However, the civil society organizations have been overlooked in the implementation of national strategic plan. They have received extremely little funds and support from the government. This is an area the government needs to improve on in order to spread awareness to the grass-root levels, as civil societies have proved to be a valuable asset in spreading awareness to the remote and inaccessible areas. The guidelines and aims of PMTCT are usually under constant revision in order to keep up with the ever evolving virus strains. Just recently, they were revised to include nevirapine and zidovudine. These are dual therapy regimens normally effective in inhibiting the enzyme reverse transcriptase used by HIV to replicate. Moreover, they are remarkably efficient with extraordinarily little side effects. Without a doubt prevention is better than cure. The South African government initiated educating its citizens about AIDS and HIV. Education was deemed the most effective measure of not only reducing the pandemic in South Africa, but also eradicating the deadly virus. Education is normally based on preventive measures such as condom use, transmission and the need for testing. Furthermore, it enlightens the citizens on care for both the infected and affected individuals. A National Communication Survey, carried out in 2009, indicated that awareness levels on behavioral risks associated with AIDS and preventive measures were high. Moreover, the survey noted that the knowledge of condom use across different age groups in the population was at an average of 87%. The knowledge of other preventive measures, such as abstinence, faithfulness to one’s partner and responsibility, remained low. However, the levels had shown a considerable amount of improvement. It was also noted that those citizens who responded to treatment, about 87% believed antiretroviral therapy was the most effective. On the other hand, 73%t of those under treatment identified antiretroviral therapy as a means of saving and prolonging lives of infected individuals. This level of knowledge had shown a considerable improvement than in the previous years, only about forty percent knew of the antiretroviral therapy (The South African Department of Health, 2007).
The use of condoms during high risk sex, for example, during sex with a prostitute, did provide the best indication of patterns of sexual behavior. Most HIV infections occur during unprotected sex with an infected individual. Risky sexual behavior is also responsible for cases of re-infection and resistant HIV strains, which are normally difficult to treat. A National Communication Survey, carried out in South Africa in 2009, showed that condom use was lowest amongst couples and highest among unmarried people and those couples with an unstable relationship. Particularly, the survey noted that only 15% of couples in a stable relationship used condoms compared to about 75% percent of single individuals. It was the reason South African government together with non-governmental organizations introduced a program to encourage condom use. Under this program, couples were counseled and given free packets of condoms. Moreover, the price of condoms was subsidized to encourage users and buyers.
Enhanced availability of antiretroviral drugs and therapy is a key concept to ensuring better health and higher life expectancy. The South African government has, therefore, ensured increased access to essential antiretroviral medication in all provinces. A survey showed that the percentage of people receiving antiretroviral treatment had increased drastically from about 14% to about 42% between 2005 and 2009. Another worrying trend is the number of orphans left behind by parents who succumbed to HIV and AIDS. These orphans do not receive education because they cannot afford it. Therefore, they turn to crime because their minds do not find constructive outlets. As a result, the government has sought to assist these children by funding orphanages and supporting their education. This is in line with the millennium development goal number six, which seeks to reduce the number of orphans affected by HIV and AIDS.
Other policies and recommendations, adopted by South African government to combat the spread of HIV and other infectious diseases, include: lowering the levels of stigmatization directed towards people who have revealed their status. This sort of stigma, attached to such people, can serve to demoralize and stress them. Especially, stress levels have been shown to reduce the body immune capacity, ultimately lowering the life expectancy. Moreover, efforts are also directed towards reducing the levels of concomitant sexual partnership, prevalence of sex amongst different generations and violence against ladies. Measures directed towards intensifying pre-existing strategies on combating HIV and AIDS have been formulated. Such strategies include programs such as PMTCT, which have helped in reducing the prevalence rates in South Africa.
Ladies have been found to be more susceptible to HIV infection than their male counterparts. This situation is compounded by the fact that these women are defenseless during rape cases and sexual molestation. Their biological nature and inequality in the way society treats them have also contributed to their high susceptibility to infection. In an effort to curb this, the South African government has advanced measures in reducing the vulnerability of young ladies to the deadly virus. Such measures include longer jail terms and strict punishment to rapists. Laws, meant to protect such harmless ladies, have also been enacted in the Parliament. It is of no doubt that levels of literacy contribute a lot to the awareness about a particular situation. As a result, the government has come up with decisive plans of strengthening the literacy levels in prevention and treatment. This will ensure that more South Africans are aware of the sexual behaviors associated with AIDS and of the antiretroviral therapy. Their increased awareness would serve reduction of prevalence rates of infection in the population. Lastly, mitigation efforts have been intensified to reduce rates of co-infection amongst people living with the virus. Co-infection with diseases like tuberculosis reduces the life expectancy of individuals living with HIV.
The levels of HIV prevalence are disturbing in South Africa because they are higher than those of countries found in Central and Western Africa. The levels might have stabilized recently, but efforts should be focused on lowering these levels. The decline in these levels in recent years might be encouraging, however, the differential rates of infections are still high in the rural populations, owing to the high poverty and illiteracy levels. Even more disturbing are the cultural practices that expose the young women to AIDS. Such practices include marriage to older male partners and inequality in gender-power distribution. On the other hand, efforts, made by the government, have served to sustain and strengthen the fight against HIV and AIDS. The government must be commended for its efforts. On the other hand, in order to achieve the United Nations Millennium Development Goal number six sooner, it should come up with more effective measures of reducing the transmission of the virus and chances of re-infection. Such measures should include ensuring almost 90% access to antiretroviral therapy and spending more money on preventive measures.