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HIV/AIDS is a pressing health concern for South Africa, which has one of the biggest HIV endemics in the world. The UN Global Goals call for action on ensuring that everyone in the world has access to the health services that they need. Join us by taking action here for the Global Goals.

A foundation supported by Archbishop Desmond Tutu has announced a new programme to help reduce new HIV infections among young people.

The Desmond Tutu HIV Foundation, which is based at the University of Cape Town (UCT), said the initiative will be particularly focusing on working with girls and young women.

There were 270,000 new HIV infections in South Africa in 2017 — down from a high of 530,000 in 1998, but there is still work to do.

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Young women aged between 15 and 24 make up 29% of new HIV infections in South Africa, according to UNAIDS.

“South Africa has the largest HIV epidemic in the world, and adolescent girls and young women acquire HIV at twice the rate of their male peers,” according to the foundation.

The foundation will be adapting the Informed, Motivated, Aware, and Responsible About AIDS (IMARA) programme — an HIV-prevention package developed by the University of Illinois, in the United States — for a South African context.

“We urgently need to find solutions for young women and adolescent girls in this region,” said Professor Linda-Gail Bekker, co-investigator on the study.

“Every week almost 2,000 young women and girls in South Africa get infected with HIV,” said Bekker.

The IMARA programme includes educational programmes on STIs, including HIV, as well as communication skills that are designed to strengthen young women’s relationships with their mother or female caregiver.

“It also focuses on the importance of healthy peer and romantic relationships, effective parental monitoring, and developing positive decision-making skills,” said the foundation.

The programme will also encourage participants to consider how the media and its portrayal of young women influences their behaviour, and how those behaviours may affect their health outcomes, according to the foundation.

As well as helping to prevent STIs, the programme is also designed to increase the numbers of young women and girls getting tested for HIV, and connect them with clinics where they can get care and treatment.

Bekker said it is critical to empower young women to be able them to protect themselves.

“There is also some evidence to show that family support is key, especially from an older female relative, such as a mother, an aunt, or older sister,” she added.

According to the foundation, the IMARA programme reduced the risk of new STI infections by 45% among black girls and young women aged 14 to 18, compared to the control group.

The programme will be rolled out in two phases, according to Bekker.

The first phase will focus on adapting the IMARA programme for a South African context. That will be carried out in a pilot study, involving 50 pairs of mothers/caregivers and daughters.

The second phase will launch the adapted programme with 525 pairs of mothers/caregivers and daughters — with participants being tested for HIV and other STIs at the beginning of the study, and again at six months and 12 months after enrolment.

HIV counselling and testing, and pre-exposure prophylaxis (PrEP) will also be offered at each assessment. Participants who are interested in PrEP or who test positive for an STI, including HIV, will also receive treatment at the foundation.

According to OUT's TEN81 Centre, PrEP is a ground-breaking medical discovery which has been proven to be highly effective in preventing HIV-negative people from getting HIV if used daily.

OUT's TEN81 Centre is a clinic that offers sexual healthcare to lesbian, gay, bisexual, and transgender people, sex workers and people who inject drugs in Pretoria.

“The drug was approved by South Africa's Department of Health and international bodies such as the World Health Organisation,” said OUT's TEN81 Centre Health Manager Johan Meyer.

“We hope to understand if this intervention is something that we can roll out more broadly to change the statistics of STIs, unintended pregnancy, and HIV in young women and girls,” Bekker concluded.

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Defeat Poverty

Desmond Tutu Foundation Is Working to End HIV and STI Infections Among Young Women in South Africa

By Thato Mahlangu