OZIEL MDLETSHE
The Human Sciences Research Council (HSRC) recently released the key findings of the sixth South African HIV Prevalence, Incidence, and Behaviour Survey.
The data reveals that KwaZulu-Natal, which had the second-highest HIV prevalence in the country, saw a reduction from 18.0% in 2017 to 16.0% in 2022. This decline translates to 1 980 000 people living with HIV (PLHIV) in the province, a slight drop from the 1 990 000 PLHIV recorded five years ago.
As a long-standing HIV activist, I welcome this reduction as an opportunity for us to reflect on our community responses to the epidemic.
Despite this small victory, the survey highlights deeply concerning trends that we must confront. Most notably, 68.3% of PLHIV in KwaZulu-Natal are unaware of their status.
This statistic underscores the challenge we face in ensuring that people know their HIV status, which is the cornerstone of effective HIV prevention and management. Additionally, the study shows a troubling decline in condom use, a trend that demands immediate attention.
From a community perspective, these findings beg the question, are our interventions truly making an impact on behaviour change? Science has brought us incredible advancements in the fight against HIV, including antiretroviral therapy (ARVs), which has significantly improved the lives of many of us living with HIV.
We also have prevention options like Post-Exposure Prophylaxis (PEP), Pre-Exposure Prophylaxis (PrEP), and the vaginal ring known as Dapivirine used by women. Despite these tools, we still see gaps between scientific developments and individual behaviour.
This raises a critical question: why is there a disconnect between scientific progress and community behavior? It seems that, while we have made strides in the scientific domain, on the other hand, we are struggling to translate those advances into everyday practice within our communities.
One area that stands out as particularly alarming is the ongoing struggle with tuberculosis (TB), which remains the leading cause of death in South Africa, despite being a curable disease.
The lessons we have learned from TB management are sobering and relevant to the HIV epidemic. That suggests that, even if we find a cure for HIV, we will still face significant challenges in curbing new infections and ensuring long-term management of the disease.
As the TB experience has shown, scientific breakthroughs are not enough to eliminate a disease; sustained community engagement and behaviour change are critical.
Being free from HIV is not just a medical task, it requires a collective effort that includes both scientific advancement and robust community engagement.
We need to understand that behavioural change is complex, and the solutions that work in laboratories or clinical settings may not always translate seamlessly into the real world. This is why community advocacy must play a stronger role in closing the gap between science and the people.
Community advocacy provides a platform where scientific findings can be communicated in a way that resonates with individuals at risk.
Too often, we talk about prevention tools like PrEP and PEP in abstract terms, without addressing the cultural, social, and economic factors that influence people's behaviour.
The task ahead of us is to create better platforms for community participation, ensuring that individuals are not just aware of scientific developments but are empowered to apply them in their daily lives.
We also need to invest more in behavioural interventions that target the root causes of risky behaviours, such as stigma, lack of education, and limited access to healthcare. As a community, we must be proactive in addressing these barriers.
Encouraging open conversations about sexual health, promoting regular HIV testing, and challenging the stigma around HIV are essential steps in creating a more informed and engaged population.
Achieving the 95-95-95 goals set by UNAIDS—95% of people living with HIV knowing their status, 95% of those diagnosed on treatment, and 95% of those on treatment achieving viral suppression—requires more than just scientific innovation. It demands that we address the social and cultural realities that influence behaviour. Until we close this gap between science and community, we will continue to face challenges in controlling the HIV epidemic.
In conclusion, science has brought us closer to managing and even preventing HIV, but without strong community advocacy, these advancements will not reach their full potential.
We must ensure that our communities are fully engaged and empowered to make informed decisions about their health.
This requires translating scientific knowledge into practical, accessible, and culturally relevant interventions. Only then will we see the true impact of the remarkable progress that science has made in the management of HIV.
Oziel Mdletshe is an HIV and Human Rights activist.
Daily News