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100 signatures reached
To: The Minister of Health (National Department of Health- Dr Aaron Motsoaledi)
Better Care for HIV Positive People and their Partners
We, the undersigned, call on you to commit to ensuring that peer led:
1. Assisted Partner Notification is prioritized and accessible at all HIV Testing Services centers (at facility and community testing level both in public and private sector)
2. Discordant partners are listed as a priority group in all HIV related documents or strategies, prioritized and have a program that supports safer conception service among other services.
To Health MECs in all provinces
We call on you to ensure that every health care worker (both public and private) facility is able to offer a basic package of services to HIV positive people and partners (that incorporate Assisted Partner Notification and Safer Conception Services)
To ensure that people with HIV are supported at a testing level with skills to safely disclose their statuses (APN) to their partners so that they can also access HIV services. We also want an urgent roll out of safer conception services (SCS) for serodicordant partners so that they can achieve their reproductive health needs without putting the negative partner at risk of HIV infection.
Why is this important?
Most people living with HIV do not disclose their statuses to their sexual partners due to fear of rejection or gender-based violence. This means that the one with HIV may struggle to adhere to treatment leading to poor compliance or virological failure and the one with unknown status is at risk of HIV in case she or he is HIV negative. On the other hand, reproduction is a human right irrespective of HIV status and serodiscordant partners have no access to a program designed to assist them in safely achieving their reproductive needs. Those who want to conceive, considerations in choosing the optimal method to achieve pregnancy include transmission risk, treatment efficacy, and affordability should be prioritized. Research has proven that HIV-negative partners in serodiscordant couples are at risk of HIV infection if the index partner did not receive any intervention. Due to non-availability of assisted partner notification support for HIV positive people who want to disclose safely to their partners and safer conception services for discordant partners, people tend to keep their HIV statuses to themselves and engage in unprotected sex in order to meet their reproductive need. In 2016, World Health Organization (WHO) released self-testing and Partner notification guidelines which state that Voluntary assisted partner notification services should be offered as part of a comprehensive package of testing and care offered to people with HIV. The same year, South African National Department of Health released Health Sector HIV Prevention Strategy that focused on rendering HIV prevention service to serodiscordant couples among other services but until now, there is no guide on service delivery to HIV positive people and their partners even though the 2017-2022 NSP mentioned the need for Assisted Partner Notification and discordant partner support (including Prep). Serodiscordant couples are listed among vulnerable population on the strategy released in 2016 but other groups like truck drivers, inmates, OVC's, survivors of sexual abuse, Young women, and Girls and migrant population have programs specific for their health needs but no services to support people with HIV people and their partners. The Dukashe Family (in the picture - discordant marriage) is fortunate enough because the couple is in the health field and could afford safer conception service even though the wife struggled to disclose the status for a very long time (as most people with HIV do).