Lack of privacy sees number of ARV defaulters rise

Mabuyane, Aids Council to mark World Aids Day at Walter Sisulu University in Whittlesea

The Eastern Cape government is seeing a high number of people defaulting on their HIV treatment.

More than 800,000 of the total provincial population of more than 6.4 million people live with HIV, with OR Tambo district carrying the highest number of infections.

Between April and September, the default rate was 30%, according to the health department.

With December 1 observed as World Aids Day, premier Oscar Mabuyane, with the provincial Aids Council, is driving a campaign to warn people about the dangers of dropping their guard in fighting the pandemic.

“The province has come a long way in the fight against HIV and Aids. Current statistics reveal that, over the past four years, the province has gradually shown a decrease in positivity yield against the total tests done.

“Positivity yield is now sitting at 4%; however, the government is still experiencing a high number of people defaulting from treatment.”

Mabuyane and the province’s Aids Council will commemorate World Aids Day on Wednesday at Walter Sisulu University in Whittlesea, in the Enoch Mgijima local municipality.

Provincial health spokesperson Yonela Dekeda said in a bid to address the defaulter challenge, health teams had been conducting community dialogues and training stakeholders with the emphasis on sharing educational and awareness information on HIV/AIDS.

Dekeda said a number of issues contributed to the defaulter rate.

“Covid-19 has played a role in the number of people who visited healthcare facilities for their HIV treatment.

“Patient movement from one area to the next, and not returning to their area of origin, also contributed to the recorded number of defaulters because once they don’t return to where they come from, those people are recorded as defaulters,” Dekeda said.

The Treatment Action Campaign (TAC) said severe overcrowding and clinics that were too small to service their growing number of patients were just the start of problems for the province.

TAC general secretary Anele Yawa said while 91% of people living with HIV knew their status in the province, only 72% were on HIV treatment, of which 88% were virally suppressed.

Yawa said their statistics were drawn from the Ritshidze Eastern Cape State of Health report, which monitors 49 facilities across the Eastern Cape: 14 in OR Tambo district municipality, 11 in Buffalo City Metro, nine in Alfred Nzo district municipality, six in Amathole, five in Nelson Mandela Bay and four in Chris Hani district municipality.

“This translates to just 66% of all people living with HIV receiving ARVS in the province and only 58% of all people living with HIV being virally suppressed.

“The failure to make sufficient progress towards the 9595-95 targets, most especially keeping enough people on treatment, can be linked directly back to the crisis in our clinics in the Eastern Cape. [The targets refer to 95% diagnosed among all people living with HIV, 95% on antiretroviral therapy among diagnosed, and 95% virally suppressed among the treated.]

“People living with HIV lead complicated lives, and may well miss appointments and even miss taking some pills. When they do, meeting them with support when they return to the clinic helps ensure longterm adherence.

“But people living with HIV who return to the clinic and are treated badly, or who fear they will be, will often not come back — even if that means stopping treatment altogether.

“A lack of confidentiality and privacy are other factors that can impact lifelong adherence. The most commonly observed privacy violation was more than one person being consulted or counselled in the same room, in six facilities.”

Yawa said clinic staff’s attitude remained a major barrier for people living with HIV and as a result many defaulted.