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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.
Global information and education on HIV and AIDS
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.
Commenting on the current challenges around treatment in an interview with Avert, Sibongile Tshabalala, Chairperson of the Treatment Action Campaign said:. Although there is still a lot of stigma, the normalisation of treatment is helping people talk differently about HIV. The main challenge around treatment is stopping people from defaulting, either because pastors and churches suggest that they are not needed or because people cannot cope with poor side effects including depressive symptoms.
In March it was estimated that there were , civil society organisations working in the South African HIV response. One of the most notorious civil societies is the Treatment Action Campaign, formed in They have been a driving force in the South African response ever since, promoting access to HIV treatment and care for all South Africans. Funding is a major issue facing many civil society organisations.
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Drops in external funding are making civil society organisations more dependent on financing from the government. While domestic funding is a more sustainable model, the shift has increased competition amongst organisations, and is seen by some as undermining their ability to challenge government policy in their work.
Tuberculosis is the leading cause of death in South Africa. Still the South African National AIDS Council predicts that there will be some funding gaps, however at these early stages it is unclear how severe these will be, especially since there is a level of uncertainty around the availability of international funding for HIV and AIDS in the coming years, particularly from US funding bodies with the new Trump administration.
The NSP outlines plans to roll-out Dolutegravir.
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It is thought that the introduction of these medicines will help reduce some of the treatment costs, having been proved to be safer and more effective that the regimens currently being used. South Africa has made great strides in tackling its HIV epidemic in recent years and now has the biggest HIV treatment programme in the world. Moreover, these efforts are now largely funded from South Africa's own resources.
HIV prevention initiatives are having a significant impact on mother-to-child transmission rates in particular, which are falling dramatically. New HIV infections overall have fallen by half in the last decade, however, there are still too many. While the short term financing of South Africa's HIV epidemic is secure, in the longer term, the government needs to explore other strategies in order to sustain and expand its progress.
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