HIV/Aids and TB remain a leading public health challenge for Ekurhuleni.
Latest statistics suggest 450 000 people in the metro are HIV positive. Currently 167 698 of them are on ARVs, of these 7 243 are children under 15. In the year 2013/14, 39 127 new patients started treatment.
According to DA shadow MMC for health and social development, Geoff Fenn, the perception that it is a shame to be diagnosed HIV positive discourages many people to test for fear of being discriminated against, resulting in late treatment of the disease.
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“Late treatment means treatment might not be successful and it’s difficult to recover the immune system to normal levels. Late treatment also means the infected person is highly infectious with a high viral load, compared to those on treatment with an undetectable viral load, who are highly unlikely to infect their partners,” Fenn explained.
According to Fenn, areas where the metro has the most challenges are in certain highly vulnerable groups such as “men who have sex with men (MSM). “We use this term as this group does not always identify themselves as gay or homosexual, sex workers and intravenous drug users.”
The MSM group is especially vulnerable as this group of people is difficult to identify and engage with because they are secretive and nervous about coming out. This is especially so in townships, where these groups are discriminated against and need constant education about risky behaviour.
Therefore, special programmes need to be introduced that will make it easier to engage with MSM.
“For injecting drug users (although not widely spread) needle exchange programmes have been shown to be effective in reducing transmission rates. Decriminalising sex work has also been effective in reducing HIV transmission as sex workers don’t feel threatened and can voluntarily seek help without threat of legal action.”
Another big challenge used to be the diagnosis of TB, which was difficult to detect in the past and would often lead to false, negative results, even with X-rays and sputum tests.
“We now use a gene Xpert test in clinics and private practice. It can tell you if the TB is a resistant strain and gives a result in under 24 hours.”
The use of this new technology is significant because it is imperative to treat TB first before starting ARV treatment as a severe life-threatening reaction can be triggered by starting ARVs before TB treatment. “Now, it is recommended to treat the TB for two weeks prior to commencing ARVs.
Since the introduction of prevention of mother-to-child transmission programmes, under 2%, or 297, babies were born HIV positive in 2013/14. However, there are still some pregnant mothers who aren’t testing for the virus.
“So our approach to stem the tide going forward should include concentrating our efforts on vulnerable groups with a higher incidence. Awareness programmes should be directed at those communities where clinics experience a higher incidence of HIV. The effectiveness of condoms in reducing transmission must be re-affirmed. More people need to be put onto ARVs because those taking their treatment properly have undetectable viral loads and are highly unlikely to transmit the virus.”
