Rural women living with HIV in circumstances of poverty in South Africa face discrimination in relationships and in communities because of their gender, HIV status and economic marginalisation. A new Amnesty International report based on interviews with rural women, the majority of them living with HIV, exposes the overwhelming challenges they face in the midst of the severe HIV epidemic affecting the country. Despite gradual improvements in the government's response to the HIV epidemic and the adoption of a widely-welcomed five-year plan, five and a half million South Africans are HIV-infected – one of the highest numbers in any country in the world. Fifty-five percent of them are women. South African women under 25 are between three and four times more likely to be HIV-infected than men in the same age group.
Equity and HIV/AIDS
The government of Rwanda, through the National AIDS Commission, is intensifying condom use campaigns with plans to install seven hundred condom vending machines countrywide in 2011, the executive secretary of the National Aids Commission, Anita Asiimwe, has said. The Commission plans to install the vending machines at places of hospitality like hotels, bars, and restaurants for easy access. The machines helped many people avoid the embarrassment of buying condoms in ordinary shops, she said. The condom use campaigns were launched in 2009 and had proved positive with people changing attitude towards the method. The campaign launched to mark 2009’s World Aids Day was meant to sensitise the public on condom use on top of abstinence and faithfulness – topics which were given much publicity but without quantified results. The seven hundred condom vending machines follow another one hundred and fifty machines that were installed in 2009.
Between 1997 and 2002, according to a new report from Stats SA, South Africa's official statistics agency, the number of recorded deaths in the age group from 20 to 45 more than doubled, from a little over 100,000 to more than 200,000. Although most deaths likely to be linked to AIDS are officially recorded as due to associated diseases such as TB and pneumonia, the age and disease pattern provides strong evidence of the growing impact of AIDS. Other previous studies, such as those from South Africa's Medical Research Council, have provided similar indications. But the issue is still contentious, as AIDS denialists have used the relatively low numbers attributed directly to AIDS to claim that researchers are exaggerating the problem. The latest issue of the AfricaFocus Bulletin contains postings that examine the issues in detail.
South Africa's Health Ministry spokesman Sibani Mngadi dismissed harsh criticism of its AIDS policy by a top UN official "with contempt" and said he was no Messiah for Africa's HIV/AIDS crisis. UN special envoy on AIDS in Africa Stephen Lewis closed a global conference with probably the most blistering attack ever on South Africa's "lunatic fringe" approach to AIDS, calling it immoral and ineffective.
At least 28% of schoolgirls across South Africa are HIV positive, with only 4% of boys at schools HIV positive in comparison, according to figures released by Health Minister Aaron Motsoaledi at a National Council of Provinces ‘taking Parliament to the people’ event. He added that 94,000 schoolgirls got pregnant in 2011 and about 77,000 girls had abortions at public facilities. The minister attributed the high figures to the sugar daddy phenomenon, a transactional sexual relationship between older men with money and schoolgirls, where sex is traded for physical goods, such as cell phones and accessories. Young women put themselves at risk because they don’t have the agency to be able to negotiate safe sex, he argued. There is the risk for considerable physical, psychological and emotional harm. In recognition of the growing problem, in January 2012 the KwaZulu-Natal department of health launched a campaign against sugar daddies with a call to action to ‘protect your loved ones from sugar daddies’.
A new project by the South African NGO, Health Systems Trust (HST), will enable communities across the country to provide feedback on progress in the rollout of free anti-AIDS medication. HST, based in the east-coast city of Durban, is developing a monitoring and evaluation tool to screen communities' access to free antiretroviral (ARV) drugs, and will also provide technical assistance in lobbying provincial and national government. The national treatment programme has come under fire from activists over the slow pace of delivery and problems with the procurement of ARVs.
Good governance in the Southern African Development Community (SADC) was the key to dealing with HIV/AIDS, Judge Edwin Cameron said. "Where there are human rights abuse, we cannot deal properly with Aids," Cameron said in Johannesburg at the launch of the AIDS Rights Alliance for Southern Africa's (Arasa's) report on HIV/AIDS and human rights in the SADC region. The report is an evaluation of the steps taken by countries in the SADC region to implement international guidelines on HIV/AIDS and human rights.
In the fight against HIV/AIDS, think 'DRC' and not 'ABC', a new Southern African Development Community (SADC) report says. The report said the old model of controlling the lethal virus through a programme of ABC (Abstinence, Being faithful and Condom use) should be replaced by 'DRC' - Delaying sex, Reducing partners and continued Condom use.
While a number of countries in southern Africa have made great strides in improving access to antiretroviral (ARV) treatment for HIV-infected adults, progress in rolling out treatment for HIV-positive infants and children has lagged behind. Namibia is a notable exception. Over 7,600 children are receiving ARV treatment – 100% of those estimated to be in need of the life-prolonging medicine. Mother-to-child HIV transmission (PMTCT) programmes are available at 202 health facilities. ‘We are meeting targets for children on ARVs, but they are starting late,’ said Dr Agostino Munyiri, chief of health and nutrition at the United Nations Children’s Fund. Children born to HIV-positive mothers should ideally be tested when they are six weeks old, but the median age for testing is currently 17 weeks. ‘Many present with malnutrition and only then are tested for HIV, and even then not all are tested,’ Munyiri added. ‘We know they come back for immunisation [against various diseases]; we need to catch them at that stage.’
This report from the Centre for Health and Gender Equity outlines the importance of the female condom in preventing the spread of HIV. Female condoms are not readily accessible in most countries and significant investment is needed to overcome barriers to their use such as cost and difficulty of use, however the report finds that in the countries where they are accessible, there is a growing demand for them. The report concludes that high quality female condom programming is critical to increasing female condom demand and uptake. The role of the US government in these programmes is highlighted. The authors recommend policy changes that will promote the integration of female condoms into HIV prevention and family planning programmes within US funded development programs, including PEPFAR.