11 12 August 2011 Upper Eastside Hotel, Cape Town

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1 11 12 August 2011 Upper Eastside Hotel, Cape Town

3 The AIDS Priorities Seminars The AIDS Priorities symposia series is presented by, with additional support from the President s Emergency Plan For AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID). These symposia will provide a forum for dissemination of state-of-the-art knowledge on relevant topics in HIV/AIDS for practitioners and health service managers and will be held several times a year in venues across the country. This sixth symposium on Mind, body, HAART: Integrating mental health into HIV care has been convened by a programme committee headed by Dr James McIntyre, Executive Director of Anova Health Institute. Welcome Message On behalf of the organizing committee of the AIDS Priorities; Mind, Body, HAART Symposium, a very warm welcome! This year, we are focusing on some of the challenging areas that drive the HIV epidemic and shape our response to it. We hope that you will participate actively in the discussions, and enjoy the next 2 days. Conference Organising Committee: Dr James McIntyre Ms Helen Struthers Mrs Heather Humphreys Dr Lena Andersen Dr John Joska

4 List of Speakers Dr Lena Andersen Mr Glenn de Swardt Dr Kirsty Donald Red Cross Children s Hospital Dr Hetta Gouse Dr Jackie Hoare Dr John Joska Prof Ashraf Kagee University of Stellenbosch Prof Crick Lund Centre for Public Mental Health Ms Ayesha McAdams-Mahmoud Emory University Dr Coceka Mnyani Prof Charles Parry South African Medical Research Council Dr Kevin Rebe Prof Soraya Seedat University of Stellenbosch Prof Leickness Simbayi Human Sciences Research Council Dr Kevin Stoloff Ms Helen Struthers Prof Rita Thom University of Witwatersrand Prof Mark Tomlinson University of Stellenbosch List of Chairs Dr Lena Andersen Dr Simone Honikman University of Cape Town Prof Graeme Meintjies G F Jooste Hospital Prof Leslie Swartz University of Stellenbosch Ms Helen Struthers Prof Mark Tomlinson University of Stellenbosch

5 Notes:

6 Thursday 11 th August Registration PLENARY 1: Setting the scene Chair: Ms Helen Struthers No health without Mental Health: The need to integrate mental health into HIV care Panel Discussion with primary ARV personnel: Dr John Joska Where does mental health feature in today s clinics? HIV Risk Factors and Prevalence among Older Women Dr Coceka Mnyani TEA / COFFEE PLENARY 2: Mental Health Internalised AIDS Stigma Depression in People Living with HIV/AIDS Chair: Prof Leslie Swartz Prof Leickness Simbayi Prof Rita Thom Addressing Trauma and Post Traumatic Stress Disorder in HIV Prof Soraya Seedat Structural Barriers to Adherence to Antiretroviral Treatment Discussion LUNCH PLENARY 3: Mental Health & MSM CBT+TT = S/M 4 MSM I want my health back please, I ll take my ARV s Prof Ashraf Kagee Chair: Prof Mark Tomlinson Dr Kevin Rebe & Mr Glenn de Swardt Dr Kevin Stoloff The potential for couples HIV testing and counselling in South Africa Discussion TEA / COFFEE Ms Ayesha McAdams-Mahmoud W/Shop A: The what s and where s of dealing with patients with mental disorders: A refresher course on the counselling approach W/Shop B: 1700 Cocktails Case Studies in HIV Psychiatry: Integration, insight & holism

