Vulindlela finds pathways to answers for HIV

In Vulindlela, the winter grass is yellow and an icy wind blows off the white-coated Drakensberg. But in the small collection of park homes that make up the local clinic and research site, there is warmth in the people's faces and voices.

"I nearly cried when I heard the good results," Gethwane Makhaya says excitedly, speaking about the study conducted in her community of a vaginal gel containing an antiretroviral called tenofovir.

The study of 889 women, mostly from Vulindlela but also including 278 Durban women, found that the tenofovir gel protected almost 40 percent of the women from getting HIV.

Vulindlela means "open a way", but until recently only poverty and Aids had entered the semi-rural area alongside Midmar Dam in the KwaZulu-Natal Midlands.

Only one man in 10 and seven percent of women had formal jobs, according to a household survey. Most of these jobs provided meagre incomes: farm labour, domestic work and truck driving.

Makhaya, however, was the exception. Her intellect carried her off to the University of KwaZulu-Natal where she met renowned HIV-Aids researchers Salim and Quarraisha Abdool Karim of the Centre for the Aids Programme of Research in SA.

When Inkosi Sondelani Zondi, head of the 12000-strong Inadi ward of Vulindlela, asked for help to address Aids, she introduced him to the researchers

For the past nine years, Caprisa has been working in Vulindlela - both conducting research and providing much-needed HIV-Aids treatment, including ARVs that were previously only available in Pietermaritzburg, an hour's taxi ride.

Some research findings were grim. By the age of 16, one in 10 girls was already HIV-positive. By 24, more than half were infected. By 30, two-thirds of the women were HIV-positive.

Inkosi Zondi estimates that he has lost a quarter of his people to Aids: "Seeing so many people infected and dying, I was thinking who can help to keep the kingdom and the community. Caprisa was the answer."

One of the things fuelling the high HIV rate is that local men don't like condoms. In addition, most young women have older partners who are far more likely to have HIV. An unspoken third reason, according to Makhaya, is the high rate of survival sex where young women trade sex for things, sometimes even little things such as food and cold drinks.

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