Reply:

 

The Department has always paid special attention on the children and adolescent access by monitoring the age group in the UNAIDS 90-90-90 targets on HIV and AIDS treatment.

The prevention of Mother to child HIV transmission is intended to reduce vertical transmission, the target is that all pregnant HIV positive women should give birth to HIV negative children, in that way this will decrease the burden of HIV in children. All these women are initiated on ART and viral suppression is monitored closely to remain at <50 or that they are virally suppressed so that they transmit the virus.

All children exposed to HIV are given HIV prophylaxis for the duration of breast feeding. Those babies who are vertically infected are initiated on ART immediately after diagnosis.

We have acknowledged the gap on access of HIV services within this population gap and have developed various strategies such as the following:

1. Development and implementation across all the provinces of the Paediatric and Adolescent HIV Matrix of Interventions Plan: The key objectives of the intervention plan are to:

• • improve rates of earlier HIV diagnosis in children and adolescents and
  • increase access to quality HIV treatment and care for children and adolescents.
  • retain children and adolescent in sustainable treatment.

1. Monthly provincial virtual calls as part of M&E for the programme and the Matrix Paediatric and Adolescent HIV Matrix of Interventions Plan. Provinces report back on progress of interventions, highlight challenges and share best practices that aim to improve indicators.

1. Department of Health continues to ensure public health facilities provide adolescent- friendly health services.

1. The Department of Health , in response to palatability of the paediatric ART suspensions, has since introduced Lopinavir/Ritonavir pellets for children, which is the new formulation of drugs, approved for use in SA. These pellets make adherence easy and encourages the caregivers to give treatment for viral load suppression.

1. To date all provinces have procured the product and both nurses and doctors can prescribe LPV/r oral pellets.

1. Department of Health with its partners continues to implement the Adolescent Girls and Young Women (AGYW) Programme and Determined, Resilient, Empowered ,AIDS-free, Mentored and Safe (DREAMS) program, which offers an age-tailored combination prevention package for adolescent girls and young women aged 15 to 25. The DREAMS partnership is an ambitious public-private partnership aimed at reducing rates of HIV among adolescent girls and young women in the highest HIV burden districts. The aim of the project is to:

• • empower adolescent girls and young women and reduce risk through youth-friendly reproductive health care and social asset building;

• • mobilize communities for change with school- and community-based HIV and violence prevention;

• • reduce risk of sex partners through PEPFAR programming, including HIV testing, treatment, and voluntary medical male circumcision; and

• • strengthen families with social protection (education subsidies, combination socio- economic approaches) and parent/caregiver programs.

The department has established Youth zones in some public health facilities, priority being to improve the accessibility of health services to young people and support for the HIV infected youth. Nationally the department has established 1027 youth zones out of 3434 public health facilities.

Youth Zone are youth friendly spaces within the health facility, meant to attract more young people to access health facilities. Youth zones, by dedicating time and environmental space and prioritise youth in service provision which is not limited to biomedical but include extramural activities and other initiatives. Youth zones encourage adolescents to have support groups and discuss health related and age appropriate topics including taking ART and remaining on ART.

The National Department of Health is in partnership with loveLife and Soul City to support implementation of youth prevention interventions including prevention of HIV , starting on ART and teenage pregnancies.

Soul City’s rise young women’s club comprises young people at community level that group themselves and meet on a monthly basis to discuss the social challenges in their communities and empower each other on health related issues and discuss support of young women on ART.

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