Lentswe, Klerksdorp - The North West Province carries one of the heaviest HIV burdens in the country. Around 22.7% of adults between the ages of 15 and 49 are living with HIV, and in some districts, prevalence is close to 20.3%. The impact is felt most acutely in poorer, rural and mining communities where access to regular care is harder.
For people living with HIV, daily treatment works in exactly the same way. Medicines, called antiretrovirals (ARVs), keep the virus under control so it can’t multiply in the body and allow infections to take hold. This is referred to as “keeping the virus suppressed.”
When HIV goes undiagnosed or, is not managed with medication, the immune system becomes too weak to fight off illnesses. A person is said to have Advanced HIV Disease (AHD) when their body has very few CD4 cells left (the “soldiers” of the immune system), or when they have additional illnesses. Antiretroviral Therapy keeps the virus under control and helps the immune system grow strong again. However, if treatment is stopped, the virus multiplies quickly and damages the immune system again. This causes the body’s defences to drop to dangerously low levels, leaving the person vulnerable to serious illnesses like TB, meningitis, and pneumonia.
However, AHD can in most cases be managed through re-initiation of treatment and a firm commitment to take the treatment exactly as prescribed and with the support of families, caregivers, and the wider community.
Building resilience from within
Understanding the everyday challenges people face in taking medication daily is key to tackling Advanced HIV Disease (AHD). For example, many medicines need to be taken with food, but for families living at or below the breadline, having enough to eat before medication can be a real struggle. On top of that, costs associated with refilling prescriptions and attending regular clinic visits can be difficult for families to manage.
Recognising these barriers to continuous care is crucial, and no one understands these challenges better than community members themselves.
The strength and resilience of our communities are a powerful force when individuals are supported. Our communities embody the spirit of ubuntu as well as the belief that “it takes a whole village to raise a child” - and have always come together to care for one another.
Improving outcomes for children with HIV requires genuine collaboration and commitment from many role players. In the North West Province, several Civil Society Organisations (CSOs) are transforming the future for children and adolescents living with AHD, supported by a strong consor-tium. CSOs are community-based groups working alongside government services to ensure that communities have access to the support they need.
CSOs Lefika La Ka, Boithuto Lesedi Project, Lifeline Rustenburg and Dr Nthuseni Murudi Foundation are working through a partnership called IMPAACT4HIV to keep children and adolescents living with HIV connected to care by addressing the root causes of treatment interruption.
These organisations trace children who have missed clinic appointments, support caregivers with transport and counselling, and partner with schools to ensure children can continue their education while managing their health. They also collaborate closely with the Department of Health and Social Development to link families to the medical treatment and social support they need to survive and thrive.
By helping families navigate the clinic system, providing emotional and practical support, and connecting households with government services, these organisations give children a better chance at recovery and a healthier future. When health, education, and social services work hand in hand with community organisations, children are far more likely to stay in school, take their treatment consistently, and have the food and stability they need at home.
Advanced HIV Disease (AHD) and the Future beyond the Diagnosis
AHD can be prevented by starting treatment early, taking HIV medicine every day at the same time, going for regular clinic check-ups, asking for help if it’s hard to get to the clinic, and keeping the body strong with good food and rest. With daily treatment and support, HIV can be controlled, AHD can be avoided, and people living with HIV can live long, healthy lives. With the right care, even someone with AHD can recover and live a long, healthy life. The key is to act fast and make sure people know their HIV status early.
