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Monitoring cases of HIV & TB
The country with the highest number of people living with HIV is South Africa. In response, the CDC in South Africa has worked toward HIV epidemic control through programs designed for HIV prevention and treatment, as well as "system strengthening" (CDC, 2022). Inspired by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), they aim to increase voluntary medical male circumcision among men aged 15 years and older" (CDC, 2022). They focus on giving services to populations that need it the most, which include "sex workers, men who have sex with men, transgender people, people who inject drugs, and people in prisons" (CDC, 2022). This is promising, seeing as Black and mixed race Africans make up the majority of South African prisons (Makou, Skosana, & Hopkins, 2017). In 2021, 68% of patients with HIV had received antiretroviral therapy, and 94% of patients with tuberculosis (TB) had been tested for HIV and had received antiretroviral therapy with TB treatment (CDC, 2022).
According to the CDC (2022) "adolescent girls and young women are two and a half times more likely" to get HIV, thus they have intiated the Determined Resilient Empowered AIDS-free Mentored Safe (DREAMS) program. This programs aims to address the factors that increase risks of getting infected with HIV among women, such as "multiple evidence-based activities such as post-violence care, parenting/caregiver programs, and facilitating access to existing resources such as cash transfers and education subsidies" (CDC, 2022).
The CDC in South Africa is also implementing research using population surverys, which will help them to grasp a better understanding of HIV prevalance and incidence. This also includes HIV drug resistance surveillance, and HIV mortality surveillance (CDC, 2022).
Actions Taken to Get Rid of AIDS in South Africa
Antiretroviral Therapy and Services
Antiretroviral therapy, also known as ART, is a treatment that was made to help people living with AIDS improve their quality of life. According to the CDC, ART is useful because it will "consistently suppress viral load, maintain high CD4 cell counts, prevent AIDS, prolong survival, and reduce risk of transmitting HIV to others." Reasons why people may not go with ART is due to their personal or religious beliefs, cognitive abilities, or their health conditions (CDC, 2018).
Information on how ART is helpful (HIVinfo, n.d. )
Lowering the CD4 Cell Count Eligibility
South Africa has first began the treatment of AIDS in the year 2004. Previously, treatment was only for patients with a CD4 cell count of 200 cell μL−1 or lower (Bessong et al., 2021). Since 2004, we have seen a great increase in who is eligible for treatment which has allowed for us to prolong the life span of those with AIDS in South Africa.
What is the CD4 Cell Count Eligibility Now?
Since 2011, the guidelines for South Africans to receive ART was having a CD4 cell count ≤350 cells/μl (Kluberg, 2018). However, this number is not what is recommended by the World Health Organization. It is recommended to start treatments when the patient is diagnosed with AIDs. This is called the 'test-and-treat' method (Kluberg, 2018).
UNAIDS 90-90-90 Target?
The UNAIDS 90-90-90 target was put into place to ensure that 90% of people with HIV are aware of their disease, 90% of people diagnosed with HIV are receiving treatment, and 90% of people who are on ART achieve viral suppression (UNAIDS, 2014; UNAIDS, 2015). This target was created in December 2014 by the Joint United Nations Programme on HIV/AIDS.
Global AIDS Program (GAP)
This program was brought by the U.S. Centers for Disease Control and Prevention in 2010 and it is to ensure the delivery of complete HIV/AID and tuberculosis services to millions of South Africans. After this program was put into action we saw a spike in numbers with the amount of people getting tested and counseled, and an increase in people on ART.
Using Media to Spread Mental Health Awareness
Newspapers, television shows, performing arts, radio shows and social media are used for international events such as World Mental Health Day, Mental Health Awareness month. They use media as well as various communication materials for distribution in the communities. South African Depression and Anxiety Group (SADAG) has weekly media releases to local and national media as well as public service announcements to ensure that mental health issues are raised regularly in various settings. Since 1995 SADAG has been one of the largest mental health support and advocacy groups in Africa and provides counseling services, mental health awareness programmes, media campaigns, school talks and rural outreach activities across the country (Kakuma et al., 2010).
References
ART Adherence | Treatment, Care, and Prevention for People with HIV | Clinicians | HIV | CDC. Centers for Disease Control and Prevention. Retrieved June 12, 2022, from http://cdc.gov/hiv/clinicians/treatment/art-adherence.html
Centers for Disease Control and Prevention. (2022, March 10). CDC in South Africa. Centers for Disease Control and Prevention. Retrieved June 2022, from https://www.cdc.gov/globalhealth/countries/southafrica/default.htm#disease
Kakuma, R., Kleintjes, S., Lund, C., Drew, N., Green, A., & Flisher, A. (2010). Mental Health Stigma: What is being done to raise awareness and reduce stigma in South Africa? African Journal of Psychiatry, Vol 13(No. 2). 10.4314/ajpsy.v13i2.54357
Kluberg, S. A., Fox, M. P., & LaValley, M. (2018, June 27). Do HIV treatment eligibility expansions crowd out the sickest? Evidence from rural South Africa. Wiley Online Library. Retrieved June 12, 2022, from https://onlinelibrary.wiley.com/doi/full/10.1111/tmi.13122#:~:text=In%20August%202011%2C%20South%20Africa's,the%20WHO%202010%20guidelines%2015.
Makou, G., Skosana, I., & Hopkins, R. (2017, July 18). Factsheet: The State of South Africa's prisons. Africa Check. Retrieved June 18, 2022, from https://africacheck.org/fact-checks/factsheets/factsheet-state-south-africas-prisons
UNAIDS. (2014, October). 90-90-90: An ambitious treatment target to help end the AIDS epidemic. UNAIDS. Retrieved June 9, 2022, from https://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf
UNAIDS. (2015, October 27). UNAIDS 2016–2021 Strategy. UNAIDS. Retrieved June 9, 2022, from https://www.unaids.org/sites/default/files/media_asset/20151027_UNAIDS_PCB37_15_18_EN_rev1.pdf
UNAIDS. (2018). UNAIDS data 2018. UNAIDS. Retrieved June 9, 2022, from https://www.unaids.org/sites/default/files/media_asset/unaids-data-2018_en.pdf
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