PrEP can prevent HIV

As South Africa commemorates World Aids Day on 1 December and 16 Days of Activism against Gender-Based Violence (GBV), from 25 November to 10 December, Vuk’uzenzele explores the relationship between GBV and HIV/AIDS.

The Gender-Based Violence and Femicide (GBVF) Response Fund strives to ensure that South Africa is free from GBVF against women; children; and the lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual and more (LGBTQIA+) community. 

The fund was launched by President Cyril Ramaphosa in February 2021, to support the implementation of the National Strategic Plan on GBVF. According to the fund’s website, it plays a critical role in making change happen, based on research, awareness and practical support to organisations actively engaged in the fight against GBVF.

One of the organisations supported by the fund is the KwaZulu-Natal based Gugu Dlamini Foundation, which received R250 000 from the GBVF in 2022. 

Executive Director of the Gugu Dlamini Foundation, Mandisa Mabaso, established the foundation in 2010 after her mother – the late Gugu Dlamini – was stoned to death in 1998 in Durban for disclosing her HIV-positive status.

“The foundation aims to strengthen local governance to improve the GBVF response, which is essential to achieving HIV epidemic control in South Africa,” says Mabaso.

“It also aims to reduce HIV/AIDS infections, increase access to care and improve health outcomes for females and males infected and affected by HIV/AIDS,” she adds.

The funding that the foundation receives assists 522 255 women and girls and 900 men and boys from families affected by GBV and domestic violence; abused persons living with disabilities; and the LGBTQIA+ community, says Mabaso.

According to UNAIDS, in areas of high HIV burden, women who are victims of GBV face up to a 50% higher chance of acquiring HIV. Some of the reasons for this are rape and the refusal by men to use condoms.

What is PrEP?

One of the ways to prevent HIV infection is by taking Pre-Exposure Prophylaxis (PrEP), which is a medicine taken daily by HIV-negative people who are at high risk of being exposed to HIV, through sexual contact or injection drug use.

In August, Health Minister, Dr Joe Phaahla said that South Africa has the highest oral PrEP initiation in sub-Sahara. He said that 70%, or 2 419, of South Africa’s public primary healthcare facilities have integrated oral PrEP into their routine package of services.

“A person on PrEP does not have to take it for the rest of their lives, they can choose to take it every time they are at risk of being infected with HIV. However, for PrEP to be effective, it must be taken every day [during this time],” confirms Mabaso.

It should also be used with other protective methods, such as female and male condoms, because PrEP does not protect a person against other sexually transmitted infections and it is not a contraceptive.

Mabaso says that in cases where a couple wants to have a baby, PrEP can assist to prevent HIV infection of the HIV-negative partner and the unborn baby.

Meanwhile, earlier this year, the South African Health Products Regulatory Authority approved the use of a vaginal ring as a PrEP. The ring contains an antiretroviral drug called dapivirine and must be changed every month. In addition, a new PrEP – an injection that lasts for two months – is awaiting approval. Once approved, people will no longer have to remember to take a pill each day.

Safe sex

The foundation also aims to reduce HIV infections by promoting the use of condoms and safe sex.

“We urge children and youth to delay engaging in sexual intercourse until they are ready to make more informed and healthier choices,” says Mabaso.

“We also promote safer sex by emphasising condom use and only having one partner at a time. The abuse of drugs – especially those that are injected – is strongly discouraged as it increases the risk of being infected with HIV,” she adds.

The foundation also empowers people living with, at risk of and affected by HIV/GBV to know their rights and to access justice and legal services to prevent and challenge the violations of human rights.