Pascalinah Kabi
LESOTHO leads countries in sub-Saharan Africa in terms of condom use among women between the ages 15 – 24 years; a sign the country is making strides towards preventing new HIV infections.
This is according to a report issued this week by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in Namibia ahead of annual World AIDS Day commemorations on 1 December.
Titled “Get on the Fast-Track: The life-cycle approach to HIV”, the report contains detailed data on the complexities of HIV and reveals that girls’ transition to womanhood is a very dangerous time, particularly in sub-Saharan Africa.
The report, which was launched by Namibia President Hage Geingob and UNAIDS Executive Director Michel Sidibé in Windhoek, also shows that the life-extending impact of treatment is working. Countries are getting on what UNAIDS refers to as the fast track to ending the AIDS epidemic by 2030, with an additional one million people having accessed treatment from January to June.
By June 2016, some 18.2 million people were on life-saving medicines, including 910 000 children – double the number of five years earlier. UNAIDS also states that 18.2 million people now have access to HIV treatment, saying that the fast-track response was working.
The report reveals that 80 percent of Basotho women aged between 15-24 years reported using a condom during their last sexual encounter with a non-regular partner in the 12 months prior to the survey.
When used consistently and correctly, condoms are highly effective in preventing the sexual transmission of HIV. Lesotho’s HIV-prevalence is the second highest in the world at 25 percent.
The report calls for condom availability and accessibility to be rolled out in combination with promoting and enhancing women’s ability to negotiate condom use.
“Nearly a quarter of women aged 15–49 years in sub-Saharan Africa had an unmet need for family planning in 2015. Powerful new tools for HIV prevention such as pre-exposure prophylaxis (PEP) remain underutilised,” reads the report.
The report also reveals that Lesotho was among the six eastern and southern African countries experiencing a decline in new infections among children aged between 0-14 years.
Mr Sidibe said adolescence was a turbulent time and a particularly dangerous time for young women living in sub-Saharan Africa.
“As they transition to adulthood, their risk of becoming infected with HIV increases dramatically,” he said.
“When women and girls are empowered, they have the means to protect themselves from becoming infected with HIV and to access HIV services. No one should be left behind through the life-cycle approach.”
He stressed that vulnerable communities – such as sex workers, people who take drugs intravenously, men who have sex with men, prisoners and migrants – needed access to the HIV treatment and prevention options that best meet their needs.
Increasing treatment coverage, Mr Sidibe said, was reducing AIDS-related deaths among adults and children; adding that the life-cycle approach had to include more than just treatment.
“Tuberculosis (TB) remains among the commonest causes of illness and death among people living with HIV of all ages, causing about one third of AIDS-related deaths in 2015. These deaths could and should have been prevented,” he said.
“TB, like cervical cancer, hepatitis C and other major causes of illness and death among people living with HIV, is not always detected in HIV services.”
Mr Sidibe also noted that drug resistance was one of the major threats to the AIDS response, not just for antiretroviral medicines but also for the antibiotic and anti-tuberculous medicines that people living with HIV frequently need to remain healthy.
“More people than ever before are in need of second- and third-line medicines for HIV and TB. The human burden of drug resistance is already unacceptable; the financial costs will soon be unsustainable.
“We need to make sure the medicines we have today are put to best use, and accelerate and expand the search for new treatments, diagnostics, vaccines and an HIV cure.”
He also called on world leaders, partners, activists, communities and people living with HIV to get on the fast-track to end this epidemic.
Contacted for comment, National Aids Commission (NAC) Chief Executive Officer Keratile Thabana said they were yet to study the report.
“Personally I have not seen the report and I wouldn’t want to comment from the top of my head. Once we have studied the report, we would comment on its findings,” Ms Thabana said.
In a separate interview, Christian Council of Lesotho (CCL) Secretary-General Khosi Makubakube said while the high condom usage was a positive development, it was disconcerting that girls as young as 15 years old were already sexually-active.
“From a morality point of view, it is absolutely saddening that young ladies are sexually-active. However, it is commendable that they value their lives by using condoms as one of the many prevention methods,” Mr Makubakube said.
He said that women aged 15-24 years should value their virginity instead of engaging in sexual activities.
“We commend the young ladies protecting themselves by using condoms, but as the church we strongly feel they should wait until they are married to start engaging in sexual activities. Girls aged between 15 and 24 years should take pride in their chastity until they are married,” said Mr Makubakube.
