Charlize Theron opens the Aids 2016 conference: "It's not sex that causes Aids, it's sexism and racism"

Nicodemus Oaxamub, a transgender activist from Namibia

It's cool to wear a condom

Sex workers lead the way

Poster at the TB/HIV care sex workers' clinic

Truvada: the once a day pill that staves off HIV

LIZ McGREGOR writes: Grace Bura (not her real name) came to South Africa three months ago from her home town of Dar es Salaam to set up a new business: sex work.  She is based in one of Durban’s biggest brothels and earns R70 per transaction. R240 of her earnings each day go to the brothel owner for rent. It’s hard and dangerous work, she says, but much more lucrative than the small clothing business she had at home. What’s more, the exchange rate works in her favour and the rands she earns here buy a decent living for her child, who lives back home with his grandparents.

Sex work in South Africa is particularly risky because of the high prevalence of HIV. Around 60% of sex workers are infected.   Fortunately for Grace, though,  her move here has  coincided with the launch of the most promising new HIV prevention tool yet.  In May this year, the Health Minister, Dr Aaron Motsaoledi, announced that 10 sites across the country would start giving pre-exposure prophylaxis (known as PrEP) to sex workers.  It comes in the form of a once-a-day pill, Truvada, which works by blocking an enzyme called HIV reverse transcriptase. By blocking this enzyme, it prevents HIV from making more  copies of  itself in the body. If taken every day, Truvada gives 99% protection against HIV infection.

One of the sites chosen to dispense PrEP is the TB/HIV Care clinic in eThekwini, which already provides comprehensive health care services to sex workers.

Grace first heard about Truvada from a TB/HIV Care counselor. “I know about this clinic because I have seen the ladies come to the brothel,” she said. “She called me and told me to come here to get tested. I agreed because I want to look after my health.  Thank god I was negative.”

Grace started on Truvada on June 22. She returned to the clinic yesterday (14/07/2017)  to get two months’ advance supply because she is going to work in Johannesburg for a while. “Work is slow here now,” she explains. “If you go away and then come back, they think you are new and you get more clients.”

If Grace keeps on taking her pill every day – and there is every indication she will – she will be able to protect both herself and her clients, as well as their partners.

This is a giant step towards defeating a virus that accounts for more than 30% of deaths in South Africa.

The voices that MUST be heard

JOHN MUTSAMBI writes: The voices that must be heard this week are those most affected by HIV: adolescent girls, young women and others at high risk of contracting HIV.  We advocates must take advantage of the multiple platforms at the conference to demand that their needs for HIV prevention, care and treatment are prioritised.  Human rights should be at the centre of these demands.

At a stakeholder consultation meeting, an adolescent girl remarked, “We have a problem of unwanted pregnancies and a greater risk of getting HIV. We need contraceptive services and ways to protect ourselves from infection to be available in schools because we find it very challenging to seek services at our local clinics. The nurses there embarrass us by asking why we need condoms or contraceptives.”

A sex worker said “We are often harassed by the police and arrested for loitering and for soliciting sex. Our condoms and ARVs are sometimes confiscated as evidence.”

Let us also advocate for the voices of communities to be heard. We must work closely with them to identify ethical issues when setting priorities for HIV prevention, care and treatment.

In order to make an impact at the conference, we must be united. To quote Helen Keller: "Alone we can do so little, together we can do so much.”

Days before AIDS 2016 kicks off, our bloggers gather for a workshop

Sharing tips on how to write brief, clear bulletins and make video and audio recordings

Teenagers must be heard: 19-year-old Sandiswa 

All ears: Aluta (left) and Wadi 

Getting the word out: Brave and Lebogang 

AIDS 2016: A push for prevention

Treatment Action Campaign activists marching at the 2000 Aids conference in Durban

LIZ MCGREGOR writes: AIDS 2016 kicks off in Durban in four weeks' time with an ambitious goal: to achieve for HIV prevention what AIDS 2000 achieved for treatment in the same city 16 years ago.

It was a time of crippling AIDS denialism in South Africa. Anti-retroviral treatment was available but prohibitively expensive. Few in the developing world, where the epidemic was at its most vicious, could afford it.

AIDS 2000 launched a global campaign to bring treatment to all those who needed it, with civil society groupings such as the Treatment Action Campaign at the forefront.

Former South African President, Nelson Mandela, summed up its purpose in his closing address: "This is....a gathering of human beings concerned about turning around one of the greatest threats humankind has faced..."

In 2016,  nearly 16million people worldwide are on treatment. South Africa has the biggest HIV programme in the world.

Effective methods of prevention and treatment have been developed but they are not reaching enough people. UNAIDS estimates that there will be a 10-fold increase in new HIV infections and eight times as many AIDS-related deaths by 2030 unless action is taken now to address and prioritise the needs of the most vulnerable.

AIDS 2016 runs from July 18 to 22. The theme is "Access Rights Now".

www.AIDS2016.org