South Africa’s statistics with regards to HIV and AIDS are not nearly as positive as those of Swaziland, so we can definitely stand to learn from them. One must take into consideration that our country’s population is much larger, and that we have different internal and external factors that contribute to the spread. However, if we can compare the kingdom of Eswatini to say, a small city in SA – we can tackle the HIV situation in SA like one would eat an elephant; one bite at a time.
How did they manage their HIV goals?
The prime minister of Swaziland, Ambrose Dlamini, shared the good news of their achievement as author of an article in the Daily Maverick.
“Despite facing the world’s highest HIV prevalence, Eswatini has made the remarkable achievement of being the first African nation to surpass the UN 2030 target of 95–95–95”, it reads, “This means that in our kingdom, 95% of people living with HIV have been diagnosed, 95% of those diagnosed are on treatment, and 95% of those on treatment are virally suppressed. Having reached this goal 10 years ahead of the target, Eswatini becomes the first African nation to achieve this feat”, it explains.
The prime minister attributed this victory to strong interventions and community prevention programming.
Unfortunately, abstinence and the use of condoms would only be a temporary solution. The real results came when mother-to-child transmission was made their top priority. “This dropped the rate of transmission from approximately 30% to less than 1%. This was a major breakthrough”, Ambrose stated.
Where are we in terms of 95-95-95?
Sadly, South Africa is thought to account for 20% of HIV infections, globally. According to estimates, there are about 7.7 million people in SA living with HIV.
It is thought that at least 10% of those who are HIV positive, are not aware of their status. We have recently achieved the first part of “90-90-90” goal, as we have 90% of HIV positive persons aware of their status.
However, only 68% of those who are aware are getting treatment, which means that only 62% of all who live with HIV are getting treatment. Out of that 68%, 87% are virally suppressed, which means, only 54% of those living with HIV is virally suppressed. To be virally suppressed means to have the virus almost undetectable in your blood – and greatly reduces the chance of transmission and illness due to the virus.
All and all, we are not near the 90-90-90 goal just yet, so it will take some serious work to get to 95-95-95.
The reason so many are unaware of their status may be due to a variety of reasons; perhaps they don’t have access to screening, they are not aware or educated about HIV, or just as often: “It probably won’t happen to me” – HIV does not discriminate against gender, age, race or class. Even though it is more prevalent in some communities, no one is immune.
Mother to child transmission
As mentioned, mother-to-child-transmission (MTCT) was a pivotal point in the success of Swaziland. “Once your status or that of your partner is known as HIV positive, it is of utmost importance to always make use of condoms. Women with HIV may be placed on a Depo Provera contraceptive injection, to be administered every 10 weeks”, Responsible Pharmacist at Mopani Pharmacy, Corné Cilliers explained.
However, “Life is what happens when you are busy making other plans” is how the saying goes – and as we’ve established, not everyone is aware of their status.
Pregnancy is a huge challenge if you have HIV, but you don’t have to face it alone, and it is not a solid guarantee that you will infect your baby; you need to make sure that you follow your doctor’s instructions to the letter, and go about it, well-informed.
A mother can greatly reduce her child’s chances of contracting the virus if the following is considered:
- Taking anti-retroviral (ARV) medications during pregnancy
- Making a careful choice between caesarean and normal delivery
- Not breastfeeding
- Having the baby take ARV’s for a specific time after the birth
HIV in 2020
We are fortunate to have about half a century’s worth of research and knowledge on HIV. This illness does not have to be the end for you. It can be managed, and you could live a long, healthy life.
However, one pandemic affects another – access to medical care and medication has been limited since SA went into a nationwide lockdown in March. Although lockdown restrictions have been lifted here and there, cases of COVID 19 diagnosed at the clinics among staff often results in a temporary shut-down, and patients leaving empty-handed.
As we’ve seen with the current rate of vaccinations in a previous article, many patients are avoiding trips to clinics and pharmacies in fear of contracting the COVID 19 virus. Those with HIV are at high risk, but this is all the more reason to stick to your treatment.
When patients are non-compliant with their medicine, the virus can build a resistance to it. It also gives the virus the upper-hand to gain momentum, which will be detrimental, should the patient contract the COVID 19 virus at any point.
How ARV’s work
A doctor will prescribe a combination of medication, based on your age, lifestyle, other medical issues or factors. Due to con-compliancy of patients in the past, they are now adding an extra medication into the mix, to prevent the virus from becoming resistant.
“See it as a war within your body. The virus will try to multiply and populate throughout the body. Your medication is a warfare tactic, soldiers in the fight, a strategy. You need to take all your medications specifically as prescribed, to block off the virus and prevent it from multiplying within the body”, Corné explained.
Mopani Pharmacy as your partner in support of HIV
If you are unaware of your status, you should definitely get tested – especially if you are pregnant. This is the first bite of that elephant.
Mopani Pharmacy offers screening and counseling for HIV. “We offer extensive support at Mopani Pharmacy to our HIV positive patients. We will discuss the ARV therapy goals, to make sure that our patients understands exactly how to keep themselves and their partners safe and healthy”, Corné explained.
“The next step is to explain the use of medication, and possible side effects. Some may be tempted to leave their treatment because the side effects are too severe. Please don’t. They only last a few months, and you really need to stick to your regimen, religiously. Set alarms on your phone or keep a diary if you have to! You should always keep at least three days’ worth of medication on you, so you never run out. ”
It is important to remember that this is a lifelong treatment and can never be stopped. Having one pharmacy dispensing your chronic and acute medicines will be beneficial, “We will be able to cross-reference your medicines for contra-indications and be able to make good recommendations on which supplements would be most beneficial for you”, said Corné.
Mopani Pharmacy also offers Blister packs to keep track of which medication should be taken when, and can dispense this monthly, so you will never have to run out of medication.
We are a while away from that 95-95-95, to reach it by 2030 will be nothing short of a miracle. But it goes beyond those who are living with HIV, silently. It starts with, a content creator writing an article on a sensitive subject – for the sake of delivering information on something important. A person getting tested; because even though they are scared, they know, that knowing their status could save their life, and the life of their partner. It starts with acknowledging others’ efforts in managing and beating this illness, and learning from them.
It starts, with you.
Websites and helpline numbers: www.sahivsoc.org | National Aids Helpline : 0800 012 322 | National HIV Health Care Workers Hotline: 0800 212 506