Keeping young women HIV free

AS South Africa commemorates Youth Month, the various challenges that young people have to face cannot be ignored. In addition to unemployment and gender-based violence (GBV), one of the major challenges faced by young people, particularly young women between the ages of 15 and 24, is the risk of contracting HIV.

Studies show that four decades after HIV was first identified, adolescent girls and young women (AGYW) in the age group 15 to 24, continue to account for almost a quarter of all new HIV infections in South Africa.

Put differently, this is approximately 180 new daily infections in this age group. An article published in The Lancet offers some answers, suggesting adolescent girls and young women in this age group are generally infected by HIV-positive men in their late 20s and early 30s, who are often unaware that they have HIV.

Shout-It-Now, a South African nonprofit company, is part of the solution – it brings its free, mobile, youthfriendly medical and behavioural HIV prevention, GBV, and sexual and reproductive health services (SRH), particularly to young girls and women in the age group 15-24, to communities in Gauteng and the North West.

Dr Albert Machinda, chief operating officer at Shout-It-Now said, “Knowing what we now know about HIV infections in young girls and women and the relationship between GBV, we know that the use of pre-exposure prophylaxis or PrEP can go a long way towards protecting them from contracting HIV.

“We know that due to structural socio-economic inequalities, young girls and women are not always in a position to negotiate safe sexual relationships.

“Various studies have shown that when taken daily, PrEP is 99% effective in preventing HIV infections, it can be the answer to keeping young girls and women HIV free. Importantly, PrEP can be stopped when there is no longer a risk of contracting HIV.

“Despite all the benefits of PrEP, we have seen a very low uptake, due to low awareness of it as a new HIV prevention option.

“Furthermore, for those few who do try PrEP, there are problems with

proper adherence to its consistent use due to stigma and judgement from loved ones and family.

“The Desmond Tutu HIV Centre and the University of California have found that when young women disclose their use of PrEP to loved ones, the attitudes and perceptions they may face can impact negatively on its continued use. This means they are at increased risk of HIV infection which could be prevented by the daily use of a single pill.

“We, therefore, call on families, loved ones, teachers, pastors and mentors to be supportive too, and to actually encourage young people, and women, in particular, to use PrEP. The consequences of not using PrEP can last a lifetime,” said Dr Machinda.

Shout-It-Now is also able to offer, among other services, on-site PrEP initiation to at-risk adolescent girls and young women in the communities in which it works. It is important to note that youth need to be 15 years or older to be eligible to access PrEP, he added.

“We prioritise the psychological and emotional safety of those who require our support and therefore recruit skilled professionals from the communities in which we work to be part of our teams. We can offer services that are culturally and linguistically appropriate.”

He observes that Ekurhuleni has one of the highest HIV prevalence rates in the country, and this scourge occurs in tandem with other sexually-transmitted infections (STIs), teen pregnancies and gender-based violence (GBV).

The district’s latest statistics from 2016 estimate that the overall HIV prevalence in the city is at 12.7% (7.03 million infections), with an estimated 18.9% of the adult population aged 15 to 49 being HIV positive.

Shout-It-Now’s mobile vehicles travel around Ekurhuleni to offer fast, free and friendly services to youth at various locations and times. Their highly-skilled and trained staff are recruited from the community and understand the culture and particular challenges young people face growing up in the region.

The HIV prevention pill, PrEP, can be accessed at 151 of the province’s 368 primary healthcare clinics, according to the Department of Health. In addition, 1 227 public sector healthcare facilities across the country have reported that they have started patients on PrEP, amounting to 36% of all facilities.

Shout-It-Now is a South African non-profit company that provides free, mobile, innovative and integrated community based biomedical and behavioural HIV prevention, gender-based violence, and sexual and reproductive health services to communities in Gauteng and the North West.