HIV treatment expanded to accommodate all HIV-positive people

11 May, 2016 

Health Minister Aaron Motsoaledi.
Image by: Gallo Images / Nardus Engelbrecht

All HIV-positive people at state health facilities will be put on treatment from September, irrespective of their CD4 count.

The move was welcomed by experts, who say it will help prevent people getting "lost" between diagnosis and starting treatment when their CD4 count drops to 500 - often years after infection.

A CD4 count is a measure of a person's immune system strength.

Salim Karim, director of the Centre for the Aids Programme of Research, said the move resulted from "compelling" evidence that it was better to start treatment for HIV-positive people earlier. A five-year study of more than 4200 people in 35 countries showed those who were treated earlier had 50% less chance of having an Aids-related or unrelated disease.

The trial was so convincing it was stopped early as it became unethical to deny participants access to treatment.

Karim said early treatment would reduce the number of new infections because people on ARVsare not infectious. But of the 6.4million people in South Africa who were HIV-positive, not all will take the treatment, especially men.

Karim said: "Almost all women have multiple interactions with the healthcare service for contraception, antenatal care and childbirth; men who interact with the health service are largely restricted to those requiring care for illness and or injury." He said there was a disproportionately lower ARV coverage in men.

Motsoaledi said a new South African-designed HIV and TB app, which provides treatment guidelines for health workers, had been downloaded 150,000 times. The app allows health workers to complain directly to the national Health Department if there is a medicines shortage.

Motsoaledi said from next month an ombudsman would be in place, who would act as a "public protector" of health and take up complaints from unhappy patients.