‘Research shows that the spread of the disease among people between the ages of 15 and 24 years is faster. They do not want to test. They are dying in large numbers. They fall in love and have unprotected sex with adults who are way older than them. Older people, on the other hand, prefer these young boys and girls and they call them ‘Ben-10s,’ says Disease Control Department Psychologist, ’Moelo Sehlabaka-Ramahlele.
LESOTHO joins the rest of the global community in commemorating World Aids Day on 1 December. World Aids Day — one of eight official global public health campaigns marked by the United Nations World Health Organisation (WHO) alongside World Health Day, World Blood Donor Day, World Immunisation Week, World Tuberculosis Day, World No Tobacco Day, World Malaria Day and World Hepatitis Day — raises awareness about the epidemic, which is caused by the spread of the Human Immunodeficiency Virus (HIV). Government and health officials, non-governmental organisations and individuals around the world observe the Day, often with education on prevention and control.
The first World Aids Day commemoration was held on 1 December 1988 and each subsequent campaign has focused on a specific theme. However, since 2011 the global theme has been “Getting to Zero: Zero new HIV infections. Zero deaths from Aids-related illness. Zero discrimination”.
HIV causes the Acquired Immunodeficiency Syndrome (Aids) which has no medical cure, and continues to ravage communities unabated.
The Ministry of Health will lead Lesotho’s 2014 World Aids Day commemoration in Thaba-Bosiu on 1 December and in this wide-ranging interview, Disease Control Department Psychologist, ’Moelo Sehlabaka-Ramahlele, tells Lesotho Times (LT) reporter Lekhetho Ntsukunyane how the country has fared in the fight against HIV and Aids and what is expected to take place next Monday.
LT: World Aids Day is a sombre occasion for the global community as it reminds us of the killer among us. How is Lesotho going to commemorate the Day and where?
Sehlabaka-Ramahlele: World Aids Day in Lesotho will officially be commemorated on 1 December in Thaba-Bosiu. To be exact, the commemoration will be at the Lesotho Evangelical Church grounds. However, as part of the commemoration, we had already started the journey by engaging on know-your-status campaigns throughout the country ahead of the bigger event on Monday next week. World Aids Day is commemorated annually worldwide on this day, and Lesotho is no exception. The main activities planned for this commemoration include scaling-up national HIV-testing and counseling services in all the 10 districts of the country, and this began early this month. Monday’s commemoration will also acknowledge and honour some of the heroes and heroines of our time who continue to live with HIV and have a positive influence in our communities on the commemoration day. The honour will be extended even to the heroes and heroines who have since passed away were brave enough to disclose, to the public, how they lived with HIV and Aids. Our country theme for the Day is: “HIV Testing for All; Getting to Zero”.
LT: How do you conduct these campaigns?
Sehlabaka-Ramahlele: As the campaigns were launched officially on 20 November this year, our appeal to all the leaders, be it in government, churches, area chiefs, workplaces and others, is to show support for processes that ensure people are tested and know their HIV status so that, if necessary, they receive proper treatment on time. On 1 December, there will be reports from all the 10 districts of the country concerning the outcome of anti-HIV/Aids campaigns. Each of these districts was given a target regarding how many people should be tested, so they will be presenting their reports showing how far they have gone in reaching the target. The commemoration of World Aids Day should not be regarded as a brainchild of the Ministry of Health; it is a national issue, hence all sectors in society should be involved. We are inviting every Mosotho to be part of this.
LT: Why do you have to put so much effort into encouraging people to test for HIV?
Sehlabaka-Ramahlele: It is very important for people to know their HIV status. Living with HIV and Aids does not mean the end of your life. The government has embarked on a variety of efforts to assist people living with HIV and Aids. It is only through knowing your status that the government can be able to assist you. This is why, for the first time ever, we are going to honour those people who showed the courage to say to the public they were living with HIV and Aids, giving people hope that there is still life after infection. People just need to take care of themselves. The government has ensured that after knowing that you are HIV positive, there is immediate treatment depending on the severity of your condition. The government went further, moving from only providing for the treatment to preventing infection from an HIV-positive mother to her baby. That has been a milestone achievement as we succeeded, in most cases, in ensuring that the baby is not infected even during labour. The ministry further recently introduced the VMMC (Voluntary Male Medical Circumcision) campaign, also in a bid to reduce chances of HIV infection on males by 60 percent.
LT: What are the other activities scheduled for World Aids Day commemoration?
