20 July 2016

Africa: I Am Still Not Getting the Treatment I Need

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I am an HIV positive South African woman. Eight years ago I attended the first international Aids conference in Mexico. This is my second international Aids conference, here in Durban in South Africa, is hosting. It's only Day 2 of the conference yet a lot has already been said.

I have learned that a major milestone of 17 million people living with HIV globally accessing treatment has been achieved. However, the remaining 20 million people living with HIV and who urgently need treatment are not accessing it. In my own country of South Africa, although we have the biggest treatment program covering 3.4 million on treatment, the other half aren' on treatment. This is terrible and is unacceptable.

Young women in the community where I live and work in Gugulethu, Cape Town, aren't getting tested because nurses are rude to them and judge them. As long as this happens, there's no way we'll reach the much-talked about UNAIDS 90 -90-90 targets. Those young women who test HIV positive are coming late for care, and they don't access treatment. Why do we still, in 2016, have delays in starting treatment? Young women deserve better. South Africans living with HIV deserve better.

As a woman who has been on antiretroviral treatment since 2003, I know that I, and others like me, deserve more than has been done by my government, funders and other stakeholders. Even though I've been taking my ARVs for a long time, I still struggle with pill burden. Many years ago, WHO recommended that patients with CD4 count of more than 350 should not take non nukes (nevarapine) because of its toxicity. Why am I, in 2016, still taking them? To me, saying that we "lack resources" to do genotypic resistance assays is only one of countless excuses.

At AIDS 2016, I've also heard about the genotype resistance assay test. I'm hoping that we can form a new coalition of people working on vaccines and the cure working together. Let's keep the promise.. #TreatmentASprevention. Many patients in South Africa are already resistant to second line regimens. This can prevented if everyone who starts treatment would get genotype resistance essay tests. It's a big shame that we do not have many options, and are still limited to ARVs that are toxic.

It's about time that all of us, irrespective of whether we live in Mpumalanga or Copenhagen or Atlanta, have the best treatment available. Until then, the "End of AIDS" won't be a reality.

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