7 Friday 12 th August Registration PLENARY 4: NeuroAIDS Chair: Prof Graeme Meintjies The Mind and Cognition in HIV Dr Hetta Gouse Cognitive Impairment in HIV-Positive Children Dr Jackie Hoare & Dr Kirsty Donald Discussion TEA / COFFEE PLENARY 5: Behavioural Interventions Chair: Dr Simone Honikman Alcohol use and its effect on HIV and AIDS in Africa: Designing effective responses for policy / practice Prof Charles Parry Cognitive-behavioural therapy for the treatment of adherence and depression in people living with HIV/AIDS Dr Lena Andersen Discussion LUNCH W/Shop C: Informed psychotropic prescribing in HIV TEA / COFFEE W/Shop D: Detecting common mental disorders in everyday HIV practice PLENARY 6: LOOKING FORWARD Chair: Dr Lena Andersen Keynote Address: Scaling up Mental Health Aspects of HIV/AIDS Care: Challenges for Policy, Services and Research Prof Crick Lund Panel Discussion: The Role of Mental Health in HIV/AIDS Care: Where we are now and where we are heading? Ms Helen Struthers, Dr John Joska, Prof Crick Lund, Prof Mark Tomlinson CLOSING

8 SPEAKERS Dr. Lena Andersen received her doctoral degree in Clinical Psychology from Hofstra University in New York. She specializes in cognitive-behavioral therapy (CBT) and is currently working on adapting a CBT intervention for the treatment of depression in people living with HIV/AIDS. Lena is an honorary lecturer at the University of Cape Town. She is also involved in developing training protocols and training counselors in a range of areas from basic counseling skills to mental health in HIV. Her interests include CBT, depression, HIV, and mental health services in primary care. Glenn de Swardt is the project director of Health4Men, a project of the that established the first public-sector clinic dedicated to MSM sexual health in Africa, in partnership with the Department of Health. He has published widely on psychosocial and mental health dynamics of MSM and features regularly in the gay media. He is the founding member of the Pride Shelter Trust, Africa s first shelter for queers, located in Cape Town. He is the past chair of Cape Town Pride and remains very involved in the city s gay community. Glenn has consulted widely on HIV prevention strategies targeting diverse MSM groupings, and is currently actively involved in Health4Men s initiative to train healthcare workers in the public sector to deliver MSM-competent services. Dr Kirsty Donald is a paediatric neurologist heading up the Division of developmental paediatrics at Red Cross Children's Hospital and the University of Cape Town. Her interests include developmental outcomes in resource-poor settings including the effects of alcohol and illicit drug use in pregnancy on infant development and brain structure, the neurological and neurocognitive sequelae of HIV and organophosphate poisoning. She is also involved in medical undergraduate teaching and curriculum development as well as developing diagnostic and outreach services for disabled children particularly in the field of Autism and intellectual disability. Dr Hetta Gouse received her PhD (specialising in neuropsychology) from the University of Cape Town. She is affiliated with the based at Groote Schuur Hospital and is the senior neuropsychologist and project manager of the neuropsychology programme. She is involved in research addressing questions related to the neuropsychology of, and social cognition in HIV-associated neurocognitive disorders and methamphetamine use, and heads up the HIV neurocognitive clinic. Dr Jackie Hoare is a Specialist Neuropsychiatrist and Senior Lecturer at UCT. She is a member of the Royal College of Psychiatrists. She is currently working on her PhD in neuroimaging and neurocognitive disorders in HIV-positive children. Dr John Joska is the director of the Division of Neuropsychiatry at UCT and a principle investigator in the GSH- HIV Mental Health Group. He has more than 5 years of experience in clinical neuropsychiatry, and is the Western Cape Provincial programme manager for HIV Psychiatry. His interests include neurocognitive disorders in HIV/AIDS, mental health in the elderly, and mental health services. He recently completed his PhD in Neurocognitive disorders in patients initiating HAART in the Western Cape. Professor Ashraf Kagee is Professor of Psychology in the Department of Psychology at Stellenbosch University where he teaches courses in research methods and cognitive psychotherapy. He is a graduate of the University of Cape Town, University of Portland, Ball State University and Stellenbosch University, and has completed research fellowships at the University of Pennsylvania School of Medicine and the HIV Center for Clinical and Behavioural Studies at Columbia University. Professor Kagee s current research interests include common mental problems among persons living with HIV and barriers to adherence to antiretroviral treatment, especially structural barriers in resource-constrained contexts. As a psychologist and researcher, he has an interest in identifying and developing evidence-based interventions to help ameliorate psychological disturbance and enhance adherence among users of antiretroviral treatment. Prof. Kagee has published numerous scholarly articles in peer-reviewed journals mainly in the area of health psychology. He is a member of a working group of the World Health Organisation tasked with identifying the diagnostic criteria for Stress-Related Disorders for the forthcoming International Classification of Diseases 11 th Revision.

