In June 1981, the U.S. Centers for Disease Control and Prevention reported a rare type of pneumonia that appeared among young homosexuals in California. They were not aware at the time, but these were the first documented cases of AIDS.

In 1983, virologists from the Pasteur Institute managed to isolate HIV, the virus that causes AIDS.

Since then, HIV has infected 85.6 million people, and 40.4 million people have died from AIDS-related diseases.

In the early years, the disease was known as the "gay plague" because it seemed to exclusively affect homosexual men.

However, it is now known that HIV is not limited to the homosexual community.

Today, women are significantly more affected by HIV than men, with young women being particularly vulnerable. In sub-Saharan Africa, adolescent girls and young women accounted for more than 77% of new infections among young people aged 15 to 24 in 2022.

From July 22 to 26, the 25th International AIDS Conference is being held in Munich, Germany. This event will bring together people living with HIV, scientists, policymakers, healthcare professionals, and communities to share knowledge and experiences gained in the fight against HIV over the past 40 years.

The Conversation Africa portal has published numerous articles on this major health challenge. Here are some highlights.

Advances in Prevention
One of the most significant medical advances in the fight against HIV in recent decades is pre-exposure prophylaxis, or PrEP drugs.

These drugs significantly reduce the risk of contracting HIV through sexual contact and can be taken as an injection or a daily pill.

A clinical trial conducted in South Africa and Uganda, involving 5,000 young women, showed that a two-year injection of the PrEP drug lenacapavir was 100% effective in preventing infection.

This medical advance is not only significant but also a crucial option for young women who cannot take pills regularly due to stigmatization or risk of violence. A twice-yearly injection can provide them with protection against HIV.

Discrimination and Violence
In South Africa, laws prohibit discrimination based on sexual orientation.

However, in practice, many African cultures consider homosexual relations taboo and un-African.

A study of men who have sex with men in the Zulu community found deeply rooted stigma associated with cultural beliefs. Participants reported frequent ridicule and abuse, often leading to depression, suicide, and drug abuse.

As a result, many are afraid to check their HIV status or seek medical help at local health facilities. One study participant stated:

"I would rather die from my illness than use these facilities."

Ikekhwa Albert Ikhile emphasizes the need for better access to healthcare for vulnerable populations in his article.

Aging and HIV
Most HIV prevention and treatment programs and policies in South Africa focus on adolescents and young adults. However, a growing group of middle-aged and older adults with HIV, or at high risk of infection, remains neglected.

An exception is the research known as Health and Aging in Africa: Longitudinal Studies in South Africa, or Haalsa.

This ten-year project in rural northeastern South Africa aims to better understand the "gray" HIV epidemic, which affects people over 40 years old.

Research has shown that sexual activity is common among this age group: 56% of respondents were sexually active in the past 24 months. One-quarter live with HIV, and social stigma discourages them from testing.

Laws Against Sexual Diversity
Research has shown that young people with diverse sexual or gender identities are at higher risk of discontinuing HIV treatment, not only because of stigma but also due to strict laws.

In 13 countries in Eastern and Southern Africa, laws and policies criminalize homosexual relations.

Research in Malawi, Zimbabwe, and Zambia has found that criminal laws and negative cultural and religious beliefs cause deeply rooted intolerance towards sexual or gender diversity.

Researchers Kaymarlin Govender and Patrick Nyamaruze report that study participants spoke about verbal abuse, gossip, and physical violence.

Overall, 42% had at least once considered suicide. According to one 18-year-old:

"I feel like I'm nothing, I'm useless... And, sometimes, I think if I can die today, I can rest."

Treatment for Migrant Women
In 2020, it was estimated that there were 4 million migrants in South Africa, some of whom were women living with HIV. The public health system struggled to meet the needs of this mobile population.

The COVID-19 pandemic exacerbated the situation.

Migrant women who left the Gauteng province and tried to return to collect their medication could not do so due to border and lockdown restrictions. Others were denied care because they lacked documentation.

There were also reports of mistreatment and xenophobic attitudes from healthcare workers.

Melanie Bisnauth writes that ensuring effective treatment for mobile populations is crucial to reducing the number of infections and working towards the goal of ending the HIV epidemic by 2030.

Original:
Nadine Dreyer