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​​ Empowering women by protecting them from HIV                                   

 

Engaging with women who are disempowered around their sexual health and safety is what motivates Dr Thesla Palanee, Director of Clinical Trials at Wits RHI, to get up for work each day.

A medical biological scientist by training who achieved a PhD in Biochemistry in 2004, Thesla says:  “We aim on a daily basis to shift these women’s mind sets, instil hope and show them their own value when they cannot see it clearly.”
Her work is mainly centred around two ongoing Phase 3 HIV prevention trials:

• FACTS 001 looks at the use of an ARV-containing gel around the sex act.
• ASPIRE explores the use of an intravaginal ring containing the ARV Dapivirine used independently of sex which may provide long-term protection during anticipated and unanticipated sexual intercourse. (These vaginal rings need to be replaced every four weeks.)

Vaginal microbicides, which are self-initiated, offer women a critically needed new tool to prevent HIV, complementing existing HIV prevention strategies or future ones still being developed.

Her appointment as co-chair of the international ASPIRE study came about only after urging from Professor Helen Rees, founder and Executive Director of Wits RHI.

“Were it not for Helen’s encouragement, I would never have considered applying. It’s been almost two years since I was awarded the co-chair position and I continue to learn daily from the trial participants and study teams locally and internationally on this very intense but fulfilling journey.”


Value and power of women

She adds:  “Women’s Day is important to me as it signifies the recognition of the value and power of women and their contributions to social change.

“I personally find interacting with our trial participants extremely rewarding, with real conversations and recognition of their fears around an epidemic more close to them than is comfortable.

 “If our work could improve the lives of women globally in a positive way and curb this growing HIV epidemic, then we would be truly reaping the rewards of efforts well invested.”

 

 Empowering sex workers

Sex workers are marginalised, victimised and criticised. They face abuse, physical violence and even death on a daily basis.

Help and compassion, for them, are scarce commodities.Wits RHI recognised the role of sex workers in the spread of HIV infection as far back as 1996 and has been working to improve their lives and curb HIV infection in this group for almost two decades.

Maria Sibanyoni, a nurse and qualified public health expert, was recently promoted to Programme Manager of the Sex Worker Project. This involves liaising with internal and external stakeholders and donors, overseeing activities and providing leadership to a team tasked with empowering sex workers and working with truck drivers, who routinely use their services.



Meet them where they are

When a project to provide an exit strategy for sex workers from the profession proved unsuccessful, Wits RHI decided instead to empower them to take care of their health.

There are an estimated 4400 sex workers in Johannesburg’s inner city, and approximately half of these are now registered in Wits HRI’s database.

Protection from HIV infection, for them and their clients, is obviously a priority in their treatment, as is regular screening.  Equally important, though, is addressing their emotional and mental health needs.

Regular workshops are held, the word spread by peer educators, who are sex workers trained by Wits HRI and given a stipend to encourage other sex workers to register for the services at the Hillbrow Health Precinct.

At the workshops, art therapy and drama are tools used to help participants talk about how they became involved in sex work, and to develop coping mechanisms. Maria is passionate about providing assistance to these women, who risk their lives on a daily basis to support their families.

Victimisation by police is rife and Maria and her team have worked hard to change perceptions and engender respect for the human rights of sex workers. Success has been mixed; but progress is evident, she says.

“They may be sex workers, but let’s not forget they are first and foremost, women. And they need protection from abuse and violence, and to provide for their children, just the same as any woman.”
 

 

Keeping women well for the sake of their children

It takes a special kind of female professional to decide to risk entering the rough streets of Hillbrow to come to work. 

Yet, for Dr Lee Fairlie, this is exactly the kind of place she wants to be. The Hillbrow Health Precinct is an oasis of sanity, security and access to healthcare for hundreds of thousands of women and children living in Johannesburg’s inner city.

As head of Paediatrics at Wits RHI, she leads a team that supports improved paediatric care for children and adolescents in numerous districts and sub-districts in South Africa.  

She spends three days a week in Hillbrow, treating HIV-infected children and conducting research aimed at making a difference in the lives of those children.

“Every child in our clinic is cared for by a woman caregiver. So it’s vital for us to keep our mothers and caregivers well and alive.
If they aren’t there, the children in their care are also likely to die young,” she explains. 

For those HIV-infected caregivers, this means ensuring that they go onto antiretroviral therapy (ART) early, and, most important, that they remain on their treatment.

It also includes promoting planned pregnancies, which have been shown to have far better quality-of-life outcomes. Here, prevention of mother-to-child-transmission plays a vital role.

 
Pressures women face

Lee sees daily the pressures women face in our patriarchal society, where gender-based violence is endemic.  
Poverty and food insecurity add to this, so that transactional sex and HIV infection are commonplace.

“Treating the health issues that arise is easy compared to the social issues these women face,” she points out.
 
Yet her work is making a difference. She also trains health care providers to treat mothers and children with HIV and, one patient at a time, lives are being changed. Lee lights up when she speaks of how well children respond to ART. “This is the best part of my job,” she says.

International recognition of her work has resulted in Lee’s appointment to one of the scientific advisory committees of IMPAACT, an international paediatric HIV study consortium.

 

                                                                Thesla Palanee.jpg

                               Dr Thesla Palanee

 

 

 

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                                      Maria Sibanyoni
 
 
 
 

 Dr Lee Fairlie, head of the paediatric technical team_section 4.4.3 paediatric technical team.jpg
                                      Dr Lee Fairlie