AIDS2018: Humans in the Age of HIV-Condoms are not enough

By Ngqabutho Mpofu

Nosicelo Kokoti cannot be described as an adolescent woman anymore.

However, at the age of 31, she is as passionate as ever about the need to address the health issues of the youth, and adolescent girls in particular. She is a soft spoken and serious young woman. Drawing a smile from her is hard work. Almost as if she is constantly thinking about the problems at hand. As a Treatment Action Campaign (TAC) member, youth clinic health navigator and a sexual and reproductive health club facilitator, Nosicelo has extensive knowledge of her subject matter and speaks with a quiet passion in her native Xhosa.

Acknowledging the problems brought on by the lack of in depth information provided by the Life Orientation programmes in schools, specifically in Cape Town, Nosicelo and her team have worked tirelessly to speak to in-school youth about HIV and sexual and reproductive health rights and services. The fact that her team is also comprised of young people helps bridge the gap and make learners more open to speaking openly to them. However, this project operates on a small scale because of personnel and funding issues. “We speak to principals and School Governing Bodies about the nature of our work. Sometimes parents and SGBs find our work problematic because they think that we are promoting sexual relations between students, when we are addressing the realities of adolescent boys and girls.”

Nosipho says that “a lot of schools do not give us permission to speak to the learners. We currently speak to adolescents in 13 schools here in Khayelitsha. We only speak to secondary schools. We have very little time in which to speak to the adolescents as they have other commitments. We provide them with condoms and we make sexual reproductive health cool. We also speak to them about the dangers of concurrent partnerships.” Through her work, Nosipho has realized that adolescent boys are more willing to collect the condoms they provide, with an average of 60% of the condoms being collected by them.

They also speak openly about other impediments that make adolescent girls, at almost 2 000 new infections a week in South Africa a very high-risk group. As someone whose parents both died at an early age, leaving her in the care of an aunt with limited means, Nosicelo is aware of the appeal of sugar daddies, a trap she did not fall for, despite some of the seeming appeal. “Our workshops also focus on the issue of intergenerational relationships. I try make it as interactional as possible, with adolescent girls debating the issue between themselves. We try and instill the lesson that they need to be okay with what their lot in life is at that particular time and stress the need to strive to better themselves and their families in various ways, without resorting to sugar daddies.”

“Our greatest victory has been the creation of six clubs of adolescent girls. Over the years these clubs have had a steady membership, the members speak openly about the challenges they face and the members continue to be HIV negative as a result of responsible behavior. They also haven’t had STIs. If that were to change we would offer them critical support, but we sincerely hope not. The goal is to move up to ten groups within Khayelitsha.”

Finally, for Nosicelo, “as a key population as well, adolescent girls should be treated in the same way as sex workers. I strongly believe that PrEP should be readily available for (sexually active) people as young as 12, if we are to curb the scourge of HIV among the youth. Condoms are not enough…”

This article is part of a Spotlight special series on people who form part of so-called key populations.