Monday, 12 February 2018: During reproductive health month, Right to Care, an HIV/Aids not-for-profit organisation has called on South African healthcare workers to actively implement and support strategies that target people at risk and ‘blessers’ who are driving the HIV epidemic among young women.
Prior to the eighth African Conference of Sexual and Reproductive Health (12 – 15 February in Johannesburg), Ms Hermina Manjekana Dyeshana, programme specialist for Maternal, Newborn, Child & Women’s Health; Prevention of Mother to Child Transmission & Nutrition at Right to Care says, “The conference theme: Advancing the Sexual Health and Reproductive Rights of Girls and Women in Africa requires us to also focus on the “missing “men who are driving the epidemic. They are known as the players, plyers, sugar daddies or blessers. They enter into relationships with young girls as a transaction: you give me unprotected sex and I give you money, a cell phone, airtime, new clothes, make up, school fees, a car, whatever you or your family might need. The blessers are normally older men who have concurrent sexual partners in their own age group and are sometimes also married. These men are driving HIV transmission, and compounding an already massive public healthcare problem.”
Dyeshana says, “We know that there are large numbers of older HIV-infected men who have multiple concurrent partners. Very few know their HIV status and many opt not to be tested at all. Those who are recently infected with HIV have extremely high viral loads. Tragically, they are not entering the health system to get support or treatment. This is a major concern.”
Dyeshana continues, “However, we cannot alienate the blessers as we need to bring them in for HIV testing and other screening and treat them accordingly. Right to Care is involved in programmes to reach men in places where they frequent and are comfortable, for example at popular social spots clubs, entertainment areas, hostels, taxi ranks and at their places of work. Making condoms available and dispelling myths around condom use is also a large part of our work.”
Young women however bear the brunt of the HIV pandemic in SA. Nearly a third of all new HIV infections in South Africa occur amongst 15 – 24-year-olds and adolescent girls are eight times more likely to be infected with HIV than their male counterparts. A recent HSRC study shows that almost a quarter of all new infections occur amongst young women aged 15 – 24.
Dyeshana says: “It’s all about economics. Most of these young women cannot afford to buy the things that they need and are therefore willing to engage in transactional sexual relations with older men to get them. So young vulnerable woman will gladly accept what her blesser gives her, and she repays him with unprotected sex. Regrettably, the unintended gifts include pregnancy, or an STI like HIV. Then, the happy blesser goes home to his wife or may even stop along the way take part in several other extra-marital relationships.”
Right to Care has welcomed the Minister of Health’s recent launch of a campaign to reduce infections, decrease teenage pregnancy, keep girls in school longer until tertiary level when they are a bit matured to be able to make informed decision to negotiate condom use and finally provide greater economic opportunities for them so they are not lured into unhealthy blesser relationships.
Says Ms Dyeshana: “Despite the need to focus on the blesser, our primary focus remains on young people. We are supporting programmes that have been developed to reach young men and women in schools and universities and have placed our full weight behind the Department of Basic Education’s national policy on HIV and Aids for learners and educators in public schools and FET institutions.
“We are also motivating for youth-friendly facilities and services, where a youngster can enter a health facility without feeling judged by either the nursing staff or by the other older patients waiting at the same facility. Youth friendly facilities are ideal as operating hours should be flexible enough to accommodate attendance after school. Ideally services need to be rendered by young staff members who understand youth.
“We are making headway. People are accessing information, services, care, treatment and support. These include screening & testing for pregnancy, TB and STIs, including HIV. A range of contraceptive methods are on offer depending on clients request and suitable criteria at reproductive health services Treatment is also available upon diagnosis made. Counselling and education is also offered including referrals to relevant facilities.”
Right to Care also supports the DREAMs (determined, resilient, empowered, Aids-free, mentored and safe) programme. Many adolescent girls and young women lack a full range of opportunities and are often devalued because of gender bias, leading them to be seen as unworthy of investment or protection. Social isolation, economic disadvantage, discriminatory cultural norms, orphanhood, gender-based violence, and school drop-out all contribute to girls’ vulnerability to HIV.
Photograph of Ms Hermina Manjekana Dyeshana: https://drive.google.com/file/d/1EhW_z6qB-G5_SRIpMoVntoSHOGXYLPCk/view?usp=sharing
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Right to Care is a non-profit organisation that supports and delivers prevention, care, and treatment services for HIV and TB. Through technical assistance, Right to Care supports private sector, the Department of Health and the Department of Correctional Services. In addition, through direct service delivery, Right to Care treats patients for HIV, TB and sexually transmitted infections. The Right to Care Paediatric and Adolescent Programme has developed useful tools to help clinics disclose to their patients and to run adolescent support groups. It also provides training and mentoring, and runs helplines to assist clinics in managing their paediatric and adolescent patients.”