The antenatal care HIV sentinel surveillance surveys have been conducted in the country annually since 1990 and biannually since 2015. The survey’s primary objectives are to estimate overall HIV prevalence and to determine trends over time and across geographic locations (province or district) and age among pregnant women attending antenatal care at 1,589 sentinel surveillance sites in all 52 districts and nine provinces of South Africa. Since 20173, several secondary objectives have been included to evaluate the performance of the country’s PMTCT programme concerning all four programme pillars.

READ THE FULL REPORT HERE

Sexually Transmitted Infections (STIs) do not discriminate or respect boundaries; they can affect anyone who is sexually active regardless of nationality, race, ethnicity, religion, gender, sexual orientation, and economic status.

STIs are among the most common communicable diseases and constitute a major global public health burden.  The World Health Organization (WHO) estimated that, in 2016, there were approximately 377 million people aged 15-49 years newly infected with gonorrhoea, chlamydia, syphilis or trichomoniasis (four common, treatable STIs).  This corresponds to just over 1 million new STI cases worldwide every day.  In South Africa, estimates of people newly infected with STIs in 2017 were approximately 4.5 million for gonorrhoea, 6 million for chlamydia and 71 000 for syphilis.

People become infected with STIs through having unprotected vaginal, anal or oral sexual intercourse with infected partners.  A large proportion of people with STIs may not have any signs or symptoms, and so maybe unaware that they are infected.  Common symptoms and signs of STI include abnormal vaginal or penile discharge; pain during urination; ulcers in the genital area; swellings in the groin, and genital warts.  Untreated STIs result in long-term complications such as ongoing lower abdominal pain, infertility and adverse pregnancy outcomes like stillbirths and preterm delivery.  Treatment for STIs is given free of charge at primary healthcare clinics across South Africa.

The WHO is collaborating with partners to develop accurate, rapid, simple and affordable tests for STI screening at point of care (clinics).  People infected with STIs may be at increased risk of acquiring HIV, and also of transmitting HIV to partners if they have STI-HIV co-infection.  Therefore, HIV testing and linkage to care is an important part of STI management.  Elimination of mother-to-child transmission of both syphilis and HIV through the screening and treatment of pregnant women is a public health priority.

So how do we prevent the spread of STIs in our communities?

• We need to STOP STIGMA around STIs: so that those with infections can access care and treatment without fear of discrimination.
• We need to COMMUNICATE: talk freely with our partners about STIs and safe sex practices and educate our children about STI prevention.
• We need to COOPERATE: with each other and with healthcare workers, access treatment if infected and also refer partners for care.
• We need to CONDOMISE: consistent and correct condom use will protect against infection and prevent spread to others.

Learn more about the work of the Centre for HIV and Sexually Transmitted Infection by clicking here.

Resources:

https://www.cdc.gov/condomeffectiveness/male-condom-use.html

https://www.cdc.gov/condomeffectiveness/Female-condom-use.html

Sexually transmitted infections (STIs) are a serious public health issue. It’s estimated that globally, more than a million people are diagnosed with one or more sexually transmitted infections like gonorrhoea, chlamydia or syphilis every day. What’s more concerning is that the prevalence of infection with chlamydia for example, have remained unchanged over the past 10 years despite better screening in developed countries.

As the name suggests, STIs are spread mainly through sexual contact. This includes vaginal, anal and oral sex; some infections can also be spread by non-sexual means – for example, from mother to child during pregnancy or childbirth.

STIs can have devastating effects on sexual, reproductive and general health. They can also lead to a number of complications. If left untreated chlamydia and gonorrhoea can cause damage to reproductive organs and result in long term complications such as infertility. People can even die if certain STIs such as syphilis are left untreated, or if they have complications such as pelvic inflammatory disease in the case of chlamydia.

To make matters worse, STIs increase the risk of HIV infection and transmission. This is because the body’s response, which is meant to help fight the sexually transmitted infection, causes a concentration of “activated” immune cells in the infected area. It then becomes easy for HIV to infect and replicate in the immune cells that are “activated”.

So it’s cause for concern that South Africa, with – 7.9 million people living with HIV in 2017 – also has a high volume of STIs.

In 2017 there were an estimated 2.3 million new cases of gonorrhoea, 1.9 million new chlamydia cases and 23,175 new syphilis cases among women aged between 15 and 49. Among men of the same age there were an estimated 2.2 million new cases of gonorrhoea, 3.9 million new cases of chlamydia and 47,500 new cases of syphilis.

These high numbers of STI cases in South Africa have partly been due to inadequate prevention and treatment gaps. Some people with STIs such as chlamydia, may go untreated because they don’t show any symptoms.

Better STI screening for high risk clients – regardless of symptoms – and better training of healthcare workers is necessary. In addition, structural problems such as limited access to client-friendly STI detection and treatment services need to be addressed. Of course, all of this costs money, which is in short supply. That’s why the need for better prevention cannot be overstated.

STI prevention in the past

Prevention of STIs other than HIV has largely taken a backseat while the country focused on HIV prevention. HIV prevention concentrated on reducing the number of sexual partners people have, increasing the correct and consistent use of condoms, early detection and treatment, and promotion of male circumcision. These measures were of some benefit in preventing other STIs.

But the increasing availability of antiretroviral drugs and advances in research have brought a new message to people living with HIV: an HIV positive person with an undetectable viral load can’t transmit the virus to their HIV negative partner.

