 18% respectively from 2016-2018) and that AIDS-related deaths are reducing – which contributes to a greater pool of youth living with HIV.
Various factors contribute to the disproportionate prevalence among males and females; these factors range from biological to social. Women are biologically more vulnerable to HIV infection compared to men. Women are also socially more vulnerable to HIV infection. Age discordant (and often transactional) sexual relationships are common in our communities and are often governed by power dynamics, which pose a large threat to the efficacy of our HIV response and the agency of women.
Boys on the other hand, are exempt from these challenges and tend to have lesser chances of contracting HIV and other sexually transmitted infections, especially if they are circumcised.
In an effort to further scale up programmes to holistically respond to the vulnerabilities faced by adolescent girls and young women, SANAC and key partners are concluding a rapid assessment of the She Conquers Campaign. This assessment will provide recommendations for a coordinated and resourced prevention response with accelerated efforts to ensure that all youth (not just adolescent girls and young women) are reached with targeted interventions that will keep them in school, HIV-free and safe from abuse.
SANAC is also focusing on interventions with male sexual partners of young women, and men in communities. SANAC in partnership with the National Department of Social Development have been hosting Boys Assemblies and Men’s Parliaments in all districts of South Africa. These forums bring together men and boys to tackle issues of HIV prevention, toxic masculinity, femicide, gender-based violence and the importance of fostering health-seeking behaviour. In addition, investments from the Global Fund have been earmarked for young boys 10-14 and also male partners of adolescent girls and young women to ensure a comprehensive approach to prevention.
In the next couple of weeks, the country will observe the STI/Condom Week (10-14 Feb) and the National Department of Health in collaboration with SANAC will relaunch the Max Condom in an effort to improve the use of condoms as a form of protection against HIV and STIs. It has been noted in various studies that condom use is declining in the country and we need to change this narrative.
SANAC is also lobbying for the continued scale up of Pre-Exposure Prophylaxis (PrEP) in all public health facilities, especially to key and vulnerable populations.
The SAHR report remains a critical resource for all stakeholders of SANAC to inform interventions against emergent challenges and a transforming epidemic.
For more information, please contact: Musa Mhlongo, SANAC Communications 082 474 1703 / firstname.lastname@example.org