This youth month we stop and think about adolescents - aged between 10 and 19 - especially female adolescents, who continue to show high HIV infection rates.
Worldwide, 25% of all new HIV infections are in adolescent girls and young women aged between 15 and 24. And unlike most age groups, adolescent mortality is increasing, with HIV being the leading cause of
adolescent death in Africa (UNaids, 2019).
Adolescents are also less likely to seek HIV services or stay on treatment.
HIV treatment outcomes, including retention, are worse for this age group than for adults.
These facts remind us of Nkosi Johnson, who, at 11 years old stood like an emblem of the HIV struggle, “a reluctant hero and activist” and smiled bravely to demand urgent and decisive action against the virus in South Africa.
Nkosi stood on a huge stage at Kingsmead cricket stadium during the 2000 Durban Aids conference, in a dark suit hanging on his fragile and tiny frame, with his big heart visible for all to see.
Nkosi made a clarion call at his world-renowned speech that we all must remember. First, he asked parents to be open about HIV with their children. In his cracking voice, he said: “My mommy Gail and I have always been open about me having Aids.”
The primary problem with addressing the needs of adolescents and youths living with HIV demands that parents are open with their children about their HIV status. Many children are left behind because parents don’t have the stamina to face their stigma and HIV status.
So, in memory of Nkosi and to accord these young souls - and the “fastest-growing” population of AYLHIV (adolescents and young people living with HIV) - a better future, we must address this problem.
Children have the right to dream. Let’s help them realise these dreams and not die prematurely and unnecessarily.
Nkosi also asked us not to discriminate against children living with HIV.
In his words, he thanked the government for developing a policy on HIV and said: “I am very proud to say that there is now a policy for all HIV-infected children to be allowed to go into schools and not be discriminated against.”
A 2019 study by Maskew (and others) indicates that only 50% of those aged 15-19 successfully initiated antiretroviral therapy through to viral load testing.
This is a test that measures the effectiveness of the treatment and usually takes place at six months, one year, and then annually after treatment is started.
A factor affecting the rate of treatment among adolescents is that they are dealing with changes in parental versus personal responsibility for maintaining their health.
They may be taking more risks, relying more on their peers for support, and becoming more interested in serious sexual relationships.
They may drop out of treatment to avoid disclosing their activities.
“I hate having Aids because I get very sick and I get very sad when
I think of all the other children
and babies that are sick with Aids,” Nkosi said. “I just wish that the
government can start giving AZT (an antiretroviral medication) to pregnant HIV mothers to help stop the virus being passed on to their babies.”
All children hate living with HIV and we can make it better and easier than Nkosi had to endure.
To do this we must heed his clarion call: “Care for us and accept us - we are all human beings.
“We are normal.
“We have hands.
“We have feet.
“We can walk, we can talk, we have needs just like everyone else.
“Don’t be afraid of us - we are all the same”.
More than 28% of the South African population is between the ages
of 0-14 years, while those under 25 years make up more than 45%.
HIV prevalence among young women is almost four times greater than that of young men.
In 2018, 540 000 young women were living with HIV, compared to 180 000 young men. In the same year, 69 000 young women became HIV-positive, compared to 28 000 young men, meaning they are more than three times more likely to acquire HIV than their male counterparts.
The difference is particularly acute among 10 to 19-year-olds, with 33 000 adolescent girls becoming HIV-positive in 2018, compared to 4 200 adolescent boys. We can’t destroy a future by our inaction in protecting children from HIV when there is treatment available (UNaids, 2019).
Maybe Nkosi’s power was because he was an “innocent victim” who contracted HIV through his biological mother rather than through sex
(like many of our adolescents and teens today); perhaps it was because he had no agenda other than to live for as long as he could and to help
others from suffering similarly; possibly it was because he was black and poor.
But Nkosi’s frail skeletal body and thin voice became as much an emblem of suffering, activism, and revolution as the dead body of Hector Petersen, being carried after the massacres in Soweto in 1976, was in the time of apartheid.
Nkosi died on June 1, 2001. Let’s honour his memory by heeding his call for our future leaders. Voices 360
Maxon is the deputy manager at the Department of Health in KZN
Saturday Star