Stigma and discrimination remain significant barriers to effective HIV management in South Africa. Many individuals are reluctant to seek testing or treatment due to fear of social ostracism or discrimination in healthcare settings. This stigma not only hampers efforts to diagnose and treat HIV but also undermines preventive measures such as pre-exposure prophylaxis (PrEP). Comprehensive education and awareness campaigns, alongside policy reforms to protect the rights of people living with HIV, are crucial in combating stigma. Additionally, addressing co-infections such as tuberculosis (TB), which is highly prevalent among people living with HIV, is essential. Integrated care models that provide simultaneous treatment for HIV and TB can improve health outcomes and reduce mortality rates. Overcoming these challenges requires a multifaceted approach that includes community engagement, policy changes, and sustained funding for healthcare infrastructure and services.
South Africa has made significant strides in expanding the availability of pre-exposure prophylaxis (PrEP) options for HIV prevention. Initially, daily oral PrEP, primarily using a combination of tenofovir and emtricitabine, was the mainstay, offering an effective method for individuals at high risk of HIV exposure. Recently, innovative PrEP options have been introduced to cater to diverse needs and improve PrEP uptake and persistence. One notable addition is the long-acting injectable cabotegravir (CAB-LA), administered every two months, providing a discreet and convenient alternative for those who find daily pills challenging. Moreover, the development of the Dapivirine vaginal ring offers a female-initiated method, worn for a month at a time, empowering women to take control of their HIV prevention. These varied PrEP options, supported by comprehensive implementation programmes and community outreach, enhance the accessibility and acceptance of HIV prevention strategies, significantly contributing to the reduction of new infections in South Africa.
For more information on current and ongoing HIV Prevention research DTHF is conducting please see the information provided in our most recent annual review: