DEPARTMENT OF HEALTH RESPONSE TO KEY POPULATIONS KEY POPULATIONS PREVENTION INTERVENTIONS Ms E Marumo HIV PREVENTION STRATEGIES 13 June 2017 1
Background SA has about 7.1 million people living with HIV (PLHIV) prevalence rate of about 19.1% among 15 to 49 years. Although the local epidemic is generalised; there are notable groups that are proportionately affected and more vulnerable to HIV, and that play a role in the spread of the epidemic and in its effective control 2
Back ground cont. SEX WORKERS PROVINCE HIV PREVALENCE CAPE TOWN 40% JHB 72% DURBAN 55% MEN WHO HAVE SEX WITH OTHER MEN (MSM) PROVINCE HIV PREVALENCE CAPE TOWN 27% JHB 43% PWID 14% INMATES 23% Sources : IBBS 2014.IBBS 2015/16, RAR,NSP 2017-20122
Key Populations as per NSP 2017-2022 4
Key populations cont KPs refers to the populations at high-risk of acquiring and/or transmitting HIV as compared to the general population. The DOH KP programmesaims to provide: enabling environment for health seeking behaviour Empower key populations to reduce their own risk of HIV and STI acquisition and transmission, and to seek appropriate interventions In close collaboration with implementing partners to deliver outreach services 5
Government response to Key Populations NDOH initiative to reduce HIV burden among key populations HTA Programme (EST 1800 sites) Target HIV, STI, and TB prevention among KP Screening, Treatment, care and support Addressing biomedical, behavioural and structural interventions 6
HTA Programme What is a HTA? Geographical area, which contains hot spots, and places where people are at highest risk for acquiring or transmitting HIV infection due to social factors, which make them vulnerable to the diseases. 7
Purpose of the HTA programme To increase HIV prevention, care and treatment and support services to people at high risk, through a sustainable, coordinated High Transmission Area programme, focusing on working in partnership with other stakeholders to expand access to HIV/STI/TB prevention and management services in High Transmission Areas 8
Objectives of the HTA programme To reduce HIV/STI/TB incidence among high-risk populations and their sexual partners. To improve health outcomes of all high risk populations through the provision of focused and appropriate services, in an enabling environment. 9
Implementation modalities and package of interventions KP Programme Recommended service packages per model Targeted HIV, STI, and TB prevention among KP Addressing biomedical, behaviouraland structural interventions Clinical Model HIV testing services STI screening, diagnosis and treatment TB screening, diagnosis and treatment Sexual and reproductive health Treatment of minor ailments Provision of condoms and condom compatible lubricants NDOH initiative to reduce HIV burden among key populations KP Programme Screening, Treatment, care and support Nonclinical Model Community engagement including health dialogues Sexual and reproductive health screening Risk reduction counselling and skills building Education and awareness around HIV, STI and TB Distribution, demonstration, and promotion of condoms and condom compatible lubricants.
New initiatives PrEPinitiation and Rollout for sex workers and MSM 11
PrEP Initiations by Province June 2016 March 2017, as of 18 April 2017 JUNE 2016-MARCH 2017 1,232 PrEP INITIATIONS TOOK PLACE AT 13 SITES ACROSS SOUTH AFRICA PROVINCIAL COVERAGE: GAUTENG (5 sites) KWAZULU-NATAL (4) LIMPOPO (2) MPUMALANGA (1) NORTHERN CAPE (1) SW MSM AGYW 12
PrEP initiation among MSM 3-20 April, 27 total clients have initiated on PrEP at the three MSM clinics Out of a total number of 141 negative HIV tests, this represents an 19% uptake at 3 MSM sites TOTAL Total number of HIV tests 149 Number of HIV negative results 141 Number of PrEPinitiations 27 (19%) Number of HIV positive results 8 Number of ART initiations 12 13
Next steps Continue sensitization training for all health care workers and providers Provide on-going assessment of the existing HTAs to identify gaps Continue key populations competency training and mentorship programmes Strengthen reporting systems Strengthen collaboration with other departments for systems strengthening Strengthen recruitment processes for peer educators Commissioning research studies inform implementation of the programme 14
Conclusion Need for expansion and mapping of HTA programmes to reach even harder to reach populations Continue rolling out innovative approaches for combination prevention for key populations for better outcomes 15
Thank you 16