9 Professor Crick Lund, BA (Hons), MA, MSocSci (Clinical Psychology), PhD, is an Associate Professor and Director of the Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town. He is currently CEO of the Programme for Improving Mental health care (PRIME), a DFID funded research consortium focusing on the integration of mental health into primary health care in low resource settings in Ethiopia, India, Nepal, South Africa and Uganda. He trained as a clinical psychologist at the University of Cape Town and was subsequently involved in developing norms for mental health services for the national Department of Health. He has also worked for the World Health Organisation (WHO), on the development of the WHO Mental Health Policy and Service Guidance Package, and consulted to Lesotho, Namibia and Indonesia on mental health policy and planning. His research interests lie in mental health policy, service planning and the relationship between poverty and mental health. Ms Ayesha McAdams-Mahmoud, MPH, CHES, is a research project coordinator in the Hubert Department of Global Health at Emory University in Atlanta, Georgia, USA. Her research is on determining the acceptability of couples HIV testing and counseling in diverse settings, as well as exploring the mental health of sexual minorities as it relates to health disparities and societal discrimination. She has worked in the field of stigma awareness and HIV prevention as a media specialist, health educator, researcher, and testing counselor. She worked as a journalist in the U.S. and South Africa before beginning her public health career. Dr Coceka Mnyani, BA (UCT), MBChB (UCT), FCOG (SA), is an obstetrician and gynaecologist, and a senior medical programme advisor at in Johannesburg, South Africa. She is the lead person in the Anova-supported PMTCT programme in Soweto, Johannesburg. She has been active in policy and training in the South African state sector services. Dr. Mnyani has presented at both local and international meetings and conferences. Her key interests are in women s health, and specifically on HIV-related issues. Prior to her medical training, she qualified as an archaeologist and hopes to return to doing excavations in the future. Professor Charles Parry is the Director of the South African Medical Research Council s Alcohol & Drug Abuse Research Unit (ADARU). He will have been employed at the MRC for 21 years this September. He was educated in South Africa and the USA and has an MSc in Mathematical Statistics, an MA in Clinical Psychology and a PhD in Community Psychology. He returned to South Africa in 1990 after completing a postdoctoral fellowship in Clinical Services Research at the Western Psychiatric Institute & Clinic in Pittsburgh. He currently has an appointment as Extraordinary Professor in the Department of Psychiatry at Stellenbosch University. He has authored more than 100 articles in peer-reviewed journals and co-authored two books, and is on the editorial/advisory boards of six international journals. In 2006 he was appointed to the World Health Organization s Expert Panel on Drug Dependence and Alcohol Problems and in 2010 was appointed to the technical advisory group of the UNODC/WHO joint programme on drug dependence, treatment and care, and the board of the Global Alcohol Policy Alliance. Dr Kevin Rebe, MBChB, has specialised in Internal Medicine at UCT and sub-specialised in HIV and Infectious Diseases under the guidance of Prof Gary Maartens / UCT. He obtained his diploma in HIV Management. He has spent 6 years working at GF Jooste hospital which has the highest in-patient HIV and TB case load of all Western Cape emergency hospitals. While there, he co-founded the Infectious Diseases rapid response unit together with Prof Graeme Meintjes and initiated the hospital s ART program. He has been with Anova Health Institute since 2008 and is the Medical Director of Health4Men and the Ivan Toms Centre for Men s Health in Cape Town. His main interest has been the clinical management of HIV infected patients at community hospital level. His major interest has always been prevention and treatment of HIV and other STIs among men who have sex with men. He particularly enjoys working with stigmatised communities such as MSM commercial sex workers and drug users. Professor Soraya Seedat is Professor of Psychiatry in the Department of Psychiatry (Faculty of Health Sciences) at Stellenbosch University (Cape Town, South Africa) and holds the South African Research Chair in Posttraumatic Stress Disorder from the Department of Science and Technology and National Research Foundation. In addition, she co-directs the Medical Research Council Unit on Anxiety and Stress Disorders. She has extensive research experience in the assessment and treatment of anxiety disorders, with a special interest in clinical and translational work in childhood and adult posttraumatic stress disorder. She has been the recipient of several awards including a World Federation of the Society of Biological Psychiatry Fellowship, a Lundbeck Institute Fellowship Award in Psychiatry, an MRC mid-career award, and an Anxiety Disorders Association of America Career Development Award. She has co-authored more than 170 peer reviewed journal articles and book chapters.

