SANCA DURBAN ALCOHOL AND DRUG CENTRES

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2 STEERING COMMITTEE MEETING : DEVELOPING SERVICE QUALITY MEASURES FOR SUBSTANCE ABUSE IN SOUTH AFRICA LAGOON BEACH HOTEL, CAPE TOWN NOVEMBER 2008

3 INTEGRATING HIV ISSUES INTO DRUG TREATMENT SERVICES DELIVERY : REFLECTIONS ON YEAR ONE OF MRC-CDC PROJECT Carol du Toit A PROJECT FUNDED BY PEPFAR THROUGH A GRANT AWARDED TO MRC THROUGH CDC

4 METHODS In 2007, a consortium of organisations was formed: - promote cross-training of drug treatment and HIV prevention service providers - facilitate integration between drug and HIV services - ensure drug users are linked to appropriate prevention, care and treatment services MRC, with funding from CDC-SA/PEPFAR (in collaboration with five local NGOs), began to roll out HIV risk reduction interventions aimed at: - IDUs and NIDUs, including MSM, CSWs, and other vulnerable women (VW) who engage in transactional sex in Cape Town, Durban and Pretoria Interventions include : - community outreach - HIV risk reduction counselling - expanded access to VCT - referrals to drug treatment, HIV/STI care and treatment, and other social services

5 SA Medical Research Council has: METHODS Been responsible for preparing an outreach manual to NGOs on how to address drug-related HIV risk behavior Training NGOs in the use of this manual and in how to conduct outreach and other activities related to the roll-out of the project Been responsible for the regular monitoring of activities undertaken by the NGOs Has established a system for collecting/capturing data on indicators/targets on an ongoing basis, and trained service providers on these activities Is responsible for the analysis of this data

6 RESULTS (OUTCOMES) Training courses attended/provided individuals in how to promote HIV/AIDS prevention in vulnerable drug using populations - 45 individuals in VCT Service outlets - 12 new targeted condom service and 12 new VCT outlets established Networking/collaboration with other organisations - NGOs have built strong links with each other and various other organisations and stakeholders within each of the cities * club owners, drug treatment centres, a hospice, ARV clinics, AIDS programmes, the Department of Social Development, Department of Justice and Department of Health, policing forums and other police services, youth centres and a school, university programme, community care centres, ATIC, FBOs & anti-drug forums - Lifeline has negotiated with a government treatment centre to consider opening a separate treatment programme for street sex workers - SANCA Durban has been accredited by the Department of Health for VCT sites at the Out-patient Clinic and Lulama Treatment Centre

7 RESULTS (OUTCOMES) New services offered to clients - NGOs conduct regular outreach activities in communities and venues which their target populations are known to frequent * awareness campaign * condom demonstrations * educational sessions * generally providing information & building rapport with clients - Clients are referred to appropriate services & encouraged to develop a risk reduction strategy with the outreach workers - VCT is also offered to the target populations by * Creating awareness of VCT services offered * Making VCT accessible - To date: * 3221 drug users have been reached through community outreach programmes promoting HIV/AIDS prevention * 474 drug users tested for HIV and received their results * 187 were referred from VCT to other services

8 THE SANCA DURBAN EXPERIENCE Core business : treatment of alcoholism, drug dependence and gambling Recognised need for the intergration of HIV issues into treatment services Progress hampered by financial and human resources constraints Opportunity for partnership with MRC-CDC

9 THE PATH TO SUCCESSFUL INTEGRATION OF HIV ISSUES INTO EXISTING TREATMENT PROGRAMMES Identify Project Coordinators and key personnel Development of operational plan - Re-visit existing treatment programmes to make provision for integration of specific HIV related services - Be realistic Strategise around integration into current workload Evaluate human resources capacity - In-house capacity - Recruitment of outreach workers - Specialised training Ensure compliance with statutory requirements to allow for access to condom supplies and tests for use in VCT services Ensure compliance with MRC-CDC requirements Marketing/awareness initiatives - Staff Buy in, Marketing to patients - Networking NGOs, CBOs, FBOs, State Departments, Treatment Centres - Communities Particularly around community based VCT sites

10 THE PATH TO SUCCESSFUL INTEGRATION OF HIV ISSUES INTO EXISTING TREATMENT PROGRAMMES Implementation of Operational Plan We found the following processes to be very important : - Regular meetings with MRC - Regular monitoring/supervisory/feedback meetings with outreach workers - Regular meetings with full team - Regular feedback on project to entire SANCA staff - Drawing up of monthly schedule in order to monitor target achievements an to ensure timeous submission of reporting documentation to MRC Monitoring and evaluation Ensure sustainability of project

11 ACHIEVEMENTS Targets : Brief Description of Target Reached Target 1. Condom Service Outlets Training of Outreach Workers Individuals reached through outreach work VCT Service Outlets Training of VCT Counsellors Individuals who received VCT services Individuals referred from VCT to other resources Accreditation by Department of Health of VCT sites at SANCA Durban Out-patient Clinic and Lulama Treatment Centre Upskilling of staff Successful integration of HIV related issues into our treatment programmes

12 Under-estimation of start-up period Staff resistance Volunteers/Outreach Workers - Commitment - Drop-out rate - Ethics Administrative requirements CHALLENGES

13 REFERENCE (SLIDES 4-7) : MRC PRESENTATION ON INTERVENING TO ADDRESS DRUG USE AND SEXUAL HIV RISK PATTERNS AMONG VULNERABLE DRUG USING POPULATIONS IN CAPE TOWN, DURBAN AND PRETORIA, SOUTH AFRICA

14 THANK YOU