Inclusivity is key in the fight against HIV

Friday, January 19, 2018

In recent years, South Africa has made great strides towards providing support to those infected and affected with HIV. Today, the country’s response to HIV/Aids treatment and prevention is regarded as among the most progressive on the continent.

But with global statistics showing that transgender women are nearly 49 times more likely to be infected with HIV than other adults of reproductive age, the time has come to zoom in on HIV vulnerability of transgender women, writes Steve Letsike.

The South African government and its partners, is implementing the largest HIV treatment programme in the world, which includes an estimated 4.2 million people.  However, with an estimated 7.1 million people who are infected with HIV, it is clear that much more remains to be done. While South Africa’s goals are far reaching, the country’s response to HIV is remarkable for one other reason. 

Many of us may not know that South Africa is one of very few countries around the world which has included the needs of the LGBTI community in its national response to HIV.  The national LGBTI HIV plan was launched during the 2017 8th National AIDS Conference hosted in Durban.

The plan makes it incumbent upon stakeholders to reach all key and vulnerable populations in the fight against HIV.  We know that the stigma and discrimination faced by members of the LGBTI community makes it difficult for people to test for HIV and for those infected to seek treatment.  Experience has shown us that excluding such communities from the opportunities to be tested and seek treatment only creates problems for us and compromises our vision of an HIV-free generation.

Global statistics show that transgender women are nearly 49 times more likely to be infected with HIV than other adults of reproductive age. 

Despite this, there is currently very little information in South Africa about the specific HIV vulnerabilities of transgender women.  In addition, HIV prevalence amongst transgender women also remains undocumented and as a result, transgender women remain extremely vulnerable.

It is against this background that we must welcome the first South African study looking at HIV prevalence in transgender women which was launched earlier this month.

This study is led by the Human Sciences Research Council (HSRC) and supported by the United States Centres for Disease Control and Prevention (CDC) through the President’s Emergency Plan for AIDS Relief (PEPFAR).  This study is also supported by various local and international academic and civil society partners and will be conducted in Cape Town metropolitan area in Western Cape, the Johannesburg metropolitan area in Gauteng and in East London, Eastern Cape.

Several civil society partners have been selected in helping to recruit to participate in the study.

Importantly, this study goes beyond just looking at HIV prevalence amongst transgender women.  It brings our Constitution to life in that the insights from this study can be used to develop and implement awareness campaigns targeted at the transgender community and at society at large.  This study is the first step in a journey where eventually, members of the transgender community will not suffer discrimination, exclusion and marginalisation. 

It is equally part of South Africa’s commitment to looking at the real issues which impact on the LGBTI community in general, and the transgender community in particular.  This includes the psycho-social elements of discrimination and exclusion in the socio-economic life.  This survey will yield insights and awareness which will ensure that everyone can be reached in the fight against HIV, regardless of gender identity, expression or even sexual orientation, it is about putting people first.

This study will intensify the fight towards other communicable diseases as well as HIV, participants in the study will also have access to HIV Counselling and Testing (HCT).  We will test for HIV prevalence, antiretroviral testing, HIV viral load testing, TB and for other sexually transmitted infections.

The evidence based results from the study will influence South Africa’s understanding and therefore, responses, to the public health needs of transgender women in the country.  This study will also become part of the global body of knowledge on the public health needs of transgender women.  By making public health and communication programmes more focused, there is no doubt that we will begin to see a greater return on the significant resources invested in fighting HIV.

Steve Letsike is the Deputy Chairperson of the South African National AIDS Council. –


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