10 She serves on a number of committees including the Council of the College of Psychiatrists of South Africa, the South African Biological Psychiatry Interest Group, the MRC Grants Committee, and the Faculty Health Research Ethics Committee, and is a member of the editorial board of AIDS Research and Treatment, the African Journal of Psychiatry and the South African Journal of Child and Adolescent Mental Health. Prof Leickness Chisamu Simbayi holds a Doctor of Philosophy (D.Phil.) degree in Experimental Psychology from the University of Sussex in England, United Kingdom. He is a registered Research Psychologist with the Health Professions Council of South Africa s Professional Board of Psychology. He is the Executive Director of the HIV/AIDS, STIs and TB (HAST) research programme of the Human Sciences Research Council (HSRC). He is also currently an Extraordinary Professor of Psychology at Stellenbosch University and a Senior Research Scientist (Gratis) in the Department of Psychology at the University of Connecticut at Storrs in USA. Prof Simbayi was an Associate Editor of AIDS & Behaviour from and he is currently an Associate Editor of Journal of Psychology in Africa. He also serves on the International Advisory Board of Vulnerable Children and Youth. He sits on the Board of an international non-governmental organization (NGO) known as AIDS Accountability International and he is also the Chairperson of the Boards of two local NGOs based in Cape Town, namely, Caring Network and Partners for Sexual Health. Dr Kevin Stoloff studied medicine at the University of Cape Town, completing his degree in He trained as a psychiatrist in the St Marys Rotation in London, and at the University of Cape Town. He currently works in HIV Mental Health in the Department of Psychiatry and Mental Health at UCT, and is an honorary lecturer in the department. He is the project manager of an HIV Mental Health Screening Project which is being piloted in Langa, trains primary healthcare workers in Mental Health in HIV, and runs a Mental Health Clinic at the Ivan Toms Mens Health Centre in Woodstock in Cape Town. He also provides a specialized HIV Neuropsychiatry Service to the Infectious Diseases Clinic at G F Jooste Hospital. He has an interest in psychopharmacology, addictions, and the mental health of Men who have Sex with Men (MSM.) Ms Helen Struthers has a master s degree in applied mathematics and in business management. She has worked in HIV and related services and research since Aside from managing service implementation, her interests are in the social aspects of HIV, in particular men, including men who have sex with men and male circumcision. Professor Mark Tomlinson, PhD, is an Associate Professor in the Department of Psychology at Stellenbosch University, South Africa. His scholarly work has involved a diverse range of topics that have in common an interest in factors that contribute to infant and child development in contexts of high adversity and how best to prevent compromised development in these contexts. He has completed epidemiological work investigating the association between postpartum depression and the mother-infant relationship, and the impact of postpartum depression on infant and child development. He has a particular interest in maternal health and infant and child development in conditions of high social adversity, as well as developing community based prevention programmes. He has completed a randomised controlled trial to improve the quality of the mother-infant relationship and infant attachment in a peri-urban settlement on the outskirts of Cape Town, South Africa. He is currently involved in a community based trial aimed at reducing alcohol use, reducing HIV/TB, improving maternal mental state and improving the nutritional status of women in the antenatal and postnatal period in Cape Town. He is also the principal investigator of a study based in KwaZulu Natal aimed at preventing mother to child transmission of HIV and reducing neonatal death. Recently, he has begun to focus on the health system challenges of scaling up services for infants and children. He has published in the Lancet, Child Development, British Medical Journal, British Journal of Psychiatry, PLoS Medicine and the Bulletin of the World Health Organization.

