On International Women's Day, celebrated on March 8, the spotlight is on the remarkable community influencers who have dedicated themselves to reducing HIV prevalence, particularly among young women.
Dr Ziyanda Makaba, Clinical Specialist for HIV and Paediatrics at BroadReach Health Development, highlighted the concerning statistic that women and girls accounted for over 60% of new HIV infections in sub-Saharan Africa in 2022.
The USAID-led DREAMS programme, which stands for Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe, is playing a crucial role in supporting high-risk young women and girls across the region.
Goodman Ntshangase, the Acting District Director of Gert Sibande in Mpumalanga, South Africa, highlighted the significance of community ambassadors, or “Influencers for Good”, in encouraging their fellow peers to use HIV prevention strategies.
These influencers encourage their friends and neighbours to take preventative measures for HIV, including pre-exposure PrEP, post-exposure PEP, and condoms.
They also advocate for HIV testing and the initiation of antiretroviral treatment for those who test positive. This approach is particularly beneficial in preventing mother-to-child transmission.
Dr Makaba explained that the local “Influencers for Good” operate within the Differentiated Models of Care framework, which aims to empower vulnerable individuals in their unique contexts without judgement or shame.
Their efforts are making it possible for more adolescent girls to lead healthy lives free from the burden of HIV.
Dr Makaba pointed out the tailored approaches taken by influencers to support individuals based on their HIV status.
"For someone living with HIV, the goal is to ensure they take their ARVs daily to achieve 'viral suppression,' where their viral count becomes so low that it is virtually undetectable and untransmittable.
“For those who are HIV negative but in a relationship with someone who is HIV positive or injecting drugs, they may be encouraged to take preventative PrEP, a medication that can prevent HIV if taken 7 days before exposure," explained Dr Makaba.
The impact of influencer interventions, combined with other community health initiatives at clinics, has led to significant improvements in HIV rates.
In the Nkangala and Gert Sibande districts in Mpumalanga, where BroadReach and community brigades have been active for five years, the results are evident.
In 2018, 1 520 people were initiated on PrEP, a number that has now risen to 30 094 in the past year.
Dr Makaba emphasised: "This indicates that our outreach efforts are effective, and we are persuading more people to access life-saving preventative medications."
Furthermore, the number of mother-to-child (perinatal) transmissions has halved, attributed to more mothers taking ARVs during pregnancy.
"In Year One, 251 HIV+ infants needed ARVs, and now we have half that at 124 infants. This demonstrates the effectiveness of ARVs in protecting babies when taken by mothers during pregnancy," Dr Makaba added.
One of the influential figures making a difference is Lorraine "Lolo" Simelane, an HIV/AIDS Lay Counsellor at Kempville Clinic in the Mkhondo sub-district of the Gert Sibande area.
Simelane expressed her passion for connecting with others and helping them through challenging times.
"We educate young people to make healthy decisions and access treatment and care through confidential HIV counselling and testing services. I have successfully enrolled 2 000 young people on PrEP before they started their tertiary education," she shared.
Known affectionately as “Coach Mpilo”, Sabelo Teddy Mosimaka is dedicated to supporting young people at Ezamokuhle Clinic in the Gert Sibande District.
Sharing his inspiration for becoming a coach, she explained, "I have a strong desire to share my journey with people living with HIV and to save lives. My mother, who lived with HIV for a long time, inspired me.
“She used to help people get back to care, stay healthy, and live their lives as normally as possible."
Coach Mpilo highlighted the challenges that young people in the community face, including lack of information, unemployment, limited support from community structures, and peer pressure-induced alcohol abuse.
Young people must be able to express themselves, find information in a safe environment, and receive assistance without feeling judged or stigmatised, according to Coach Mpilo.
"I help young people access support without fear of being stigmatised," she added.
“Reaching the goal of ending new HIV infections by 2030 is possible. To do this, we need a multi-pronged approach to identifying and protecting our most vulnerable from contracting HIV and ensuring those who are HIV+ have access to the necessary treatments to enable them to live long healthy lives. Community ambassadors are central to this goal,” said Dr Makaba.