HIV/AIDS in South Africa Dr. Nono Simelela Chief Director: HIV/AIDS and STDs.
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Transcript of HIV/AIDS in South Africa Dr. Nono Simelela Chief Director: HIV/AIDS and STDs.
HIV Prevalence in women HIV Prevalence in women attending public antenatal attending public antenatal clinics, 1991 - clinics, 1991 - 20002000, South Africa, South Africa
0
5
10
15
20
25
30
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
HIV prevalence in women HIV prevalence in women attending antenatal clinics by attending antenatal clinics by age, South Africa, age, South Africa, 20002000
0
5
10
15
20
25
30
35
<20 20-24 25-29 30-34 35-39 40-44 45-49
19992000
HIV prevalence in women HIV prevalence in women attending antenatal clinics, by attending antenatal clinics, by province, province, 20002000
0
5
10
15
20
25
30
35
40
1999 7.1 10.1 11.4 18 23 23.9 27.3 27.9 32.5
2000 8.7 11.2 13.2 20.2 22.9 29.4 29.7 27.9 36.2
WC NC NP EC NW GP MP FS KZN
Estimated number of AIDS Estimated number of AIDS deaths in South Africa per yeardeaths in South Africa per year
050000100000150000200000250000
300000350000400000450000500000
1998 1999 2000 2001 2002 2003 2004 2005
HIV Antenatal Surveys - HIV Antenatal Surveys - SummarySummary Nationally 24.5% of women attending
antenatal clinics are HIV positive HIV prevalence in provinces ranges from 8
to 36% 26% of pregnant women aged 20-30 are
HIV positive 17% of pregnant women aged <20 are HIV
positive Most women who are HIV positive acquired
the infection when they were <20
HIV Antenatal SurveysHIV Antenatal SurveysExtrapolation to the South Extrapolation to the South African PopulationAfrican Population
4.7 million South Africans were HIV positive in 2000 compared to 4.2 million in 1999 and 3.6 million in 1998
1 out of every 8 adults are HIV positive 1600 - 1700 new HIV infections daily
South Africa’s AIDS EpidemicSouth Africa’s AIDS EpidemicSome of the AIDS epidemic is hidden
because: The rise in AIDS cases occurs after the rise
in HIV prevalence Many HV infections are never diagnosed Many people do not reveal their diagnosisIt is estimated that there were: 200 000 AIDS cases and 180 000 AIDS
deaths in 1999 Large number of adults and children with
HIV/AIDS seen by health services
HIV and TB in Developing HIV and TB in Developing CountriesCountries
HIV increases the risk of developing active TB for those who have been infected with TB earlier in life. Risk increases from 10% lifetime to 10% per year
If newly infected, persons with HIV more likely to progress to active disease
Leading cause of death among HIV infected persons
Reducing Impacts: Priority IssuesReducing Impacts: Priority Issues
Priority Issues
Socio-economicdevelopment
Information onepidemic
Improve statusof women
Support affectedpeople & orphans
Health sectorresponses
Reduce HIV/AIDSstigma
PreventionProgrammes
Intersectoralcollaboration
Strategicchoices
Workplaceprogrammes
HIV/AIDS Strategic PlanHIV/AIDS Strategic PlanPriority AreasPriority Areas
Prevention Treatment, care and support Human and legal rights Monitoring, research and surveillance Youth - both as a specific target
population and cross-cutting through all priority areas
HIV/AIDS Strategic PlanHIV/AIDS Strategic PlanPrevention GoalsPrevention Goals
Improve the management and control of sexually transmitted diseases
Promote safe and healthy sexual behaviour
Reduce mother to child HIV transmission Promote voluntary HIV counselling and
testing Maintain blood safety Provide HIV post-exposure services
HIV/AIDS Strategic PlanHIV/AIDS Strategic PlanTreatment, Care & Support Treatment, Care & Support GoalsGoals
Provide treatment, care and support services in health services
Provide treatment, care and support in communities
Develop and expand the provision of care to children and orphans
HIV/AIDS Strategic PlanHIV/AIDS Strategic PlanHuman and Legal Rights GoalsHuman and Legal Rights Goals
Create a supportive social environment Develop an appropriate legal and policy
environment
HIV/AIDS Strategic PlanHIV/AIDS Strategic PlanResearch, Monitoring and Research, Monitoring and Surveillance GoalsSurveillance Goals
Promote vaccine development Investigate research and care methods Conduct policy research Conduct regular research and
surveillance
Selected HIV/AIDS Management Selected HIV/AIDS Management and Co-ordinating Structuresand Co-ordinating Structures
Cabinet South African National AIDS Council Interdepartmental Committee on AIDS MinMEC PHRC Directors-General Forum National HIV/AIDS Programme
Partnership SupportPartnership Support
Assist sectors to develop and implement HIV/AIDS plans
Document best practices Mobilise resources Address human rights and legal issues
STDs, Barrier Methods & TBSTDs, Barrier Methods & TB
Improve STD treatment in the public and private sector
Increase condom use Conduct HIV/AIDS/STD related research Establish pilot districts to integrate
HIV/AIDS/STD and TB care Interact with traditional healers
