HIV, the new struggle

South Africa's HIV/AIDS prevention messages may be missing the mark, but Dr Terri Lynn Cohen's presentation, Sex in a Time of HIV, didn't miss many holy cows.

Wielding a guitar, some frank anecdotes and a "tell it like it is" visual presentation, Cohen told UCT medical students that HIV is the new struggle. She was a guest of the Transformation and Equity Working Group.

A dentist at the Gauteng Department of Health, Cohen had noticed a marked increase between 1991 and 2006 of "trench mouth" among patients at the Lilian Ngoyi Oral Health Clinic where she works. Trench mouth, or necrotising ulcerative gingivitis, is a symptom of HIV.

Part of her response to the HIV pandemic is to train nurses about HIV - and to use her combined experience as a clinician, stand-up comedian and musician to tackle the problem in her distinctive way.

"Prevention is working nowhere. It's failing worldwide."

Her point is underscored by sobering statistics:

• South Africa has the highest prevalence of HIV in the world.
• Of the 40 million HIV positive people worldwide, six million are in South Africa.
• HIV causes one in three deaths in the country.

Of most concern to her is that men are not getting tested, safe sex and the use of condoms is not being eroticised, and that no-one focuses on those who are HIV negative. Citing research, Cohen said 40% of married men are having affairs.

"Right now the highest risk group for HIV is married women."

Sixty-four percent of South Africans don't know their partner's sexual history.