Southern Africa remains worst affected by HIV/AIDS

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Vital care… A baby undergoes blood tests for HIV treatment.

Alvine Kapitako

WINDHOEK – Eastern and southern Africa remain the regions most affected by the HIV epidemic, accounting for 45 percent of the world’s HIV infections and 53 percent of people living with HIV globally.
This was revealed in the newly released Joint United Nations Programme on HIV/AIDS report titled, ‘Miles to go – closing gaps, breaking barriers, righting injustices.’

However, the report says there should be a responsibility between governments, civil society, international donors and the research community in delivering steep declines in HIV infections and AIDS-related mortality.
The report was released ahead of the 22nd International AIDS conference in Amsterdam in the Netherlands from July 23 to 27.

Gender inequalities and gender-based violence, combined with physiological factors, place women and girls in eastern and southern Africa at huge risk of HIV infection, according to the report.

In ten countries in the region, laws and policies that require parental consent to access sexual and reproductive health services discourage adolescent girls from accessing the services they need to stay healthy. Namibia is among the seven countries in the region that do not require parental consent for adolescent girls to access sexual and reproductive health services. The other six countries are South Africa, Tanzania, Madagascar, Kenya, Uganda and Mozambique.

In Lesotho, for example, adolescent girls need parental consent to access sexual and reproductive health services if they are younger than 14 years.

In Botswana and Zimbabwe adolescents younger than 16 years need parental consent to access these services.
“Removal of these requirements is needed, as is the rapid scale-up of intensive combination prevention programme packages, including elements that improve school attendance and empower young women to mitigate their own risk,” it is suggested in the report.

The percentage of young people aged between 15 and 24 years who had correct and comprehensive knowledge about HIV in the region ranged from 65 percent to 23 percent.

Rwanda was on top of the list in terms of having correct and comprehensive knowledge about HIV in the region with 65 percent for both young women and young men.

Kenya is in second place with 65 percent of young men being more knowledgeable about HIV compared to young women at about 55 percent.

Namibia is in third place with about 60 percent of young women being reportedly knowledgeable on HIV while young men stood at 55 percent.

Major programmes to improve HIV prevention services for young people, especially adolescent girls and young women, are being rolled out with sponsorships from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund, the report highlights.

“Greater integration of services for HIV and sexual and reproductive health and rights, including for young people, is important for reducing HIV and other health risks,” it is emphasised in the report.
Furthermore, insufficient attention is given to key populations in the region despite extremely high HIV prevalence among them.

Population size estimates suggest there are nearly one million sex workers in need of services.
Available data on prevention programme coverage for this key population ranged from 38% in South Sudan to 74% in Kenya. The number of sex workers varies in the region.

In Namibia there are reportedly 8,100 sex workers, Angola 54,000, Botswana 4,000, South Africa 240,000, Kenya 130,000 and Zambia 18,000.

Kenya reported to have the highest percentage with over 70 percent of sex workers receiving at least two HIV prevention services, according to 2016 and 2017 data availed.
It is also revealed in the report that there were 42 percent fewer deaths from AIDS-related illnesses in 2017 compared to 2010.

The scale of the region’s HIV epidemic remains massive with an estimated 800,000 [650,000–1,000,000] people in eastern and southern Africa who reportedly acquired HIV in 2017. It is estimated that 380,000 [300,000–510,000] people died of AIDS-related illness in the region.

Mozambique, South Africa and the United Republic of Tanzania accounted for more than half of new HIV infections and deaths from AIDS-related illness in the region in 2017.

Additionally, HIV-related stigma has declined across much of the region since 2000, but it remains high in several countries and more than half of household survey respondents in Comoros and Ethiopia said they would avoid buying vegetables from a vendor living with HIV.

This discriminatory attitude was also expressed by 31 percent of people in Angola, 25 percent in Uganda, 21 percent in Mozambique, 18 percent in Zimbabwe, 15 percent in Malawi and 13 percent in Botswana, suggesting that many people still lack basic knowledge about HIV.

Even though the region has been confronting major HIV epidemics for more than three decades, special surveys indicate that discrimination in healthcare settings still occurs, especially towards key populations.
About one in three people living with HIV surveyed in Mauritius said they were denied health services because of their HIV status and that their HIV status had been disclosed without consent.

In Uganda, almost two thirds (64 percent) of surveyed people who inject drugs said they avoided healthcare services for fear of discrimination or of being reported to law enforcement authorities.
UNAIDS warned that at the halfway point to the 2020 AIDS targets, the pace of progress is not matching the global ambition.

The UNAIDS executive director, Michel Sidibé, said in a press release: “Entire regions are falling behind, the huge gains we made for children are not being sustained, women are still most affected, resources are still not matching political commitments and key populations continue to be ignored. All these elements are halting progress and urgently need to be addressed head-on.”

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