In the small maternity ward of a run-down health clinic in Delft, a half hour drive from Cape Town, the wooden benches in the waiting area are filled with young women and girls from the poor surrounding townships.
Nozuko Manong, in her white-and-blue nurse’s uniform, calls out a name and escorts a young woman into a small consulting room where the paint is peeling from the walls. Gently, Manong tells the patient the result of her HIV test. She is positive.
Thirteen years ago, Manong tested positive herself. For more than a decade she has been advising young South African women coming for pregnancy tests to get tested for HIV, part of her work for the support group mothers2mothers.
“I found out about my HIV the same time I found out I was pregnant. I couldn’t believe it. But the next day I went to a mothers2mothers support group. To my surprise, there were beautiful women there, and their kids were negative,” the nurse said.
In South Africa, with the world’s highest prevalence of HIV, the testing of young pregnant women has led to a significant cut in transmission of the virus that causes Aids to pass from mothers to babies.
“Currently, about 1% of positive mothers pass HIV to their children, but we are aiming for zero percent transmission,” Professor Sibusiso Sifunda of the Human Sciences Research Council said.
About seven million South Africans are living with HIV, according to the United Nations. Four million of them are women.
If left untreated, the chances of a mother passing HIV to her unborn child is high. But Manong was put on anti-retroviral drugs, stuck with the treatment, and her daughter avoided contracting the virus.
Sanjana Bhardwaj, health and nutrition chief at Unicef South Africa, said there had been huge strides in testing for and treatment of HIV in the last decade.
The number of new HIV infections in children aged up to 14 fell to just over 5 000 in 2015 from more than 30 000 in 2009, she said.
Nearly three-quarters of children living with HIV are able to access life-saving anti-retroviral treatment. Poverty and lack of awareness still stand in the way of all children accessing medication.
In 2014, the government said more than 95% of HIV-positive pregnant women were receiving antiretroviral medicine to reduce the risk of transmission. But fear and stigma still surround the disease.
After her baby was born, Manong had to wait three months for the results of her daughter’s HIV test.
“I was so scared to go back and get the result. But when I found out she was negative, I wanted to tell the world also that I was positive, because I wanted other mothers to know about my healthy girl,”
Now she is a “mother mentor“, offering support and health education to HIV-positive mothers and other women. Similar mothers2mothers programmes have been rolled out in Kenya, Lesotho, Malawi, Swaziland and Uganda.
NOT A DEATH SENTENCE
Tinny, 40, tested positive for HIV last month. “I came in because I thought I was pregnant. I was, but at the same time I found out I was positive,” she said.
“I was very scared and thought: how will my family react?
“When I found out it was not a death sentence but a disease, I realised it is something I can deal with.”
While South Africa’s focus has been on cutting mother-to-child transmission, a new target group is men.
“We want to facilitate disclosure to the women’s partners; that would make the men get tested,” said Sifunda.