In South Africa women are much more likely to test than men. However, there are other barriers to men testing. Those who have taken an HIV test and know their status are more likely to have a higher level of education, be employed, have accurate HIV knowledge and a higher perception of risk. Those living in rural areas are as much as two times less likely to have tested for HIV. The new National Strategic Plan has identified closing these testing gaps as being a key priority in the coming years.
They plan on decentralising testing, so that more work places and community settings are able to provide HIV tests. As well as this the country will be rolling out self-testing on a wider scale. There are many people who want to test and who do not want to interface with the healthcare system. We believe the more people testing, the better. Let's get as many people to test as possible. As a result MTCT rates have fallen from 3. The previous national HIV strategy aimed to reduce maternal mortality by three quarters between and , from deaths per , live births to 38 per , While condom distribution may have increased in recent years, there is evidence that the use of condoms may be declining.
Challenges remain in ensuring that condom programmes are able to serve all groups, particularly those with higher HIV risk. In December South Africa became the first country in sub-Saharan Africa to fully approve pre-exposure prophylaxis PrEP , the use of antiretroviral drugs to protect HIV-negative people from infection. In , it was estimated that between 30, and 35, individuals were being targeted with PrEP in ongoing and planned projects across South Africa.
People ask me, 'How can you afford to implement new interventions? Barriers to providing comprehensive sex education in schools include high drop-out rates, a shortage of teacher training, and resistance in schools because of the perceived sensitive nature of the subject matter. We need to be able to assist our learners to prevent and report incidents of violence and I think this more in-depth training will help.
These topics are so important to the emotional, social and moral development of learners who need to feel equipped to make the right decisions in their lives. By contrast, knowledge around safe breastfeeding practices among pregnant mothers living with HIV remains low.
However, the organisation has since turned its attention to breaking down the social and structural drivers of HIV among young people, including poverty and lack of opportunites. They promote the economic empowerment of young people, using a range of different communication techniques, including TV and Radio. Biggest successes in the past have included the Soul City and Soul Buddyz series, targeting adults and children respectively. The series was made in collaboration with nine other countries in southern Africa.
Each episode focused on a different context relevant topic. A recent report showed that those who watched the programme often reported having discussed the issues raised with others and there is evidence that it produced behaviour change such as increasing HIV testing. MTV Shuga is a mass-media behaviour-change campaign that aims to improve the sexual and reproductive health of young people. It began in and centres around an awarding-winning TV series, supported by radio, digital, social media and mobile elements.
Previous series have been set in Kenya and Nigeria. Evaluations of previous series have found that viewers of MTV Shuga were more likely to get tested for HIV and the airing of the show was associated with reduced chlamydia infections in young women. South Africa has the largest ART programme in the world.
This has meant that the number of people eligible for treatment has increased from 3. Initially many were concerned that the dramatic scale-up of ART would result in clinics and services becoming over-stretched and that the quality of care would suffer as a result. However, one year on, studies have shown that the increase in ART provision has had no significant effect on patient outcomes, either in terms of either AIDS-related deaths or illnesses.
Studies have, however, highlighted other issues around treatment provision. They found that men were more likely to start ART at an older age and later stage of infection and had almost double the mortality rate than that of women. This again highlights the need to engage men in testing services and ensure that they are linked to treatment.
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