HIV, STIs, South Africa and the 2010 World Cup
Things you need to know about HIV, STIs and sexual health services in South Africa
If you’re going to be one of the thousands of British football fans supporting England in South Africa this June and July it’s going to be a fantastic experience.
So that you can have fun and come home fit and healthy, HIVsport has spoken with professionals both at home and away to provide you with some down-to-earth information about HIV, STIs (sexually transmitted infections) and sexual health services in South Africa (should you need them).
South Africa has one of the highest rates of HIV in the world, with roughly 1 in 5 adults infected. Compare this figure to about 1 in 500 people in the UK and you can easily see that every day in South Africa you will be meeting lots of people who are living with HIV.
Remember, you cannot catch HIV by talking to someone, shaking their hand, sharing a glass, or using the toilet but you can if you have sex without using a condom with someone who is HIV positive. There are however a couple of other ways of catching HIV. If you want to find out more about these read ‘How HIV can be transmitted’ in the box at the bottom of this page).
How to avoid getting or passing on HIV and STIs
You cannot tell by looking at someone if they have HIV, so it’s important to take responsibility for yourself, respect your partner and make sure you use a condom each time you have sex.
However, this advice is not just for guys. So if you’re a female football fan, it would be good to pack female condoms as they are sometimes hard to get hold of in South Africa.
It’s worth remembering that many people in South Africa are unaware if they are infected with HIV and you should not rely on what other people tell you about their HIV status - sometimes incorrect information is given due to concerns about stigma and other issues. SO ALWAYS USE CONDOMS.
If you do get exposed to HIV when you are away, then without taking an HIV test you may not know about it until many years later. During this time, you may unknowingly pass the virus on to your partner or to other people you have sex with when you get back to the UK. This is how HIV gets transmitted and is something we need to work on together to prevent.
Along with HIV there is a high prevalence of other STIs in South Africa and as STIs are much easier to catch than HIV over a short number of sexual episodes, you should go to see a private doctor or visit a public sector clinic for STIs as soon as possible if you’re worried about a risky sexual experience.
The World Cup is going to bring tens of thousands of visitors to South Africa from across the world and the South African people will welcome you and be wonderful hosts. For those of you that will be out and about having fun in bars and clubs (as no doubt you will be) you will meet many new people. It may be that you ‘hit it off’ with someone and go back to your hotel or their place for sex. This is when you need to be careful and make sure you use a condom to protect yourself from HIV or other STIs so you don’t come back home with anything other than good memories (and hopefully the World Cup of course).
Remember, all this advice applies both ways. Visiting fans who don’t know they are infected with HIV or an STI may travel to South Africa this summer and unknowingly put others at risk. This is another good reason to use condoms during sex to respect and protect the local population and other visitors during your stay.
So what do you need to do if you think you might be having sex with new partners when away? Here are some helpful simple tips:
1. Pack a good number of condoms in your luggage. If this is awkward because you don’t want a partner back home to see them, then buy some at the airport before you get on the plane. There will be plenty of condoms available in South Africa but it is best to have them with you before you leave.
2. Always take a pack or two of condoms with you when you go out to bars and clubs. There is no point having them in your luggage if you end up going back to someone else’s place and they don’t have any.
3. Remember, many people are living with HIV/AIDS in South Africa, so please make sure you USE A CONDOM ALL THE TIME AND EVERY TIME YOU HAVE SEX. It's a sign of respect for yourself and others. HIV does not discriminate so neither should you.
That’s it! Simple as can be, but a potential life-saver and just as important it will mean peace of mind and no problems with the wife, girlfriend, boyfriend or whoever when you get back home. This is not to say that you have to have sex when you go to the World Cup, but is just vital, common sense information if you do.
What to do if I forget to use a condom?
Get medical help immediately! There is still a chance you can stop HIV infection happening provided you start a course of treatment known as PEP (short for Post Exposure Prophylaxis) within 72 HOURS after exposure - in fact, the sooner the better within this window of opportunity. If you leave it more than 72 hours (that’s 3 days) then PEP stands no chance of working. You need to start PEP, which is basically a 4-week course of treatment of anti-HIV drugs, as soon as possible. The longer you leave it, the less chance there is of success in preventing HIV infection. Please be aware that PEP is not always 100% successful in preventing HIV but it is the best option possible if you find yourself in a situation where you may have been exposed.
Where can I get PEP?
PEP will only be available at state institutions after sexual assault, not any other exposure. Access to PEP in situations other than this (such as having sex without a condom or if the condom breaks during sex) is most likely to be through local private casualty hospitals (most doctors will give it out, but at their discretion; HIVsport was advised that a prescription costs around $20-40).
