HIV incidence among women between 15 and 49 is increasing in South Africa while rates in other groups decline. Prevention needs more than lip service to reverse this deadly trend. With more than 2.5 million people now on antiretroviral (ARV) treatment, an increasing national focus on treatment and adherence means that women-centred prevention strategies are being neglected.
Disappointing findings that vaginal microbicide gel is not effective in preventing HIV highlights the urgent need for research into a range of HIV prevention options that will fit more easily into the lives of women. We must step-up the procurement and promotion of female condoms and create the demand for this life-saving product.
With gender based violence at epidemic levels and encouraging Pre-Exposure Prophylaxis (PrEP) research findings (a CDC trial in Botswana, for example, found that PrEP reduced the risk of heterosexual transmission of HIV by roughly 63% in the study group overall), we must identify at-risk women and start trialling PrEP treatment.
According to the World Health Organisation, some studies suggest that women using progestogen-only injectable contraception may be at increased risk of HIV acquisition. Thorough counselling on hormonal contraception must therefore be given to women across South Africa, especially HIV positive women. We must ensure that healthcare workers are properly trained to discuss the benefits and risks of all forms of contraception and how they interact with HIV and AIDS.
Perhaps most importantly, addressing the structural drivers of HIV – inequality and discrimination, stigma, unemployment, poverty, poor educational opportunities and gender based violence – must form a critical part of the country’s prevention agenda.
We call for ZERO for women and girls in the NSP (2017 – 2021).
South Africa’s women and girls need a range of prevention technologies and strategies which address their diverse realities and integrate with their lives – we need more than lip service.