World Aids Day: What you need to know
Dr Tiyiselani Mkhawana speaks about HIV and Aids, the misconceptions, and the statistics and advice in light of World Aids Day recently.
In light of World Aids Day (December 1), general practitioner Dr Tiyiselani Mkhawana spoke about the syndrome to spread awareness.
World Aids Day is a global day dedicated to raising awareness of the acquired immunodeficiency syndrome (Aids) pandemic caused by the spread of the human immunodeficiency virus (HIV) infection and remembering those who have died from it.
Mkhawana stated that according to the World Health Organisation (WHO), global statistics show that between 36 million and 44 million people were living with HIV in 2023. According to the Joint United Nations Programme on HIV/ Aids, at the end of 2023, there were over seven million adults and children living with HIV in South Africa. This is one of the highest prevalences in the world.
The WHO defines HIV as, “A virus that attacks the body’s immune system, specifically the CD4 white blood cells. HIV weakens the immune system, making it harder to fight off infections and some cancers.”
On the other hand, Aids is defined by the same organisation as, “The most advanced stage of HIV infection, when a person has a CD4 cell count below 200 or develops certain cancers or infections.”
According to Mkhawana, the good news is that the rate of new HIV infections has dropped significantly by 60% since 1995. That means that in 2023, 1.3 million people were newly infected with HIV compared to 3.3 million people in 1995. Also, Mkhawana stated there has been a significant decline in new infections since 2010.
The bad news he said is that about 630 000 people died due to Aids-related illnesses worldwide in 2023.
“The aim is to bring down the number of deaths to less than 250 000 in 2025.”
He added that some of the regions with the highest HIV rates and deaths include Eswatini, Botswana, Lesotho and Zimbabwe. Mkhawana attributed the reason to structural factors and societal conditions, individual behaviours and biomedical factors. This includes health care challenges, high-risk sexual behaviour and conditions such as genital mucosal.
“During my undergraduate studies, it was the era of ‘Poverty causing Aids’. I witnessed many people losing their lives due to lack of treatment. I witnessed the evolution of treatments from the toxic drugs, to now the recently fixed-dose combinations with minimal side effects,” he expressed.
He further mentioned despite education and advanced knowledge regarding HIV, it remains a highly stigmatised condition.
“Some of the reasons why these stigmas exist might be due to the idea that most infections are caused by sexual encounters while some are cultural and religious beliefs. Although we are living in a democratic country, people’s sexual orientation is still heavily criticised by many individuals, especially in a South African context. I have noted that with appropriate education and counselling, people adapt better to the stigma. Good support structure such as family and friends help people living with HIV to cope better,” he noted.
In South Africa, antiretroviral therapy (ARV) is accessible to all people living with HIV. This includes free treatment at a public facility. He stated the medical field also adopted a fixed-dose combination ARV therapy to reduce the pill burden. This encourages people to take their treatment.
According to Mkhawana, the availability of HIV kits at retail pharmacies is another strategy that improved the number of testing and early treatment.
“Pre-exposure prophylaxis (Prep) is used to prevent and treat HIV as well. To prevent infection, individuals should always have intercourse while wearing a condom and should avoid using any sharp object to make a wound, such as a needle.”
Mkhawana then explained a few misconceptions surrounding HIV. Some of the myths include:
• Some people believe their HIV-related illnesses are an ancestral calling
• Some people believe HIV is of a demonic background
• Someone who is infected, is of a promiscuous nature
• Some believe a certain blood type will prevent them from getting infected
• Infected women will not be able to have healthy babies
• HIV is a death penalty
He explained HIV can also have a certain effect on a person’s mental health.
“Some people present with acute psychosis due to HIV itself. So, it is important to always exclude general medical conditions in all mental health cases. It may also trigger mental health issues such as depression. This situation would need support, sensitivity and well-trained staff to manage it,” he said.