Care, Counselling & SupportCare, Counselling & Support Implement home-based care Collaborate to render care for children
infected and affected by HIV/AIDS Investigate options for caring for the
carers Ensuring training and capacity building Coordination of programmes for PWAs Development of guidelines & manuals Reducing stigma and increasing
community responsibility
Youth ProgrammeYouth Programme
Assist youth organisations to develop and implement HIV/AIDS plans
Promote, co-ordinate and support the implementation of life skills in primary and secondary schools
IDC and NGO FundingIDC and NGO Funding
Develop minimum HIV/AIDS programmes for government departments
Conduct HIV/AIDS impact studies Fund and monitor NGOs
Major Policy Drives MTCT Programme Integrated Plan
Life Skills in primary and secondary schools Home-based care (HBC) Voluntary HIV counselling and testing (VCT) Community mobilisation
Participants: Health, Education, Social Welfare
R125 million in 2001/02
Care and Support Programme Identified 2 empowerment projects – 3 more
to follow Assisted NAPWA to strengthen its
organisation Established a database of PWA Support
Groups in all nine provinces Appointment of Care and Support focal
persons in all provinces Provision of basic home-based care drugs
and supplies for 4 project, using WHO funding
Care and Support Programme Completed guidelines: adult &
paediatric palliative care, curriculum for caregivers, HBC training manual, HBC Guidelines, Nutritional Guidelines for PWAs
Models developed for HBC developed
Workshops for home carers and religious leaders
Counselling Programme VCT strategy and business plans
completed Tender for rapid test kits awarded Rapid test quality assurance
protocols developed VCT sites selected in all provinces Counsellor training in all provinces
(2219 trained to date)
Youth Programme Workshops with youth formations –
targeted and lobbied 36 to date Launched the SA AIDS Youth
Programme (SAAYP) Assisted in the launch of the
Tertiary HIV/AIDS Media Project
Life Skills Programme Audit of life skills programme (LSP) Development of support materials
for teachers, also a parent guide
Partnership Support 8 PWAs employed by government Sectoral links established:
Traditional leaders, SALGA, Hospitality industry, Transport, Business, FBOs, Women, CMA, Trade Unions
Capacity building workshops in these sectors
Funding the national antenatal survey
STDs, Barrier Methods, Research & TB Syndromic Management established in
PHC facilities Materials on STDs available STD training mandatory CPD
requirement for private GPs Support for projects, including Lesedi &
Lechabile (Welkom), Mothusimpilo & WRAP (Carletonville), National STI Initiative, Trucking Project
STDs, Barrier Methods, Research & TB Stratified surveillance piloted in
Gauteng – national implementation to follow
Collaborate on the SA Microbicide imitative
National Male Condom Policy Female condom introductory
strategy Traditional Healer training
Government AIDS Action Plan Mass media advertising Provision of communication resources Major Projects:
AIDS memorial quilt Tertiary Institutions Media Workers Living Openly
Training of celebrity AIDS ambassadors
Government AIDS Action Plan PR campaigns Provincial GAAP personnel
appointed Partnership Support AIDS Helpline – increase in call
rates
Care and Support HBC Train-the-Trainer workshops Capacity building workshop for
men living with HIV/AIDS Project and Financial Management
training for HBC focal persons PWA capacity building workshops Develop guidelines for the care of
children orphaned by HA
Care and Support Marketing care and support services
through Soul City Workshops for religious leaders and
home carers National drug literacy campaign Training workshops for HCWs on the
Clinical Management Guidelines Implementation of economic
empowerment programmes for PWAs
Counselling Programme Provincial Train-the-Trainer
workshops Training of HIV/AIDS counsellors Develop and launch monitoring
and evaluation tools for VCT VCT promotional campaign
Youth Programme Develop strategic and operational
plans for youth formations targeted
Lobby additional formations
Life Skills Programme Teacher guide and learner activity book
for grades 8 and 9 Adolescent Reproductive Health Care Flip
Chart for all secondary schools Develop peer education norms and
standards Youth Risk Behaviour Survey Develop age-appropriate IEC materials
for primary school learners
STDs, Barrier Methods, Research & TB Audit of HIV/AIDS research Establish a comprehensive
surveillance system Increase support to targeted STD
interventions Prevalence studies in specific
populations (gay men and drug users)
STDs, Barrier Methods, Research & TB Revise and reprint materials National summit on sex work Increase condom social marketing Expand female condom introduction Implement a Logistics Management
Information System for condoms Review traditional healer training
manuals