Science tells us that HIV positive people on uninterrupted ARV treatment can get to a point where they cannot transmit the virus, as long as they remain on treatment. U=U, meaning ‘undetectable equals untransmittable’ is a groundbreaking campaign that promises HIV+ people that once viral suppression is reached, the virus cannot be transmitted to their sexual partner. Although evidence supporting U=U is now overwhelming, a study released in May 2021 (1) suggests that knowledge of this fact is poor, both globally, and in South Africa.

The implications of this lack of knowledge are serious, especially considering that the world failed to reach global HIV targets (to find 90% of people living with HIV, place 90% of them on antiretrovirals and ensure 90% of them became virally suppressed) by December 2020, that there are estimated to be 8,2 million people living with HIV (PLHIV) in South Africa (2) and that the number of people starting on ARVs dropped by 35% between the first quarter of 2019/20 and 2020/21 (13) .

As Harry Hausler, CEO of TB HIV Care, states, “In summary, South Africa has a large population of people living with HIV and the number of them starting on ARVs is dropping, despite the fact that ARVs are not only life-saving, they are simultaneously an excellent way of preventing new infections too.”

In response, TB HIV Care is working with partners, such as the Eastern Cape AIDS Council to launch campaigns to raise awareness of U=U and the fact that if you are on effective treatment and virally suppressed, you can’t transmit HIV. Some of the interventions being rolled out include digital incentive campaigns to encourage PLHIV to stay on treatment, community dialogues, and a comprehensive communications strategy which involves PLHIV telling their stories live on social media platforms.

1. Bor, J., Fischer, C., Modi, M. et al. Changing Knowledge and Attitudes Towards HIV Treatment-as-Prevention and
“Undetectable = Untransmittable”: A Systematic Review. AIDS Behav 25, 4209–4224 (2021). https://doi.org/10.1007/s10461-
021-03296-8
2. StatsSA. 2021. Mid year population estimate. https://www.statssa.gov.za/publications/P0302/P03022021.pdf
3. SANAC. 2021. World AIDS Day Concept Note.

Providing economic opportunities are a critical way to reduce the vulnerability of adolescent girls and young women, both to coercive or transactional sex, as well as to HIV infection. The Training Unit was able to assist the PPPrev Programme to put this idea of economic strengthening into action to help protect AGYW.
The Training Unit provided an accredited learnership programme for 71 young women in the eThekwini district. The customised learnership equipped the participants to become facilitators, whose role includes providing structural programmes as well as acting as mentors to adolescent girls and young women in local communities. The learnership training curriculum was designed to cover all the necessary requirements for a facilitator, in line with the organisation’s job specification. These included:
• Accredited training in HIV counselling and testing
• Accredited training in facilitation and presentation skills
• Workplace readiness training
• Stepping Stones facilitator training
The intensive training phase took place over two months and was followed by their placement in the field as trainee facilitators, with work integrated learning, mentorship and supervision provided by the programme staff. The programme also integrated soft skills and personal development, which are all essential to the facilitator role. The learnership project culminated in the appointment of the participants as facilitators in the PP Prev Programme.

The Young, Wild and Free Programme (YWFP) is a pilot project which began in March 2020 as a research study which was conducted among young key populations. The purpose of the study was to determine the gaps that young key populations have in terms of sexual reproductive health and harm reduction services. In the subsequent months, the same pilot research studies were initiated in South Africa, Kenya, Russia, and Vietnam for LGBTQI youth, sex workers, and drug users between the ages of 16-24.
A community-based participatory research (CBPR) study found YKPs felt discriminated against in healthcare facilities when seeking access to services. The YWFP identified the need to conduct key populations sensitisation workshops among health care workers in an effort to reduce the stigma and discrimination experienced by young key populations.
A total of 25 awareness campaigns and 18 sensitisation trainings were conducted by the team in the eThekwini district. The programme provided ‘youth friendly’ stickers for facilities to display to show that the facility had received sensitisation and that youth-related issues and harm reduction services had been integrated within these facilities. Additionally, psychosocial support was also provided to 65 clients on an ongoing bases during the implementation phase.
YWFP has made a significant impact on young homeless and home-based substance users, their parents/guardians, health care workers, and the general public.