HIV: Ounce of prevention is worth a pound of cure

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HIV: Ounce of prevention is worth a pound of cure

Despite ‘miracle’ drugs, the Aids battle is far from won because our prevention interventions are completely out of sync

Angelo C Louw

Despite monumental feats in the fight against HIV in recent years, we are nowhere close to the end of this battle.
For as long as key risk populations are denied access to groundbreaking treatment, any breakthrough is simply null and void; without proper access to relevant treatment and health services, those most vulnerable will continue to bear the brunt of the pandemic.
A quick Google search of “HIV in South Africa” is all it takes to witness the greatest health conundrum we’ve yet faced – and perhaps the obvious answer to that same predicament. For every headline celebrating new miracle HIV drugs, you will find one pointing out growing infection rates among young girls who sleep with older men, and men who sleep with men (MSM).
This has been the trend for as long as we’ve made the distinction between HIV and Aids, and that it still continues in this fashion even in light of these “miracle drugs” is a sure indication that our prevention interventions are completely out of sync.Pre-Exposure Prophylaxis (PrEP), the most recent addition to the mix of HIV-prevention efforts, helps those who stick to the strict treatment regime from contracting HIV.
The wonderful thing about this drug is the autonomy it affords users, particularly young women who often are unable to negotiate condom use with their sex partners for a host of reasons, which is a major contributing factor to high HIV rates within this key population group.
But PrEP is not yet widely accessible in the public sector in South Africa. It is only available through demonstration sites, clinical research institutes and the private sector. A month’s supply costs between R300 and R550 from the private sector and not all medical aids will cover the cost.
Apart from a special intervention targeting MSM in certain provinces, PrEP is only given to HIV-negative people who self-identify as being at substantial risk of acquiring HIV.And if we’ve learnt anything from HSRC’s Stigma Index (2014) it’s that people are already petrified about what seeking sexual reproductive health services says about them. So how many young girls do we expect to declare their sexual behaviour as “risky” at the local clinic?
Yet, our government remains confident in its plans to curb the estimated 2,000 HIV infections that occur weekly in South Africa among women betqween the ages of 15 and 24. However, if one looks at HIV interventions that have been successful in South Africa, it becomes blatantly clear that universal access to treatment is key.The only reason for the drastic drop in mother-to-child transmission of the virus is because pregnant women in the public healthcare system have no choice but to be screened for HIV – and, if positive, undergo treatment to ensure that their babies are born healthy.
The number of Aids-related deaths have halved over the past decade simply because our government made antiretroviral therapy available to all who need it. But while these successes are outstanding, considering the scale of our HIV problem, an ounce of prevention is still worth a pound of cure, especially from a cost perspective.
New research in the US shows that while antiretroviral therapy has helped people with HIV live longer, their organs tend to age faster. What this means for our public health sector is an increase in cases of illness associated with old age, such as heart disease and diabetes.Any money saved by skimping on budgets for preventive treatment will eventually be needed for treatment of other illnesses caused by the virus down the line. In trying to be penny wise our government is being rather pound foolish.
With viable preventative measures available, any excuse to prolong this vicious cycle is exactly that: an excuse. Just another way that old men are ruining the lives of young South African girls.
• World Aids Vaccine Day, also known as HIV Vaccine Awareness Day, is observed annually on May 18. HIV vaccine advocates mark the day by promoting the continued urgent need for a vaccine to prevent HIV infection and Aids.
• Angelo C Louw is a cause communicator and activist based in Johannesburg who recently returned from a year-long Fulbright professional development programme.

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