VERONICCA MOLEFE: For the youth, by the youth - Destigmatising HIV, sex and birth control is an urgent necessity

“Hi, my name is Veronicca Ndhlovu. I am 17 and a Grade 11 student. I have a tight group of girls, and we share all kinds of advice on life, love and our dreams. One of the girls is pregnant, she still comes to school, she didn’t use a condom, or she didn’t have the contraceptive pill, I’m not sure – we didn’t get into all the details. In Life Orientation, they said that knowing your HIV status is important. I don’t want to get HIV. I am not having sex, but all my friends are, and I kind of feel left out. I wanted to prepare myself when my moment comes, so I went to the clinic a street away from my home to ask for options to prevent getting HIV and mostly to not get pregnant when the time comes, and I am ready. I just needed info, and I was so proud of myself – you’ve got this, Vero, I thought.”

Well, not what I expected.

The nurse asked me invasive, personal questions. “Why do you want those things? Are you sleeping around? Children like you should be in school, not here looking for things that don't concern you.”

I felt judged, ashamed and unwelcome. I am not even doing these things the nurse is accusing me of – how are my friends who do need these options doing it? I left with nothing. Thank goodness my mom got involved and we found a new clinic that was willing to help me. I just needed information!

That was 10 years ago.

But this is still the reality for many young people today.

Hi, my name is Veronicca, now, Molefe. I am 28 and I lead a team of youthful professionals who provide sexual and reproductive health services to adolescent girls and young women with Shout-It-Now.

I was also recently appointed 2^nd deputy chairperson on the South African National AIDS Council’s (SANAC) Health Professionals Civil Society Forum. In these two roles, I support, advocate for and develop policies and programmes that address the unique challenges faced by young people in accessing sexual reproductive health (SRH) services in a non-judgmental and relatable environment, particularly preventative services that relate to unwanted pregnancy, HIV and abuse.

The tragedy is that teenage girls in South Africa, and more particularly, girls growing up in impoverished circumstances, are at high risk of becoming pregnant and contracting HIV and other sexually transmitted diseases. Young males too are at risk, but not to the same extent.

South Africa has the highest rate of teen pregnancy in the world.

It is estimated that in the 2022/2023 financial year, 150,000 girls between the ages of 10 and 19 had fallen pregnant – which suggests some of these girls had unprotected sex. Some of these young bodies are not even developed enough to carry a baby.

There are free services like the HIV prevention pill, contraception and social services to discuss abuse specifically for the youth. Why are they not being taken up?

The harsh reality is often simply a result of girls wanting access but being met with judgment, scrutiny and shame when seeking these services.

Youth-friendly spaces have become an urgent necessity, as well as service providers who understand the lifestyles and struggles of the youth and can serve without judgment.

Shout-It-Now recruits its staff from the communities they serve, with more than 75% of staff being under the age of 35. We provide various sexual and reproductive information programmes and biomedical services, so regardless of a client’s lifestyle, whether they have had their first sexual encounter, are abstaining from sex or have no choice due to abusive circumstances – our nurses, social workers and healthcare providers serve them without judgement.

Our peer ambassadors who have been through our programmes and services welcome our clients to our mobile clinics, and every day we purposefully endeavour to create a space for open conversations. Clients have a choice of digital access to information, whether through our connect hub (call centre) or our social media platforms, and we follow this tonality from digital to in-person consults.

SANAC’s national strategic plan 2023-2028 aims to reduce barriers to accessing health and social services and promotes a new and urgent focus to reduce inequalities for all people living with HIV, TB, and STIs who are not benefiting from treatment and care services.

In achieving SANAC’s plan, widespread prevention and treatment services and facilities that are accessible and youth-friendly must be provided and young health professionals who understand youth lifestyles and will provide non-judgmental and comprehensive information, support and services should be employed.

This will only be possible through a collective effort from national, provincial and local government, relevant NGOs and other health sector organisations and the public. We need to face the realities indicated in the statistics and shift stigma and gender norms, have a reality check, and start having open conversations about sex and relationships in serving the youth, instead of conforming to outdated, conservative beliefs.

My goal is to play a role in ensuring that young people recognise their health is their most valuable asset, and that they need to make every effort to safeguard it, accessing services and seeking help, staying informed, asking questions, and boldly reaching out for support.

They have a right to know that their voices matter. Together with the youth, we can help to shape health services that serve the whole country and create healthy futures for all young people.

Having been the 17-year-old girl who was failed by the public health sector 10 years ago, it is now my privilege and my core focus to be the change advocate and support that today's youth deserve.