Adolescent girls and young women in Mpumalanga’s Ehlanzeni district are encouraged to go to special youth-friendly health facilities to learn more about PrEP, a drug that can lower the risk of HIV infection considerably. HIV prevalence in women aged 15-24 is nearly four times greater than men the same age.
Eve Matshili-Mphigalale, Right to Care’s prevention projects coordinator in Ehlanzeni says, “We are working closely with the Department of Health and other NGO partners to help adolescent girls and young women prevent HIV and stay healthy as they take the sometimes difficult journey into womanhood. We promote the use of condoms during sex, but when a young woman’s risk of contracting HIV increases, we urge her to take pre-exposure prophylaxis (PrEP).
“You take PrEP if you believe you may be at risk of exposure to HIV. PrEP is two HIV medications combined into one pill. It is highly effective in preventing the sexual transmission of HIV. If you take PrEP, it does not mean you are on life-long antiretroviral treatment.”
A person starting PrEP needs seven consecutive days of daily dosing to reach adequate levels of PrEP that will prevent HIV infection. During these seven days, other protective precautions must be used – abstinence or condoms.
Eve says that, “Healthcare workers at 15 Department of Health-accredited clinics in Ehlanzeni have been specially trained to work with adolescent girls and young women, understand their needs, help them prevent HIV and unplanned pregnancies and help them stay well so they can become healthy and confident adults. Right to Care provided the training, as well as mentoring support.
“If you come to a clinic the healthcare workers will discuss your risk and help you make the right decision about taking PrEP. It isn’t a long-term drug, but it helps you stay HIV negative when you aren’t sure of your partner’s HIV status – particularly if you can’t trust him, if you are having sex with an older man for financial benefits, if you have multiple partners or if you feel disempowered in your relationship.”
Matshili-Mphigalale explains that, “Growing from a girl into a woman can be a difficult time. Young people need understanding about what is happening to their bodies and how they feel. Adolescent girls and young women face peer pressure, they want to fit in. Relationships with parents, caregivers and siblings can sometimes be difficult. Unfortunately, there can also be unequal power relations between men and young women, particularly when negotiating sex, which makes them very vulnerable to HIV.
“Your whole life is ahead of you,” says Eve. “If you are HIV negative, do your best to stay negative. This is a time to find your voice, identify what you don’t understand and ask for support.
“If you take PrEP, and then you are not sexually active, your healthcare worker will help you stop taking PrEP,” she says. “PrEP is not a life-long medicine – you take it when you are at risk, but you need the supervision of your nurse or doctor to stop taking it,” she says.
“An adolescent girl or young woman that wants to stop PrEP needs to know when her last potential exposure to HIV took place. To prevent HIV infection, she will need to continue PrEP for 28 days after her last sexual encounter.
“Adolescent girls and young women who are sexually active and at high risk of contracting HIV are encouraged to visit facilities to take up PrEP. The health care workers will provide you with care and support.”
The youth-friendly clinics in Ehlanzeni are:
| Sub-district | Facility |
| Nkomazi Local Municipality | Buffelspruit CHC (AYFS) |
| Bushbuckridge Local Municipality | Cottondale Clinic |
| Bushbuckridge Local Municipality | Dwaarsloop (AYFS) |
| City of Mbombela Local Municipality | Kanyamazane CHC |
| Nkomazi Local Municipality | Langloop CHC |
| Bushbuckridge Local Municipality | Lillydale Clinic |
| Umjindi local Municipality | Ma Africa Clinic |
| Nkomazi Local Municipality | Mangweni CHC (AYFS) |
| Nkomazi Local Municipality | Naas CHC |
| City of Mbombela Local Municipality | Phola-Nzikasi CHC |
| Bushbuckridge Local Municipality | Shatale Clinic |
| Bushbuckridge Local Municipality | Agincourt CHC |
| City of Mbombela Local Municipality | Bhuga CHC |
| City of Mbombela Local Municipality | Gutshwa Clinic |
| City of Mbombela Local Municipality | Hazyview Clinic |
| City of Mbombela Local Municipality | Mthimba Clinic |
| City of Mbombela Local Municipality | Nelspruit CHC |
| City of Mbombela Local Municipality | Nkwalini Clinic |
| Nkomazi Local Municipality | Tonga Block C Clinic |
| City of Mbombela Local Municipality | White River Clinic |