11 CHAIRPERSONS Dr Simone Honikman has a medical degree from the University of Cape Town and subsequently completed an MPhil in Maternal and Child Health at the same institution. She has worked as a medical officer in England and South Africa in psychiatry, paediatrics, obstetrics and gynaecology and HIV medicine. She has been involved in managing a cervical cancer screening research project in Khayelitsha. In 2002, she founded the Perinatal Mental Health Project, currently located within the Department of Psychiatry and Mental Health at UCT. As Director, her role includes the strategic and operational development of the Project s four programmes which include integrated maternal mental health service delivery, health provider training, research and advocacy. She is currently the Director of Perinatal Mental Health Project and Senior Research at the University of Cape Town. Professor Graeme Meintjies is an Infectious Diseases Physician, Wellcome Trust Fellow and Associate Professor of Medicine based at GF Jooste Hospital and the Institute of Infectious Diseases and Molecular Medicine at UCT. His major research interests are TB-IRIS, cryptococcal meningitis and complications of ART. Ms Helen Struthers has a master s degree in applied mathematics and in business management. She has worked in HIV and related services and research since Aside from managing service implementation, her interests are in the social aspects of HIV, in particular men, including men who have sex with men and male circumcision. Professor Leslie Swartz is a professor of psychology at Stellenbosch University and a clinical psychologist. His research interests span the fields of mental health and disability studies, and he has been instrumental in establishing the Centre for Public Mental Health in collaboration with University of Cape Town. Recent publications include Disability and International Development (co-edited with Mac MacLachlan, Springer 2009), and Able Bodied: Scenes from a Curious Life (Zebra, 2010). He serves on the editorial boards of a number of international scholarly journals and has received awards for research and for publications. Current work includes research on access to health care for people from vulnerable groups in four African countries, and capacity building in research for national Disabled People s Organizations in southern Africa. Professor Mark Tomlinson PhD, is an Associate Professor in the Department of Psychology at Stellenbosch University, South Africa. His scholarly work has involved a diverse range of topics that have in common an interest in factors that contribute to infant and child development in contexts of high adversity and how best to prevent compromised development in these contexts. He has completed epidemiological work investigating the association between postpartum depression and the mother-infant relationship, and the impact of postpartum depression on infant and child development. He has a particular interest in maternal health and infant and child development in conditions of high social adversity, as well as developing community based prevention programmes. He has completed a randomised controlled trial to improve the quality of the mother-infant relationship and infant attachment in a peri-urban settlement on the outskirts of Cape Town, South Africa. He is currently involved in a community based trial aimed at reducing alcohol use, reducing HIV/TB, improving maternal mental state and improving the nutritional status of women in the antenatal and postnatal period in Cape Town. He is also the principal investigator of a study based in KwaZulu Natal aimed at preventing mother to child transmission of HIV and reducing neonatal death. Recently, he has begun to focus on the health system challenges of scaling up services for infants and children. He has published in the Lancet, Child Development, British Medical Journal, British Journal of Psychiatry, PLoS Medicine and the Bulletin of the World Health Organization.

Programme. Co-Chairs. Take the conversation further online follow AIDS #AIDS2016

Programme. Co-Chairs. Take the conversation further online follow AIDS #AIDS2016 EVIDENCE TOACTION This session will highlight the essential role that collaborative research plays in improving public sector policies and services for HIV treatment and prevention. Across southern Africa