As you will need to start PEP in South Africa, you will need to go to a clinic immediately to get the drugs and you will need to take the whole course of treatment as instructed. Missing doses is likely to reduce the effectiveness of the drugs.
World Cup venues will have information about the location of the local Accident and Emergency Department and local private casualty hospitals.
As soon as you get back home to the UK, make sure you visit your local sexual health/HIV clinic and explain your situation to a medical professional. The nurse or doctor will then be able to advise you what to do next. Remember, all NHS sexual health/HIV clinics in the UK offer you a free and confidential service, so don’t be afraid to tell them exactly what happened, as this will help them take care of you.
You can also call a sexual health helpline if you’ve had sex without a condom or the condom breaks during sex. They will be able to provide you with basic information and where the nearest clinic is for further advice.
Recommended helpline numbers are:
The National AIDS Helpline (0800-012-322) provides a confidential, anonymous 24-hour toll-free telephone counselling, information and referral service for those infected and affected by HIV and AIDS.
HIV-911 www.hiv911.org.za is your comprehensive guide to HIV and AIDS-related support services in South Africa.
HIV positive fans
If you are an HIV positive football fan travelling to South Africa to enjoy the World Cup this summer, there are common illnesses like Tuberculosis (TB), and Food-borne diarrhoeal diseases that you should be aware of. TB in South Africa is really the biggest risk for HIV positive people and HIVsport strongly recommends you consult your medical practitioner to check what health precautions may be necessary for you before you travel and during your stay. The football stadia are the least of the risk - simply wandering into a local supermarket or South African household may expose you to TB. For further information about potential public health risks download A Guide for 2010 FIFA World Cup Visitors to South Africa produced by The National Institute for Communicable Diseases (NICD).
If you are already on HIV treatment, ensure that you have a good supply of your medication with you for the full length of your stay. You may consider carrying your medication in your hand luggage for easy access. It may also be useful to take a letter from your doctor listing the medication you are carrying and that they have been prescribed for your use. In fact, it might be a good idea to take extra just in case your departure is delayed.
Whether you are HIV positive or not, HIVsport also recommends you get travel insurance before you leave - this is very important as there can be long queues in public clinics. Many South Africans use private healthcare insurance and access the private sector.
HIVsport wishes all England supporters (and fans of other countries), a fun time in South Africa during the 2010 World Cup. It should be a great experience and one you will never forget.
Whether you are watching the football this summer at home or abroad, HIVsport wants you to have fun, stay safe, and make sure HIV and STIs are not part of your World Cup experience.
While every care is taken in preparing this information, HIVsport does not assume any responsibility, including legal responsibility, to those who read this guidance and who may choose to take it into account when making any decisions relating to their time in South Africa or at any other time... HIVsport cannot accept liability for injury, loss or damage arising in any respect of any statement contained in ‘HIV, South Africa and the World Cup’as it is just intended as guidance, and is not a substitute for professional advice.
How HIV is transmitted
There are only four ways in which HIV can be transmitted from one person to another:
1. Sex without a condom
This is by far the most common means of transmission and straight couples are equally at risk as gay partners. HIV does not discriminate in this way. Condoms are currently the best way to reduce the risk of becoming infected with HIV or giving it to someone else during sex. HIVSport believes that young people and adults are able to make their own decisions about who they have sex with, but we firmly believe that all choices must be with respect to your own health and the health of your partner. Using a condom is a mark of respect.
2. Drug injection with a contaminated needle
Sharing needles is high risk behaviour and a potential cause of HIV transmission. If, for any reason, you are injecting steroids (or any other drug) then you should always use a clean needle and dispose of it safely after use. There is a very small risk of a needle-stick injury resulting in HIV transmission which is why all needles must be safely handled and disposed of. HIVSport does not condone the taking of illegal or non-prescribed drugs.
3. Blood and blood products
Due to advances in medical screening, there is negligible risk that transmission could occur through a blood transfusion or during an organ transplant. However, virtually every country now has effective screening mechanisms to ensure that this does not happen and is no reason not to undergo surgery or to have a transfusion when recommended by a qualified physician.
4. Mother to Child Transmission
Children can become infected from their mother at childbirth or through breastfeeding. However, this risk can be prevented provided the mother’s HIV status is known in advance.
HIV CANNOT BE TRANSMITTED BY SHAKING HANDS, SHARING CUTLERY OR GLASSES, USING TOILET FACILITIES OR IN ANY OTHER WAY.
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