Human Immunodeficiency Virus As A National Health Priority In South Africa

Human Immunodeficiency Virus, otherwise known as HIV is a virus that causes and infection and overtime would then cause AIDS. HIV is a retrovirus that infects the vital organs and cells of the human immune system. HIV can be transmitted through sexual transmission, perinatal transmission or blood transmission.

South Africa has had one of the largest numbers of people living with HIV, estimated to be 6. 4 billion people in 2012. Among this 6. 4 billion people, the estimated national HIV prevalence among the general adult population (15-49 years old) has been stable at around 17. 3% since 2005. From them, women hold a high number of affected HIV victims, with women making up 4 out of every 5 people with HIV aged 20 - 24. This causes HIV to be one of the highest health priorities in South Africa, which can affect pregnant women and cause complications during birth. HIV prevalence among pregnant women in South Africa was 28% in 2005, though there is some consideration that the number had been on a decline since then. One of the primary reasons why HIV is such a large problem is due to intimate partner violence and drug abuse among South Africans. Research has found that sexual violence and drug use play a key part in the spreading of HIV in South Africa, with the primary mediating variables being drinking and marijuana. Men who also experienced childhood sexual abuse are also likely to engage in HIV sexual risk behaviors should they be prone to drinking or smoking marijuana. Many of those who are affected with HIV also do not know that they have them as they do not want to get tested. There are also those who are HIV positive, but do not tell anybody about it because they are afraid that the community will blame them for being infected. The young and women, in general, are noted to be especially at risk for HIV due to their low relationship power. This lower relationship power affects the interpersonal dynamics of any relationship and can cause increase sexual risk due to intimate partner violence or HIV sexual risk behaviours - such as condom non use and the likelihood of multiple sexual partners among those with low relationship power. Regardless of gender, however, the youths are more vulnerable to be victims of intimate partner violence or coerced into transactional sex.

South Africa otherwise known as “the rape capital of the world”, due to the pervasive rape culture that exists in the country. In a rape culture, men and women accept that sexual violence is a way of life, inevitable and unable to be stopped. Rape culture condones physical and emotional destruction against women as a norm. Women do not have a sense of physical security and are not protected. Social factors such as poverty, gender, migration, and stigma are often addressed during HIV preventions. Interventions that target social norms are usually a priority of HIV preventions, as preventing HIV involves engaging with social practices that affect the responses of individuals, communities, and governments. This allows people to act in the own and their community’s best interests. Understanding this the South African government has implemented a health promotion strategy in line with their new operational goal of preventive medicine. It is in the hopes of education and awareness of the causes of HIV as well as the elimination of sexual violence through education and preventive measures that South Africa hopes to eliminate the spread and continual increase of HIV prevalence among the general adult population. To achieve this, their primary strategic goals as of 2015 was to prevent disease and reduce its burden by the promotion of health and to make progress to universal health coverage. To achieve these goals the government launched an awareness campaign called Khomanani, which was run and funded by the government. However, while it was deemed to be the least successful campaign made by the government, it’s effectiveness did increase by 50% between 2005 and 2008.

Two television programmes aimed at adults and teenagers called Soul City and Soul Buddyz respectively were also aired and the two programmes were deemed the government's most successful effort. The case as to why the two television series was more effective was because they provided a more engaging and informative platform that drives interest in the subject matter rather than assuming the audience already has an interest in the subject. Soul City primary effectiveness was that it was a television drama focused around HIV health issues in South Africa, and it was through engaging with the audience through the drama that the audience itself was more receptive of the health promotions that the drama provided. Similarly, the reason why Khomanani failed was because it relied on audience participation in wanting to know about HIV related health issues rather than by trying to engage them in a manner that would educate them while at the same interesting them in a way outside of having them find the subject matter interested.

Furthermore, Soul City and Soul Buddyz were more designed to gather interest in the subject through creative and engaging subject matter that the is framed by general information on HIV health related issues. The audience was not enforced to learn about HIV, thus, not much interest was garnered. The strategy that the South African government employed was adaptive in nature, that was created specifically to combat their audience in South Africa, which has a sizeable population that is still rural villages tied together by tribal origins with their own beliefs in medicine and healthcare. As such, the South African government did not try to engage their population as though they are already well-informed in HIV and are prepared to put forward the necessary personal measures to combat it, but rather as people that need coaxing and educating on the subject matter before they can be properly engaged to combat and decrease the prevalence of HIV in South Africa. This strategy was also used to help educate their population on intimate sexual partner abuse and child sex abuse in South Africa. The television campaigns and dramas they c reated to decrease the number of intimate sexual abuse and child sex abuse in South Africa - both of which are causes to the greater HIV prevalence in South Africa, which has been stated above - and the manner they did this were through television shows which had their own dramas but framed the message and information of sexual abuse inside it. Khomanani, with reference to the Ottawa Charter, has helped increase the health literacy for Africans regarding HIV and AIDS.

Soul City also helps re-orientate health care services. Educational books were made to provide information on how to prevent HIV and AIDS, how HIV is spread, how to live a longer and healthier life with HIV. Soul City’s approach is based both on the Ottawa Charter of Health Promotion and on a blend of social and behaviour change models. It encourages individuals to reflect on their health and social choices and options, through the use of real-life role models. There were also trainings and classes provided for those suffering from HIV on developing personal skills. Support groups and clubs such as Rise Young Women’s Club, were formed. The club aims to organize and empower young women to take part in making responsible actions that will mould their lives and the communities they live in. These clubs, provide a fundamental and positive peer interaction and platforms to share and grow from.

South Africa has made huge improvements in getting people to test for HIV in recent years and is now almost meeting the first of their targets, with 86% of people aware of their status. However, HIV is still a National Health Priority for them, as there are still too many people affected by it. While the short term financing of South Africa's HIV epidemic is secure, in the longer term, the government needs to explore other strategies in order to sustain and expand its progress.