November 30, 2024

Today in South Africa around 2 million people living with HIV are still not on lifesaving ARVs — some people not knowing their HIV status, others knowing their HIV status but not having started treatment, and worryingly many many people having started on treatment and then stopped. For people who travel, or for people who relocate, getting your ARVs can turn into a nightmare. It might mean being forced to be late for an appointment, and being scolded when you go back. Or it could mean being refused ARVs until you go back to your original clinic to get a transfer letter, often hundreds of kilometres away. This is another reason why TAC will be marching on 1 December to demand 6 month ARV refills for all stable people living with HIV. Getting a 6 month supply of ARVs would help frequent travellers like Mercy* from the North West, who explains the difficulties in collecting ARVs while being on the road for work — and for other people she knows who have left the province for job opportunities in Gauteng.

Diagnosed and initiated on ARVs in 2007, Mercy has come a long way with HIV treatment. 

For the North West local who uses Itsoseng Clinic in the province, she says a next hurdle is to get stable people onto a 6 month supply of their ARVs.

“I’m now on a 3 month supply, but this is still not helping that much. Sometimes I am working in other places when my clinic date comes and you can’t keep telling your employer that you have to take a day off every three months,” says Mercy.

She says currently clinic visits are a check of her vitals before being issued a script to pick up medicines at an external pick-up point. The external pick-up points she says have helped a lot, but she says going for vitals checks doesn’t have any real benefits for her. 

“If I am sick or not feeling right, I will anyway go to the clinic, so I don’t think those checks help us,” she says. 

Mercy says that many people in the North West have to leave the province to look for work in nearby Gauteng, so being expected to travel long distances to their clinics at three-monthly intervals is expensive and time wasting.

“Many people don’t have transfer letters, so they are supposed to come back to their clinics here in the North West and it is a big challenge when you don’t have a job,” she says. 

Her other issue she says is that there is not enough treatment literacy. She says better treatment literacy would allow more people to manage their treatment regimens better and this would help them be more stable on their medication. This she believes would mean more people living with HIV can move to 6 monthly ARV collections.

“I have been on my treatment for a long time so now I know, but I can see that many people are confused. Even when the clinics change the tablets or the containers it’s confusing, but the nurses don’t answer people’s questions. There are those who will take the medicine home, but they don’t drink the pills because they aren’t sure about what they were given,” says Mercy. 

ARV treatment is a lifelong adjustment, she says, and she adds that people need to be supported. 

“I was 34 when I was diagnosed, and I had to learn to accept myself and that this would be treatment for the rest of my life. I also had to tell my children who were still small then. I got support from some doctors and nurses and from my cousin at that time and that was what really made the difference. People need more of that these days,” says Mercy. 

* Name changed to protect identity

#MoreARVPillsNow

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November 30, 2024

Millions across Africa are already getting a 6 month supply, so why not here in South Africa where we have the biggest HIV burden in the world? Below we hear from Lebohang Mokhele, TAC’s National Representative of People Living with HIV who lives in Gauteng. Lebo explains how South Africa has managed in the past to very quickly roll out changes to the HIV programme to make it easier for people living with HIV to stay on treatment. Yet it’s now December 2024 and while more people are getting a 3 month supply in Gauteng, there is no public implementation plan in place for getting people a 6 month supply. She calls on the department to prioritise giving all stable people living with HIV a 6 month supply now!

In the 10 years that Lebo has been on ART she says there have been a few key improvements in helping people stay on treatment. She says the time is right to make a 6 month supply of ARVs the next step forward.

Lebo who uses the Boitumelo Clinic in Sebokeng says for her the tilt points in the decade came with the introduction of fixed- dose treatment; then there was CCMDD – the introduction of external pick-up points freed people from having to do ARV pick-ups inside clinics, then dolutegravir, a better ARV medicine with few side effects. But, she says, a most important introduction came with multi-month supply of ARVs – 2 months supply and then recently 3 month supplies at a time.

Lebo is on a 3 month supply currently and collects from a pharmacy in a mall in Alberton.

“When multi-month started for me just after Covid-19, it was such a relief to not have to go to the clinic every month. Our clinic is so small we even call it “The Mkhukhu Clinic” (the shack clinic). The infrastructure is bad, and it’s overcrowded. People have to wait outside, rain or shine, because only four people can be inside the clinic at any time. We have more people coming from the new informal settlements around the area so there are too many people,” says Lebo.

Now she says it’s time for 3 month supply to be boosted to 6 month supply. As a TAC leader, she does advocacy and outreach at clinics, and she says unanimous feedback is that a 6 month supply should be given to people who are stable.

“I think that there are so many people who are tired of being in those clinic queues, waiting for so long and having to face the bad infrastructure and sometimes the bad attitudes of nurses. It will make sure they stick to their treatments if they get a 6 month supply of ART. I really don’t see that there will be problems,” she says. 

Lebo adds that along with 6 month supply there should also be additional pick-up points outside of malls. These include at community based organisations that are based closer to where people actually live in townships. These are more ways to make sure it’s easier for people to stay on treatment and to take charge of their health, Lebo says. 

* Name changed to protect identity

#MoreARVPillsNow

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