Over the last four years South Africa has taken large strides in making HIV prevention pills available at public sector clinics, but uptake has not been as good as some may have hoped. Thabo Molelekwa asks several experts why this might be.
HIV prevention pills, also referred to as oral pre-exposure prophylaxis , contain a combination of two antiretroviral medicines. They are highly effective at preventing HIV infection when taken as prescribed by someone not living with HIV.
"Participants were worrying about their families or friends thinking they were taking ARVs," says Constance Mongwenyana-Makhutle, a research associate and co-author of the study.A peak of incidence, among other places, was recorded in Sandton, Germiston, Braamfontein and Vosloorus. Look at this infograph by Spotlight for more. #stis https://t.co/wmvDdQH7VX pic.twitter.
"I think we have not had enough public demand creation- if you think of the campaigns for getting people to take up COVID vaccines....then we really haven't done enough in this regard. It is a new concept- a pill a day to prevent HIV ......and so people need to have the idea socialised and normalised so that there is also a reduction in stigma," she says.
"PrEP for young people in the public sector is free. If they want to use private pharmacies though, they would need to pay currently. I think more can be done to make PrEP and other sexual and reproductive health services more readily available so that young people, in a way, have no excuses not to make sure they are using them ... colleges, universities and even secondary schools could also reach more young people.
Abdullah makes a similar point. If some health care workers are properly trained, can identify people at high-risk and understand the efficacy of the intervention, then the vast majority would follow and offer the service in a professional manner, he says. Recent data from a Human Sciences Research Council survey and the District Health Barometer indicate that condom use is declining in South Africa. While the reasons for the decline are not clear, one theory is that it is driven by the perceived risk of HIV infection having reduced over time.
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