UKZN Commemorates World AIDS Day 2020

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In 2019 there were 38 million people worldwide living with HIV with about 700 000 deaths caused by the disease and 1.7 million new infections, translating into about 4 600 new cases every day.

Africa has around 70% of all infections, while in sub-Saharan Africa, young women, who comprise about 10 percent of the population, account for one in every four new cases.

This is according to the Associate Scientific Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA), Professor Quarraisha Abdool Karim, who addressed participants from around the world at UKZN’s World AIDs Day webinar. Hosted by the College of Health Sciences, the theme of the event was Global Solidarity, Shared Responsibility in Recognition of the Impact of COVID-19.

Abdool Karim, who is a National Research Foundation A-rated scientist, gave an overview of the global HIV epidemic focusing on the continued high burden of the disease on young women in KwaZulu-Natal. She referred to a study conducted in a rural district in KwaZulu-Natal, which revealed that about 40% of women there were infected by the age of 23, while about 11% of young men, of a similar age to the women, were also infected. She emphasised that existing disparities needed to be addressed with the response requiring both treatment and prevention. ‘Preventing HIV infection in young women is critical if we are going to turn the tide on this pandemic,’ she said.

The infectious disease epidemiologist explored the impact of COVID-19 on HIV research and advocacy, emphasising that knowledge about the pandemic was very limited. ‘While we are seeing an unprecedented generation of new knowledge, there are still major gaps that remain. In the context of an emergency, disaster or a pandemic, we need to act and, in some instances, make leaps of faith in terms of what knowledge is available, in the interest of saving lives,’ she said.

With COVID-19, great optimism had been marred by vaccine “nationalism”. Abdool Karim cautioned against inward thinking, especially in industrialised countries.

She examined the intersectionality of pandemics and stressed the importance of addressing gender inequity, mental health and substance abuse.

Head of Internal Medicine at UKZN Professor Nombulelo Magula presented on the UNAIDS 90 90 90 U=U strategy to end HIV as a public health threat and attain targets during the COVID-19 pandemic. Magula gave an historical perspective of UNAIDS 90 90 90 which is a roadmap to ending the HIV and AIDS pandemic with the aim being that by 2020 90% of all people living with HIV know their HIV status, 90% of those with diagnosed HIV infection receive sustained antiretroviral therapy, and 90% of all people receiving antiretroviral therapy have viral suppression. ‘UNAIDS has adopted the Undetectable = Untransmittable (U=U) strategy where there is promotion of understanding that once people achieve undetectable viral suppression, then they cannot transmit infection,’ she said.

Referring to a study done at the University of Cape Town on the progress towards 90 90 90 targets, Magula said: ‘Only 79% of children know their HIV status and of those 68% are being treated. ‘This is a serious concern. We need to find those children through their grandmothers, teachers and pastors and ensure they understand very early and are counselled.’

She said transmission drivers of HIV included a lack of uptake of prevention interventions, stigma, insufficient treatment uptake, lack of disclosure, and mental health issues, including depression. ‘We need to focus on behaviour in order to stem the HIV pandemic. Some patients actually choose a path that leads to death rather than take a single pill because of the stigma they experience. We need to find strategies of changing this behaviour by working closely with communities.’

Magula commended UKZN for the 2019 Campus-to-Campus race held to raise awareness about 90 90 90 and emphasised how vital it was to work together to combat HIV. ‘We need to work together because we are all in this together! Our response has to be led and driven in all communities so that we can stop transmission of HIV by 2030 so our children and their children can live a life that is free from the HIV/TB epidemic,’ she said.

Deputy Vice-Chancellor and Head of the College of Humanities Professor Nhlanhla Mkhize presented on: The Psycho-Social Implications of COVID-19 on People Living with HIV, saying mental health was a major concern, not only in communities in South Africa and Africa but worldwide. ‘We are seeing an increase in disorders such as depression and we anticipate that these disorders are going to be exacerbated by the COVID-19 pandemic as people lose employment due to lockdown regulations,’ he said.

Mkhize said the psycho-social implications for people living with HIV and AIDS during the COVID-19 pandemic included the threat of unwanted exposure (for example when collecting medication), the exacerbation of inequalities faced by women living with HIV (including inter-partner violence), disconnection and social isolation, and food insecurity.

Mkhize appealed to the audience to lobby government to devote more resources to the management of mental health and called for social support for the elderly living with HIV and AIDS, especially during the pandemic.

Deputy Director of Science at the Africa Health Research Institute Professor Thumbi Ndung’u focused on the need for novel approaches to prevent and treat HIV infection and interactions of HIV-1 and SARS-CoV-2.

Ndung’u said a multi-faceted approach was needed for HIV prevention. Current strategies included anti-retroviral therapy, HIV education and counselling, safe sex, STI treatment, addressing poverty in young women and male circumcision.

He said next-generation tools to address HIV prevention included PrEP (pre-exposure prophylaxis), passive immunisation, vaccines and modulation of the vaginal microbiome. (Currently available, PrEP is a pill those at risk of contracting HIV take to prevent getting the disease from sex or injection drug use.) ‘I listed PrEP at the top of the list since it is the most effective first line preventative therapy but the uptake of PrEP, especially in vulnerable groups such as young women, is very low.’

UKZN student and HIV and AIDS activist Ms Nkazimulo Dludla described her journey living positively with HIV and contracting COVID-19. The inspirational young woman spoke out against stigma and appealed for support with mental challenges for people facing the two epidemics.

Dludla found fighting COVID-19 particularly challenging, especially as her father died two days before she was diagnosed. ‘I had already given up before I’d even started the fight,’ she said, but support from her family, friends and colleagues helped her recover. 

She said the stigma related to HIV, even from health workers, was severe. ‘The fight against HIV and COVID-19 doesn’t fall only on people infected by these viruses - also falls on those around us,’ she said. 

SRC Central President Mr Moses Nkambako emphasised the importance of students knowing their status and said ‘solidarity is needed in the fight against HIV.’ He paid tribute to Dludla and encouraged UKZN students to get involved with the peer education programme of the Campus HIV and AIDS Support Unit (CHASU).

Nkambako commended the University for hosting the informative event and called on all students to treat every day as World AIDS Day to combat the epidemic.

Dean and Head of the School of Nursing and Public Health Professor Mosa Moshabela highlighted salient points from the discussions, with particular emphasis on matters that needed to be drawn to the attention of the University’s Management. Deputy Vice-Chancellor and Head of the College of Health Sciences Professor Busisiwe Ncama, who facilitated the event, gave an undertaking to raise these points with UKZN Management.

Executive Director (Acting) of the Corporate Relations Division Ms Normah Zondo led a candle-lighting ceremony to remember those who have died from HIV. ‘With nearly 38 million people living with HIV and AIDS today, the candlelight ceremony serves as an important intervention for global solidarity, breaking down barriers of stigma and discrimination,’ said Zondo. ‘It is time for all of us to remember the many lives that have been lost to HIV and AIDS. It’s also an opportunity to honour those who have dedicated their lives to helping others living with HIV and AIDS.’

Words: Raylene Captain-Hasthibeer

Image: Supplied