Online Reporter
THE 30 percent fall over a year in new HIV infections among young people in Harare is very promising, but with new infections still above zero, we have some distance to go until we have an HIV-free generation.
New infections were bound to fall as we meet the targets of at least 95 percent of those infected know their HIV status, that at least 95 percent of those have started their lifelong treatment, and at least 95 percent of those being treated have reached the stage where they are no longer infectious so long as they maintain their treatment of anti-retroviral medication.
But the National Aids Council has also noted that reported new incidences of other sexually transmitted infections are also falling suggesting that the programmes to push back against HIV infection are creating changes in how younger people behave.
The STI statistics, as the NAC notes, need to be correctly interpreted. They were rising as a result of programmes to persuade people to seek medical attention promptly as soon as symptoms appeared, coupled with the general improvement by Government in the public health system so effective access to this medical attention is a lot easier. But when we compare like to like there is a drop in infection rates.
One particular problem is that in that small minority of 5 percent of those infected with HIV who do not know their status, young people tend to predominate. They often have not settled down in highly stable relationships and might not see the need for testing to be that urgent since a person infected with HIV exhibits no symptoms of medical problems for a few years after infection.
A second problem coupled with this is the regrettable fact that some older men, who for their own reasons might be dubious about being tested, want to form relationships with young women and teenage girls, using their income and wealth to offer some element of security. Such men are more likely to be HIV-positive and so can be a source of infection among younger generations.
Then we have the fact that HIV is now a controllable chronic illness and, by being diagnosed and treated, a person can live a normal life for a normal lifespan so long as they take their daily medication for life. People still die of HIV-related illnesses, when their immune system packs up, but almost all these people have never accepted treatment or have discontinued treatment.
The effectiveness of the treatment means that taking the required precautions or living a safer lifestyle seem less urgent. While no one wants to be infected, there is that tendency to believe that HIV is just a nuisance, rather than a sentence of premature death. Once viral levels are suppressed under treatment HIV-positive people can even have children safely, or almost safely since nothing can ever be certain.
The National Aids Council has been seeking more effective ways of persuading young people to live more safely, without passing moral judgements on just what they do to improve their safety since the object is to reduce infection rates. A lot of the more successful programmes are a number of peer groups and community actions, in other words using people who those who are at risk are more likely to listen to, rather than just hear a lecture.
The council has also been tackling that problem of older men and younger women and teenagers, by trying to persuade these older men to leave the young girls alone. There is not a lot of feedback but the council has been willing to use a wide variety of approaches in its work. Besides making it clear how people can be a lot safer it has also been encouraging young people to form their relationships with people of their own generation, rather than mess around with older people.
The raising of the age of consent to 18 should have some effect on such generally undesirable relationships between older men and younger women. The Prosecutor General has the right to decline prosecution when a couple of teenagers get carried away, but has the duty to push for a conviction when an older man is involved with a girl under 18.
Admittedly most of these breaches of the law on the age of consent are kept very private, and in some cases we even have parents and other family members conniving to marry off a teenage girl in an unregistered customary union so no one in authority will find out. So teenage girls do need more access to practical support when they want to complain, but they also need to put their own future higher on their private agendas.
Although HIV is now far more of a serious chronic illness rather than a fatal infection, there are still the costs over many years of medication and tests. Among the young people infected this week some will live into their 90s, because some people always do, and that means we are guaranteed that there will be people at the end of this century still taking pills every day.
So besides eliminating a medical complication among young people, we have good economic grounds for pressing forward in that goal of an HIV-free generation.
