By Helen Allen of PEPAIDS
HIV/AIDS in Sub Saharan Africa
Of the estimated 33 million people worldwide living with HIV/AIDS, 2/3 of those people live in Sub Sahara Africa (SSA) (UNAIDS/ WHO, 2009). Heterosexual intercourse is the primary mode of transmission in SSA. HIV prevalence rates among sex workers continue to be high, and there is a myriad of social, cultural, traditional and economic reasons why people have multiple sexual partners and why they may not be able to practise safe sex.Transmission of HIV from mothers to their newborn and breastfed babies is significant, while new trends showing notable infection rates among men who have sex with men and injecting drug users in some countries, indicate that epidemics across West, Southern and East Africa are much more varied than previously understood (UNAIDS/ WHO, 2009).
Why is the problem so bad?
The reasons for the high prevalence of HIV in SSA are numerous and complex. Awareness of HIV/AIDS is not so much the problem- widespread sensitisation campaigns have ensured that most people in Sub Saharan Africa (SSA) know that HIV exists.
Indeed surveys have showed that in Tanzania and Swaziland, there was almost universal knowledge of HIV (Tanzania Commission for AIDS et al., 2008; Ndayiragueet al., 2008b). The difficulty is that many people do not have a comprehensive enough grasp of the facts to understand how HIV is transmitted or how that information applies to them. Through our work with communities in Sub Saharan African countries, we have observed that, due to a host of social, cultural and economic circumstances, people are unable to choose to protect themselves. Hence, a significant part of the mission of T4A members working in the field of HIV/AIDS is to contribute to empowering people to be able to make a choice about whether or not they contract or transmit HIV.
Encouragingly, evidence suggests that the situation is improving and that HIV prevention programmes are working. For example, a recent study showed a trend towards safer sexual behaviour amongst young people in Southern Africa (Gouws et al., 2008). Access to antiretroviral treatment has also dramatically improved over the last few years, which has had an impact on the numbers of people willing to be tested for HIV. Other initiatives, such as compulsory testing and treatment of pregnant women in Zambia, have helped significantly in the prevention of mother to child transmission (PMTCT). Stover et al. (2008) found that the annual number of new HIV infections among children declined five-fold in Botswana between 1999 and 2007 as PMTCT initiatives were increased.
Overall, trends published by the World Health Organisation show that prevalence of HIV in SSA have started to plateau over the last few years. However, there is still a long way to go. Our own experience is concurrent with the literature, which indicates that effective HIV/AIDS outreach varies hugely across SSA. Crucial populations are still to be reached and there is still much to be done before comprehensive coverage is achieved. As a coalition, T4A is committed to playing its part in facilitating outreach in African communities that will empower people to become HIV/AIDS competent and to be able to make positive life choices.