The unprecedented and collaborative development of the 2007 – 2011 HIV & AIDS and STI National Strategic Plan (NSP) reflects government and civil society’s joint commitment to enhancing the lives of South Africans in the face of the country’s HIV epidemic.
This paper explores the practice of policy; areas of dissonance and convergence between health policy rhetoric and reality are analysed through the lens of a qualitative research study conducted in 2008 with 76 HIV-positive respondents in Khayelitsha, Cape Town. Through an analysis of health policy and corresponding research findings, this paper seeks to strengthen policy implementation and interventions for people affected by HIV in South Africa.
The paper centres on the following three key priorities, as stipulated by the NSP: HIV prevention; treatment, care and support; human rights and access to justice. In line with the first priority, the research findings highlight the value of tailored prevention programs for sero-discordant couples to prevent horizontal transmission, and for HIV-positive couples to prevent HIV re-infection.
The second priority, the provision of treatment, care and support, is negatively constrained by limited human and infrastructural capacity within the national health system. This finding points to the value of implementing task shifting in order to improve health care outcomes, particularly for rolling out antiretroviral programs in line with the NSP target to reach 80% of those in need of ARVs.
The third priority underlines the importance of addressing HIV as a human rights issue; the findings indicate that the respondents continue to struggle with experiences of stigma within their community, but their experience of stigma within their families has significantly decreased. This paper proposes a set of recommendations based on the findings of this study in order to engage directly, and constructively, with the NSP’s key policy priorities.