EPISODE 23 - Themes of the Season

Three major epidemics challenge us all as South Africans - HIV /AIDS , TB and Gender Violence. Siyayinqoba provides a space where people can speak out and share their successes, challenges and hardships in facing these three epidemics. In this episode we talk about these three themes.

In Khayelitsha, Cape Town, Milliha Magayiyana shares her story. Milliha is 21 years old and now works as a rape crisis counselor with school children. She started doing this work because she saw that many school children were being raped. This had been her own experience too. She was first raped by an uncle when she was seven years old. Her mother used to send her to the uncle when they were in need of things for the house. The uncle started raping Milliha and giving her money to keep quiet. This continued till she was 13 years old. Now she shares her experiences with other young people at school to encourage them to come forward if they have similar experiences. Milliha dropped out of school and started dealing with her trauma by sharing her story and volunteering for various organizations. She found that meeting other rape survivors helped her overcome the trauma - "I discovered that it's not the end of the world. I mean, instead of killing me, it made me stronger".

Fundiswa Sicithini lives in the Eastern Cape, but found out she was pregnant when in Cape Town in 2003. She had an HIV test and found out she was positive. She returned to the Eastern Cape to have her baby. She didn't enter into a prevention of mother to child transmission programme and her baby tested HIV positive. It is very common for young women, after testing HIV positive, to return home to have their baby. This is when they are lost to the mother to child transmission programme. These circumstances led to Fundiswa's son being infected with HIV. He developed TB.  Fortunately, his TB was diagnosed and he completed the six months treatment for TB and recovered.  If a child is failing to gain weight and has other symptoms such as coughing which doesn't get better, a TB test must be done. In 2007 he started on ARVs. He is now 5 years old and is happy and healthy and growing well. His grandmother helps give him his medicine every day and she takes hope from seeing him getting stronger and bigger. She encourages her daughter to also "keep on taking her medication and not to stop".

The good news is that government has now approved people who are infected with both HIV and TB to start ARVs at a CD4 count of 350 or below, instead of the old 200 or below. To take advantage of this, it is important to be tested for both HIV and TB.

It would have been much better if Fundiswa has been able to access ARV treatment before her son was born as this would have protected him from being infected with HIV. Nolubabalo Nqelenga is one mother who successfully accessed PMTCT to prevent her child being infected. She started on ARVs in 2005. Her CD4 count at the time was only 122. Nolubabalo started on a typical first line regimen of 3TC, d4T and Stocrine. Her CD4 count when up within six months, soon reaching 900 -  a normal level. Nolubabalo says she planned her pregnancy. She understood that she could quite safely have a baby if her viral load was undetectable and her CD4 count was high. She became pregnant in 2007. After she confirmed her pregnancy, her doctor changed her medication from Stocrine to Nevirapine as there are some concerns about using Stocrine in the first three months of pregnancy.  With an undetectable viral load and a high CD4 cell count there is a 99% chance of the baby being born HIV negative. To be absolutely sure, her baby received a single dose of Nevirapine syrup straight after birth (it must be within 72 hours) and also got AZT syrup for seven days.  This is preventative or prophylactic treatment to the baby which will kill off any HIV that may have made its way into his blood stream. The result was that Nolubabalo's baby tested HIV negative at six weeks.

New Deal - World AIDS Day 1 December 2009.

The new deal for pregnant women announced by Government on World AIDS Day 2009 is that mothers may now start full ARV treatment for life once their CD4 count reaches 350 instead of the old starting point of 200. Also instead of AZT now Nevirpaine is given daily to the baby for at least 6 weeks and for as long as any breastfeeding continues.

In addition any baby who does test positive for HIV at six weeks can start on ARVs immediately.