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Beyond Red Ribbons: What you need to know this World AIDS Day

For an organisation that works in the field of HIV every day, World AIDS Day can descend like a double-edged sword. On this one day, the attention of media houses, politicians, government departments and businesses focuses sharply on HIV. Our mobile teams are booked up months in advance and we hussle and strain to meet the massive demand for our services at community events and workplaces. This is good. Of course it is. We hope it means that more people are being reached with messages about how to stay healthy, and are accessing the services that will help them to achieve that. But with all this rush and hype, it is easy to become overwhelmed and to miss some of the key issues of the moment. We’ve selected a few highlights and debates (some light-hearted) as a quick guide to HIV in 2015.

‘Test and treat’ or ‘Treat all’:
It sounds simple, but it could be revolutionary. The idea of treating people who are diagnosed with HIV as soon as they are diagnosed instead of waiting until their CD4 count drops to a certain level doesn’t sound like a big change, but it could be. Treating people living with HIV with antiretrovirals sooner rather than later means they stay healthier, and they are also much, much less likely to transmit the virus to others. This is a WHO recommendation as of September this year.

Treatment as prevention:
This is a similar concept to ‘test and treat’; it suggests that providing people with antiretroviral treatment is, in itself, a form of prevention. This is because ARVs lower a person’s viral load to the point where it is very difficult for transmission of HIV to take place. A study cited in aUNAIDS report showed that in one community in KwaZulu-Natal where ARV coverage was 30-40%, a person was 38% less likely to be infected with HIV than in a similar community where coverage was only 10%.

What if you could take a pill that could prevent HIV? Well, you can. It’s called pre-exposure prophylaxis or PreP. It’s not a vaccine because you are only protected for as long as you take the one pill a day. TB/HIV Care’s AVAC fellow, John Mutsambi, has been advocating for the roll-out of PreP for young and vulnerable women. You can read more about this here and here

90 90 90
This is a strategy proposed by UNAIDS one of the strategies to end the AIDS epidemic. It aims to ensure that 90% of people living with HIV know their status by 2020 (so testing people is really important here), to ensure that 90% of people living with HIV receive antiretroviral treatment by 2020 (linking people to care after diagnosis is important here), and to ensure that 90% of those on ARVs are virally suppressed by 2020 (keeping people in care will be important here).

Fast-Tracking and Front-loading Investments:
The UNAIDS launched its World AIDS Day Report today announcing its strategy to reach the new Sustainable Development Goal of ending AIDS by 2030. This strategy includes focusing on the people most affected by HIV and on the locations where they are. The strategy calls for ‘front-loading’ investments in these locations and on services aimed as these populations instead of spreading the investment over a greater percentage of the population in a larger area.

Condom Emojis
What’s that now? Durex has launched a campaign to ask people to call for a condom emoji to be developed. What’s an emoji? Those little pictures you can insert on your phone when texting … or sexting. Durex believes the emoji will make it easier to talk (or chat) about safer sex. You can join the campaign by mentioning #CondomEmoji as much as possible on your social media feeds. Happy, safe tweeting! Read more here.

Tribute to Maria ‘Ria’ Cornelia Grant

It was with profound sadness that TB/HIV Care learnt that our beloved Senior Advisor, Ria Grant, passed away on Tuesday, 17 November. She died peacefully while she was in frail care. Her husband, Richard, was by her side.
Ria was a wonderful person who touched everyone she met with her positive energy, good humour and caring nature. She was an inspiring mentor to many and will be missed by all who knew and worked with her.
Ria joined TB Care Association as a case worker in 1976, rose to the position of Director in 1992 and helped build the organisation into a leading South African TB NGO. In 2008, she helped guide and implement the transformation of the organisation into one that also addressed HIV – TB/HIV Care Association.
Ria joined The Global Fund to Fight AIDS/HIV, TB and Malaria’s Developing Country NGO Delegation in 2009, became the African Regional Communications Focal Point in 2010 and the Lead Communications Focal Point from 2012 to 2014.  She was a strong advocate for TB and community systems strengthening at local, national and international levels.
The world has lost a great leader who cared for people with TB and their families for almost 40 years of her life. Her life should give us strength and resolve to end TB within the next 40 years.
‘Umthi omkhulu uwile’ 
‘A big tree has fallen’
Those who wish to pay Ria tribute are welcome to post messages on our facebook page. We will be collecting them to present to her family.

TB/HIV Care Hero: Nontobeko Makhosonke – the strength to refuse

Nontobeko Makhosonke works at a new facility that was opened in 2014. Because a lot of staff are new, the HAST Counsellors in the facility have found that they receive many different orders from many different directions which can be challenging. Nontobeko’s line manager, Jessica Mvelase, commends her for having the strength to politely refuse an order Nontobeko felt was not in the best interests of her client.

Nontobeko tested a client whose rapid test came back positive. The normal protocol is for a confirmatory test to be performed, but none were available at the facility. Blood was drawn for ELISA testing to check the result, but when the client returned to receive the results only the CD4 count was available. The ELISA result had gone astray.

A doctor ordered Nontobeko to perform the first ARV counselling session for the client. Since the client’s HIV status had not been confirmed, Nontobeko refused, stating she needed to have the client’s status confirmed. This was brave, but according to protocol. If the client was in fact HIV negative and during the counselling Nontobeko had incorrectly informed them that they were positive, it could have had severe consequences for the client’s life.