Gauteng Premier Mbhazima Shilowa on Thursday tabled the province’s second annual HIV/Aids report in the region’s Legislature, telling MPL’s the impact of the pandemic would peak in the province around 2010.
”Care for people living with HIV/Aids places an extraordinary load on health care services. This is expected to peak around 2010, with maximum impact on acute care in hospitals,” he said.
”Bigger clinics with doctors will care for sicker patients with Aids, including the addition of anti-retroviral treatment and palliative care. Hospitals will provide care for people with severe illness and refer to clinics, step-down beds and home based care services.
He told a half-empty legislature and a packed press gallery that the Gauteng Aids Programme (GAP) was based on the national government’s five-year HIV/Aids and sexually transmitted infection (STI) strategic plan’s three key components — prevention, care and support.
”Within this, numerous sub-programmes provide a comprehensive set of interventions to both prevent the spread of HIV and provide care and support for people infected and affected by HIV and Aids, Shilowa said.
”The report that we are presenting to the house and to the people of Gauteng today, shows that during the period under review we have made further progress in our fight against HIV/Aids,” Shilowa said.
”Our success is highlighted by the increased levels of awareness about HIV/Aids, change in behaviour especially among the young people who fall within the high risk group, reduction in the number of new infections, increased number of people going for voluntary counselling and testing and the positive attitude shown by communities towards people living with HIV/Aids.
Prevention education programmes were showing ”impressive” results, especially among those under 25.
Surveys commissioned by the Gauteng health department showed that 70% of the people in Gauteng in this category used condoms.
”The surveys also show that schools and the media have the greatest influence on youth of school-going age. The younger the learner the better the education and the stronger the degree of behaviour change,” he reported.
However, while there were encouraging trends in youth behaviour, people were still getting infected, especially the unemployed and those living in poor communities. There was therefore a need to strengthen and intensify the prevention campaign, Shilowa said.
”A new prevention programme targeting youth at greatest risk of HIV/Aids infection has been introduced. The programme uses peer education and focuses on mining towns, hostels, sex workers and prisoners,” he said.
In a departure from his prepared speech, Shilowa added that questions of morality regarding prostitution and personal opinion had to be set aside when dealing with the pandemic. While the premier did not say ”sex work is fine”, both sex workers and their customers needed to be protected from HIV/Aids and STI’s.
”Large peer education projects have been operational in the mining areas of Carletonville, Westonaria and Randfontein. The Accept sex-worker project was extended to the entire Johannesburg inner city. Future plans include taking the programme to the hostels where it will also be used to intensify the cultural programme in single sex hostels.”
There had been an increase in the number of people using Gauteng’s voluntary counselling and testing (VCT) services, Shilowa said.
The premier cautioned that a study had shown that while people were aware of the VCT service, they were also concerned about confidentiality and how they would cope with a positive HIV test result.
Shilowa also announced that the province’s prevention of mother-to-child transmission programme (PMCT) had been expanded to all public hospitals and big clinics providing obstetric services in Gauteng.
Between May 2001 and January 2003, a total of 103 799 women accessed the PMCT service, and 60 339 (58%) of them opted for VCT. Of those tested 17 741 (29%) were HIV positive. Twelve thousands mothers opted for the PMCT programme.
”It is important to note that the PMCT intervention reduces, but does not eliminate, HIV transmission from mother to baby. Tests on a limited number of babies at 12 months, showed a reduction in the rate of HIV transmission,” Shilowa said.
The GAP also provides palliative care, or care for when curative treatment was no longer effective.
This programme involved home-based care and hospice beds run by NGOs funded by the Gauteng health department. In 2002/3 it catered for 20 000 people.
There had also been a progressive expansion of social support programmes for families and people affected by HIV/Aids.
”Currently there are 37 dedicated orphan support projects in the province. Families affected by Aids also receive poverty relief assistance including free or subsidised municipal services, social security grants and food support,” Shilowa said.
Looking ahead, Shilowa said the GAP would be complemented by a renewed focus on poverty relief programmes and anti-retroviral treatments.
Neither his speech, nor the report itself, contained any detail on funding. – Sapa