Sehlabaka-Ramahlele: Before commemoration begins at 9 am, we will first lead a march starting at 7 am from Lihaseng to the church’s premises. This will be to ensure people living around that area feel that this occasion belongs to them. Perhaps I should mention that from yesterday (Monday this week), a team from the ministry here was assigned to go and start educating villagers in Thaba-Bosiu about the importance of this event. Again, this Friday, our other partner in the fight against HIV and Aids, PSI (Population Service International) Lesotho, will host a giant puppet-show which also provides education on HIV and Aids issues. Other entertainment activities, including music and poetry, will be showcased during the main event on Monday. Remember there are targets for each of the 10 districts. We are trying to increase the number of people testing for HIV. We have organised that people should be tested either at health facilities by way of PITC (Provider Initiated Testing and Counseling). This is whereby the officer at the facility will encourage or recommend that any patient coming for service at the centre undergoes testing. It is the opposite of instances where people volunteer to test. We also visit communities and go door-to-door to encourage people to test. We do not enforce it. The reports from the districts are going to be presented at the commemoration.
LT: What are these targets?
Sehlabaka-Ramahlele: The targets differ per district based on prevalence. For instance, it is 2 610 for Butha-Buthe, Berea 6 075, Leribe 7 020, Mafeteng 4 545, Maseru 11 295, Mohale’s Hoek 4 050, Mokhotlong 2 115, Qacha’s Nek 1 575 and Quthing 2 835. We have many other partners, including UNAIDS, assisting us to meet these targets. We are appealing to the communities to cooperate.
LT: How is Lesotho currently rated in terms of HIV prevalence in the world?
Sehlabaka-Ramahlele: At present, Lesotho is rated second (at 23 percent HIV prevalence) in the world after Swaziland. And the World UNAIDS 2014 report adds that in 2013 alone, there were 26 000 new HIV infections. Those are only new infections recorded in 2013. At the moment, the DHS (Demographic Health Survey) is still being conducted and a comprehensive report will be issued next year. Based on the last DHS report issued in 2009, Lesotho has a total 281 000 people living with HIV and Aids. And remember there are still a lot of Basotho who do not know about their HIV and Aids status. They have not tested. This is why now the UNAIDS says “we should close the gap.”
What they mean is that by 2020, at least 90 percent of Basotho should have been tested and become aware of their HIV status. It is useless to keep saying we have such and such a number of people living with HIV and Aids, yet we still have a lot of other Basotho who do not know about their status, and who could still be living with the disease. This is why we have this PITC programme. As we speak, we have about 50 percent Basotho who have tested and know their status. And the World UNAIDS report further shows that in 2013 only, we had 13 000 deaths related to HIV and Aids. This shows that even with the efforts we are trying to make, we still have to do more. What we realise with these big figures is that Basotho, even though they believe they know much about HIV and Aids, still have a long way to go in terms changing their behaviour. Actually, Basotho still lack knowledge and remain ignorant even after so many years of being provided with information regarding the disease.
LT: Are there any other factors increasing the spread of HIV and Aids in Lesotho?
Sehlabaka-Ramahlele: What has also accelerated the spread of HIV and Aids in recent times is the fact that people living with the disease are no longer easily seen to be ill because of the improved treatment they get. It is no longer like in the old days when they would quickly develop symptoms. And also there is no longer that stigma attached to people with HIV and Aids. And that also says people are no longer afraid of the disease and are not changing their behaviour. They engage in a lot in unprotected sex. The 2009 DHS report showed that although Basotho had some knowledge about the disease, they were just not willing to implement change in their lives because of various traditional practices they are attached to. We are more concerned about the youth. Research shows that the spread of the disease among people between the ages of 15 and 24 years is faster. They do not want to test. They are dying in large numbers. They fall in love and have unprotected sex with adults who are way older than them. Older people, on the other hand, prefer these young boys and girls and they call them ‘Ben-10s.” It is also called intergenerational sex. And all these accelerate the spread of HIV and Aids.
LT: Based on the reports you have just mentioned, what do you think is going to happen next with Lesotho in terms of HIV and Aids?
Sehlabaka-Ramahlele: It is obvious that next year’s DHS report will come with big numbers of more infections. Lesotho could soon be rated number one in terms of HIV prevalence. With the current rate of new infections, we are definitely going to overtake Swaziland. This says we still have a mammoth task to do something about this situation. You know the study further shows that each Mosotho adult only uses nine condoms a month. That shows that adults are not keen to use condoms as the main protection against infections.
LT: What could be done to change this mindset?
Sehlabaka-Ramahlele: The Global Aids Progress report has identified 12 groups of people with clear reasons why each group is left behind in the HIV and Aids education, accelerating the spread. These groups are people living with HIV, adolescent girls and young women, prisoners, migrants, people who inject themselves with narcotic drugs, sex workers, gay men and other men who have sex with others, transgender women and men, children and pregnant women living with HIV, displaced persons, people with disabilities and people aged 50 years and above. What we should do is apply recommendations which also appear in this report and close the gaps as this year’s theme for the World Aids Day commemoration stipulates.