Date of Award

Spring 2024

Degree Name

Bachelor of Science

Department

Community & Global Public Health; College of Health Sciences

First Advisor

Comfort Z. Olorunsaiye, Ph.D., MPH

Abstract

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used for treatment (UNAIDS, 2023b). In response to the HIV outbreak, UNAIDS came up with the 90-90-90 goals and later the 95-95-95 goals in an attempt to promote preventative care towards HIV/AIDS. By 2030, UNAIDS hopes to have 95% of PLHIV know their status, 95% of PLHIV on ART, and 95% of PLHIV achieving a suppressed viral load (WHO, 2023b). While some countries have successfully met these goals, other countries have fallen behind. HIV is still prevalent in sub-Saharan Africa, with most cases found in South Africa.South Africa has over 7.5 million people who are infected with human immunodeficiency virus (HIV), accounting for 17% of the global burden of HIV infections (UNAIDS, 2023). In 2022, adolescent girls and young women (AGYW) ages 15 to 24 years represented more than 77% of new HIV infections in sub-Saharan Africa (Kim et al., 2021). Of people living with HIV, 80% live within 5 major provinces of South Africa. KwaZulu-Natal has the highest HIV prevalence among these provinces (Ramjee et al., 2019). In addition, there is less than one healthcare facility per one PLHIV in KwaZulu-Natal (Kim et al., 2021). Interventions and access to healthcare with regard to medicines and treatment for HIV/AIDS is sparse due to the long distance between clinics and the lack of adequate transportation. Therefore, more than 80% of the country is more than 30 minutes away from the nearest healthcare facility (Kim et al., 2021). In the KwaZulu-Natal province, 60% of PLHIV are women, with incidence rates of 12 per 100 women in the city of Durban (Allinder & Fleischamn, 2019 & Ramjee et al., 2019). Only 42% of districts in Africa have programs that are dedicated to HIV prevention for adolescent girls and women (UNAIDS, 2023). Our target population are young women aged 15-24 in Durban, South Africa. There are about 61,970 schoolgirls total, in those186 secondary schools, in Durban (Frith, 2011). That comes out to about 333 girls per school on average that we hope to reach. In our first year, we hope to have the pop-up clinic established. This will come along with hopefully seeing a 20% improvement in knowledge around risky behaviors (which will be determined in surveys). In terms of the schools, we have confidence that CSE will be implemented in at least one school along with establishing those partnerships with the 4 schools. With those interventions, we want to increase access to male and female condoms (both male and female) by 10% from the existing 47%. In the second year, we are striving for more ambitious outcomes. That entails the hope that 50% of young women in the CSE program will know how to practice safe sex. We will continue our implementation of CSE based on our evaluation of each term. Lastly, increasing access to condoms is about 10% more.

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Introducing Comprehensive Sexuality Education and HIV Prevention and Treatment Methods through Pop-Up Clinics to Secondary School Girls in KwaZulu-Natal, South Africa

Human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system leading to people living with HIV (PLHIV) immunodeficient and more susceptible to other infections or diseases (UNAIDS, 2023b). This can lead to acquired immunodeficiency syndrome (AIDS) within 8-10 years of infection (UNAIDS, 2023b). HIV does not always present symptoms, making it hard for people to identify their HIV status without proper screening. The lack of awareness around a person’s status has led HIV to spread worldwide. In addition to the worldwide spread of HIV, there is no cure for the disease, however, antiretroviral therapy (ART) is mainly used for treatment (UNAIDS, 2023b). In response to the HIV outbreak, UNAIDS came up with the 90-90-90 goals and later the 95-95-95 goals in an attempt to promote preventative care towards HIV/AIDS. By 2030, UNAIDS hopes to have 95% of PLHIV know their status, 95% of PLHIV on ART, and 95% of PLHIV achieving a suppressed viral load (WHO, 2023b). While some countries have successfully met these goals, other countries have fallen behind. HIV is still prevalent in sub-Saharan Africa, with most cases found in South Africa.South Africa has over 7.5 million people who are infected with human immunodeficiency virus (HIV), accounting for 17% of the global burden of HIV infections (UNAIDS, 2023). In 2022, adolescent girls and young women (AGYW) ages 15 to 24 years represented more than 77% of new HIV infections in sub-Saharan Africa (Kim et al., 2021). Of people living with HIV, 80% live within 5 major provinces of South Africa. KwaZulu-Natal has the highest HIV prevalence among these provinces (Ramjee et al., 2019). In addition, there is less than one healthcare facility per one PLHIV in KwaZulu-Natal (Kim et al., 2021). Interventions and access to healthcare with regard to medicines and treatment for HIV/AIDS is sparse due to the long distance between clinics and the lack of adequate transportation. Therefore, more than 80% of the country is more than 30 minutes away from the nearest healthcare facility (Kim et al., 2021). In the KwaZulu-Natal province, 60% of PLHIV are women, with incidence rates of 12 per 100 women in the city of Durban (Allinder & Fleischamn, 2019 & Ramjee et al., 2019). Only 42% of districts in Africa have programs that are dedicated to HIV prevention for adolescent girls and women (UNAIDS, 2023). Our target population are young women aged 15-24 in Durban, South Africa. There are about 61,970 schoolgirls total, in those186 secondary schools, in Durban (Frith, 2011). That comes out to about 333 girls per school on average that we hope to reach. In our first year, we hope to have the pop-up clinic established. This will come along with hopefully seeing a 20% improvement in knowledge around risky behaviors (which will be determined in surveys). In terms of the schools, we have confidence that CSE will be implemented in at least one school along with establishing those partnerships with the 4 schools. With those interventions, we want to increase access to male and female condoms (both male and female) by 10% from the existing 47%. In the second year, we are striving for more ambitious outcomes. That entails the hope that 50% of young women in the CSE program will know how to practice safe sex. We will continue our implementation of CSE based on our evaluation of each term. Lastly, increasing access to condoms is about 10% more.