This message, however, does not directly address the transmission of STIs other than HIV. It focuses on HIV and how to manage it, but forgets that people with HIV may be vulnerable to other STIs.

Pre-exposure prophylaxis – another HIV prevention tool – involves taking antiretroviral medication to prevent HIV infection. Research has shown that, if taken consistently and as intended, it can reduce the risk of acquiring HIV. But pre-exposure prophylaxis doesn’t protect people from other STIs.

Services to test for and treat STIs are included in pre-exposure prophylaxis services as a way of assessing levels of unprotected sex and sexual risk taking among users. But the take home message about the prevention of STIs in these settings is not clear. What counselling on STIs are pre-exposure prophylaxis clients receiving or should they be receiving? How should pre-exposure prophylaxis be promoted without compromising STI prevention?

Renewed focus on STI prevention

Strategies to prevent STIs must take into account the changes and advances in HIV prevention and treatment. Policies must answer a number of questions.

For instance, how can having fewer sexual partners, the correct and consistent use of condoms, the early STI detection and treatment of oneself and one’s partners, and male circumcision be made “fashionable” when HIV is not the death sentence that it used to be?

And what’s the best way to communicate that the knowledge of infections in oneself and the partner are key to preventing both HIV and other STIs?

It’s also important to explore how best to design prevention services that communicate how STIs and HIV happen in the context of transient, short-term or longer relationships. Policy makers need to understand, too, how people can be empowered to form, maintain or terminate relationships in a manner that does not place them in harm’s way with respect to HIV, STIs or intimate partner violence.

All of these issues must be urgently considered if South Africa is to tackle its STI problem as effectively as it’s been able to deal with HIV.

Tendesayi Kufa-Chakezha, Epidemiologist and Public Health Specialist, National Institute for Communicable Diseases

This article is republished from The Conversation under a Creative Commons license. Read the original article.

In 2017, doctors from the Transplant Unit at the Wits Donald Gordon Medical Centre performed what is believed to be the world’s first intentional liver transplant from a mother living with HIV to her critically ill HIV negative child, who had end-stage liver disease.“In the weeks after the transplant, we thought that the child was HIV positive, because we detected HIV antibodies,” says Botha.

The transplant team then accessed specialised testing by HIV experts  of the National Institute of Communicable Diseases (NICD) who subsequently could not find any active HIV infection in the blood stream of the child, meaning there is a chance that the child is HIV negative. Caroline Tiemessen is Research Professor in the School of Pathology at Wits and head of Cell Biology within the Centre for HIV and STIs at the NICD.

Uniting to end TB and HIV

Each year we commemorate World TB Day on 24 March to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the global TB epidemic. The date marks the day in 1882 when Dr Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease.

Despite significant progress over the last decades, TB continues to be the top infectious killer worldwide, claiming over 4 500 lives a day. The emergence of multidrug-resistant TB (MDR-TB) poses a major health security threat and could risk gains made in the fight against TB.

The national theme for this year’s commemoration is: “Unite to end TB & HIV – South African Leaders taking action”.

South Africa’s National Strategic Plan for HIV, TB and STIs (2017-2022) wants to reduce new TB infections by at least 30%

The National Strategic Plan (NSP) is a 5-year guide for the country’s response to HIV,

Tuberculosis and Sexually Transmitted Infections. Under the new NSP we want to reduce new TB infections from 450,000 per year to less than 315,000 in 2022. To achieve this goal, however, will require all of us to work together. All of us have a role to play. Government and all sectors of society represented in the South African National AIDS Council (SANAC) are providing leadership to ensure that we successfully implement the National Strategic Plan.

We need to urgently find the missing people with TB in order to end TB

Every year, people get sick with TB, which is an entirely preventable and curable disease. However, we still have a number of people who do not even receive care, because they are “missed” by our healthcare systems after failing to be diagnosed, treated or reported.

Let Our Actions Count

We all have a role to play in ending HIV, TB and STIs by:

• Saying NO to stigmatisation and discrimination against people living with TB and HIV;
• Checking your HIV status regularly so that you can stay negative or get care to remain healthy;
• Getting screened for TB if you have a cough that is not going away or if you know someone who has TB; and
• Helping to spread the message that TB is a curable disease – and that those who have been diagnosed with the disease must just complete their treatment.

The NICD’s Centre for Tuberculosis will be commemorating this day on Monday, 26 March 2018 at the PRF Auditorium, from 10:00 – 12:30, under the theme “Tackling BIG TB”. 

Flu season is here and it’s time for most of us to get vaccinated. Each year, hundreds of thousands of people in the US get influenza and several thousand die from the disease. In this podcast, Dr. Erin Kennedy discusses the importance of getting an annual flu vaccine.

The report is the fourth one its kind and provides an important insights into the state of the HIV Epidemic in South Africa since 2002. The survey also provides important information on the effectiveness of interventions such as the roll out of the antiretroviral therapy. Another key indicator in understanding the epidemic is HIV Incidence which reflects  how many new  HIV infections.  In addition the survey studied the risk behaviours that contribute to the prevalence and incidence observed. The NICD was part of the scientific consortium that contributed to the study.

http://www.hsrc.ac.za/en/media-briefs/hiv-aids-stis-and-tb/sabssm4-launch