Catherine Martin. Abstract #157. SA AIDS Conference. June 2017

Transcription

1 Catherine Martin SA AIDS Conference Integrated sexual and reproductive health services as an entry point to HIV testing, prevention and care for adolescent girls and young women in Johannesburg, South Africa Abstract #157 June 2017

2 Background 15.6 million adolescents and young people 28% of South Africa s population 1x HIV incidence in young women is four times higher than in their male counterparts 4x Ongoing concerns Knowledge of HIV status Uptake of testing 1. Statistics South Africa. Community Survey 2016, Statistical release P Shisana O et al. (2014) South African National HIV Prevalence, Incidence and Behaviour Survey, Cape Town: HSRC Press

3 Rationale The PMTCT programme has had many successes HIV testing uptake of >98% ARV treatment or prophylaxis to >90% of HIV positive mothers 3 Elimination of mother-to-child transmission but we need to ensure that those born HIV-free remain HIV-free for life Can we leverage contraception services to improve HIV testing, prevention and treatment options for those most at risk? 3. Goga A, Dinh T, Jackson D. Evaluation of the Effectiveness of the National Prevention of Mother-to-Child Transmission (PMTCT) Programme Measured at 6 Weeks Postpartum in South Africa, National Department of Health of South Africa and PEPFAR/US Centers for Disease Control and Prevention: South African Medical Research Council; 2012.

4 The Ward 21 Adolescent Clinic The Hillbrow Community Health Centre is run by the Gauteng DOH and supported by Wits RHI s USAID-funded Adolescent Innovations Project. It provides integrated adolescent friendly primary care services to year olds.

5 Model HIV Testing SRH services Test HIV negative Test HIV positive Link to HIV prevention, SRH and STI services, including oral PrEP Retest for HIV, effective PrEP, SRH, STI and contraception services Link to ART initiation Retention in care Remain HIV negative Viral Suppression Adolescent well-being

6 Methods October 2015 HIV testing and ART for year olds April 2016 Expanded services to year olds September 2016 Active referral of AGYW seeking contraceptive services Reviewed programmatic data to observe the effect of expanding service access on HIV testing and SRH service uptake

7 Number of young people Results Headcount, Contraception, HTS and STI uptake: Oct 2015 Sep Intervention Headcount HTS STI Contraception

8 Number of young people Results Headcount, Contraception, HTS and STI uptake: Oct 2015 Sep Intervention Headcount HTS STI Contraception

9 Average number of young people per month Results Increase in average monthly headcount, contraception, HTS and STI uptake, between Oct March 2016 and April Sept % increase % increase 63% increase 0 Headcount Contraception HTS STI Oct March 2016 April Sept 2016

10 Number of young people Results Number of young people accessing HTS, by age and gender, Oct March 2016 and April Sept Male Female Male Female Male Female years years years Oct March 2016 April Sept 2016

11 Results Contraceptive method choice Implant, 1% IUCD, 0% Oral Pills, 12% Nur-Isterate, 42% Depo-Provera, 46%

12 Discussion Contraceptive services are an important entry point to care for AGYW and should be leveraged to improve HIV testing and other SRH services. Opportunities exist to expand the service offering to include newer interventions such as PrEP and screening for GBV It is essential that services are friendly, sensitive and delivered to address the needs of those at highest risk

13 Abstract #157 Integrated sexual and reproductive health services as an entry point to HIV testing, prevention and care for adolescent girls and young women in Johannesburg, South Africa Catherine E. Martin 1, Julia Michalow 1, Denver Jainarain 1, Thomas Toodi 1, Bulelani Makhathini 2, Mary Kekana 2, Buyile Buthelezi 3, John Imrie 1, Sinead Delany-Moretlwe 1 1. Wits Reproductive Health & HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg 2. Gauteng Department of Health 3. USAID / Southern Africa, Pretoria