South Africa runs the world’s largest HIV treatment programme. Along the way, our country has led the development of many innovations to make sure that SA and the world are able to end the HIV epidemic.

There have been significant successes in preventing mother-to-child transmission of HIV. In Right to Care’s programmes, there is a transmission rate of less than 1%. Right to Care’s paediatric experts have contributed to efforts that facilitated the availability of treatment that is more palatable and tolerable for children who are on antiretroviral treatment. There is still the challenge of children being lost to care.

One-third of people living with TB have HIV. TB is very infectious. An HIV-positive person who is virally suppressed is less likely to get TB. The more people who are virally suppressed, the less active TB is. There have been significant developments in TB control in SA such as finding and screening the right people, automatic TB testing and digital chest x-ray screening. The earlier TB is diagnosed, the quicker treatment can be initiated. Those at risk for TB but don’t have active TB, are started on TB preventive treatment. We look forward to the rollout of the National Department of Health’s mobile screening services in high TB areas across SA. In SA, adult girls and young women account for 35% of all new HIV infections. Through the USAID-funded DREAMS programme, young women in communities where DREAMS is active, have access to HIV testing, treatment and HIV prevention in the form of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). They are offered screening for HPV and linked to other psychosocial support services they may need.

Gender-based violence (GBV) remains a major barrier in preventing HIV. Right to Care’s healthcare workers use an intimate partner violence screening tool to identify and support vulnerable women.

The groups at risk such as adolescent girls and young women, the LGBTQ community, people who inject drugs, and men who have sex with men remain more vulnerable to HIV. It is vital that HIV treatment and prevention is delivered with other routine healthcare services in facilities by ensuring that healthcare providers are trained to respond to the needs of each patient in these groups without stigma or shame.

Challenges: Still left to do

We need to scale up comprehensive healthcare services that include HIV screening, treatment and education.

There are significant knowledge gaps about all the HIV prevention methods such as pre-exposure prophylaxis (PrEP) which prevents HIV before sex, post-exposure prophylaxis (PEP) which helps prevent HIV after sex, and voluntary medical male circumcision. People need more medication education. We also need to make sure condoms are more widely available in communities and facilities.

Source: Right to Care