June 26, 2023

Shame around sex, condom shortages contribute to HIV infection rates - TAC

The Treatment Action Campaign says lack of awareness about HIV prevention, shame around sex and shortages of condoms are among the contributors to infection rates.
The SA National Aids Council said 1 300 people aged 15 to 24 were infected with HIV every week nationally.
Campaign spokesperson Xabisa Qwabe told News24 that young people were shamed at health facilities for seeking treatment or condoms.
Lack of awareness about HIV prevention measures and shame around sex and condom shortages are among the contributors to infection rates, says Treatment Action Campaign (TAC) spokesperson, Xabisa Qwabe.

Qwabe said some young people felt uncomfortable going to healthcare centres to get condoms because of the shame associated with being sexually active.

She said those who did, reported condom shortages at local clinics. Facilities often ran out of male condoms and either had stock of female condoms without the lubricants, or lubricants without the condoms, she said.

Qabe was responding to the SA National Aids Council, which said South Africa registered 1 300 weekly cases of HIV infections among people aged 15 to 24/

Condom shortages also exposed people to sexually transmitted infections, which PrEP (pre-exposure prophylaxis) isn't effective against, she said.

"They said the oral PrEP doesn't work for them because they forget to take it. They preferred injectables every three months. We are calling on the government to introduce injectable PrEP."

National Department of Health spokesperson Foster Mohale told News24 the department acknowledged low stock and recommended that provinces closely monitor condom shortages.

He added the department encouraged the use of female condoms, which were available in larger quantities than male condoms were.

Responding to calls for injectable PrEP, he said only the oral version was available for public use.

He said:

The other two (injectable and dapivirine ring) are under either pilot or awaiting regulatory approvals. Sahpra (SA Health Products Regulatory Authority) has approved both for use in SA. Most youth would prefer the pill because it is long acting and does not worry the user with adherence issues for the two months.

In December, Sahpra announced that it had registered the Apretude 600 mg/3ml injection, which is the first and only long-acting, injectable PrEP that can be used to reduce the risk of contracting HIV.

The antiretroviral injection was called Cabotegravir, also referred to as CAB-LA/CAB.

Sahpra said CAB-LA was administered as an intramuscular (IM) injection once a month for the first two months to assess tolerability. Thereafter, a person receives an injection once every two months.

"This medication can stay in your body for 12 months or longer after your last injection.

"The Bhekisisa Centre for Health Journalism reported that the local arm of the Indian drug company Cipla had confirmed that a generic version of CAB-LA would be made at its plants in Benoni or Durban.

Qwabe believed that part of the challenge was that young people and even some healthcare workers did not know enough about PrEP.

Qwabe added:

How can they effectively prescribe something they don't understand themselves? This means they give it to young people without educating them about the importance of using it.
Qwabe also said there was a need for effective HIV awareness campaigns and mobile clinics wherever young people spent their time, including in schools, health facilities and taverns.

"Instead of waiting for them to go to clinics, treatment must be accessible wherever they are. Another reason they give up going there is the shame and questions about their sex lives," she said.

Health Minister Joe Phaahla said there was a need to raise awareness about the health and social effects of HIV.

Speaking during the opening ceremony of the South African Aids conference in Durban last week, the minister said 94% of the people living with HIV knew their status - 77% of these were on antiretroviral treatment, and 92% had a suppressed viral load. He said this was short of the "95-95-95" target.

He added:

A new set of ambitious targets calls for 95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy to have viral suppression by 2025.
Speaking at the closing of the conference on Friday, he said the national strategy plan (NSP) on HIV/Aids, STIs and TB put people and communities at the centre of the country's efforts to end Aids and associated diseases. He said the NSP provided a strategic framework to eliminate HIV, TB and STIs as public threats by 2030.

by Cebelihle Bhengu