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National viral hepatitis study on key populations set to begin recruiting

A consortium of partners is undertaking a viral hepatitis service provision and research project for key populations (people who inject drugs, sex workers and men who have sex with men) in South Africa. The study will assess information gaps on populations disproportionately affected by viral hepatitis and provide an evidence base to guide future interventions.

Hepatitis B and hepatitis C are infectious diseases that affect the liver. They are usually without symptoms for many years. This means that those infected are infectious without even knowing it and can silently develop progressive liver damage. This year the World Health Organisation (WHO) released the first ever Global Strategy for Viral Hepatitis. The strategy aims to eliminate viral hepatitis as a public health threat by 2030.

People who inject drugs, sex workers and men who have sex with men are at higher risk of contracting viral hepatitis B and C. Viral hepatitis is a particular concern in a context of high HIV prevalence because co-infection can result in more rapid progression of both diseases.

At present viral hepatitis services for “key populations” are limited in South Africa and there is very little information on prevalence levels, though studies that have been done indicate that rates are high in key population groups. The forthcoming study is funded by the Bristol-Myers Squibb Foundation Secure the Future, and implemented by TB/HIV Care Association, in partnership with the University of Cape Town, Anova Health Institute, the National Institute for Communicable Diseases and OUT Wellbeing.

Spanning seven cities – Cape Town, Johannesburg, Pretoria, Mthatha, Pietermaritzburg, Port Elizabeth and Durban – the study builds on already occurring service delivery processes.

Hepatitis B and C diagnosis usually require expensive and time-consuming laboratory activities. In this study, participants will be tested for HIV, hepatitis B and C at service delivery sites. The point-of-care (‘rapid’) hepatitis C testing will be done in a variety of ways, and the results will be compared to standard laboratory tests. This will indicate whether inexpensive rapid test mechanisms can be reliably used in the South African context. If this proves to be the case, it opens up new possibilities for making hepatitis testing a common part of health screening processes.

The study’s results will provide an evidence base to support national efforts to reach the WHO 2030 target of reducing the public health threat of viral hepatitis to zero.

TB/HIV Care programmes well-represented as Durban becomes conference hub of activity

Durban was the centre of the HIV and TB world’s attention this week as the International AIDS Society hosted both the TB Conference 2016 (incorporating the biennial South African TB Conference), and the 21st International AIDS Conference 2016 in the city.

TB/HIV Care was engaged in a variety of activities to raise the importance of addressing TB as well as HIV, to highlight the importance of health services directed at key populations and to advocate for increased investment in community-based health services.

On Sunday the 17th July, TB/HIV Care provided health services to visitors and the congregation at an event at eThekwini Community Church where the South African Minister of Health, Dr Motsoaledi, addressed the congregation on the challenges associated with TB. The Premier of KwaZulu-Natal and the KwaZulu-Natal MEC for Health as well as other high-profile guests were also be present.

A high-level delegation from UNAIDS visited TB/HIV Care’s HIV prevention in sex worker site in Durban where pre-exposure prophylaxis (PrEP) is being delivered as one of South Africa’s pilot sites.

For the duration of the AIDS Conference 2016, from the 18th-21st July, TB/HIV Care hosted a TB HIV Networking Zone in collaboration with AERAS and ACTION to ensure that TB was highlighted at the AIDS 2016 Conference. Sessions at the networking zone explored the way in which TB and HIV affect different populations differently, how to adopt a human rights-based approach when dealing with TB and HIV, and the importance of community-based and patient-centred health services.

Much of TB/HIV Care’s work with key populations was represented at AIDS 2016 through posters and presentations. These included a poster on working with communities, law enforcement agencies and political leaders to enhance HIV prevention programmes for people who inject drugs, and a roundtable discussion on fostering enabling environments for key populations for key populations with law enforcement agencies. In addition, Shaun Shelley, Advocacy and Psychosocial Co-ordinator for the Step Up Project, presented at a satellite event on harm reduction with an emphasis on programmes, policy and policing.

Finding and reaching key populations was another sub-theme for TB/HIV Care as Andrew Lambert presented a model of how to reach female sex workers with mobile health and HIV prevention services, while Andrew Scheibe, a Technical Advisor for TB/HIV Care, presented a poster on ‘using programmatic mapping to identify locations where people who inject drugs congregate and to estimate their population sizes in three South African cities’.

In the Global Village, Prof Harry Hausler, TB/HIV Care CEO, presented on improving HIV and TB services in South African correctional centres and Shaun presented a talk on harm reduction funding in South Africa, and spoke about a report on human rights violations experienced by people who inject drugs. As part of a satellite session on Hepatitis C (HCV) and HIV, Andrew Scheibe presented ideas on ‘assessing HCV and HIV co-infection among key populations in South Africa’.

Finally, TB/HIV Care submitted 22 quilts to the international HIV Quilt Project, which is co-ordinated by the South African National AIDS Council (SANAC). These quilts were made by people involved in TB/HIV Care’s programmes, including people who inject drugs, sex workers and prison inmates, as well as those dedicated to supporting them.

The quilts are part of a larger display of quilts made by people affected by HIV, which tell the story of what has been achieved since the last time the International AIDS Conference was held in South Africa in 2000. Among the successes since then is the establishment of the world’s largest antiretroviral treatment programme.

It was a busy week for Durban, and for TB/HIV Care, as researchers, policy-makers, donors and programme-implementers meet to better define problems and identify solutions.

Quilts show the progress in fight against HIV

CAPE TOWN, June 23 – On the eve of the International AIDS Conference in Durban (July 18–22), an exhibition of 17 quilts made by people affected by HIV told the story of what has been achieved since the last time the conference was held in South Africa in the year 2000.

TB/HIV Care Association unveiled quilts made as part of the larger international HIV Quilt Project, which is co-ordinated nationally by the South African National AIDS Council (SANAC), at an event at Haas Collective on Buitenkant Street on Thursday. The 2m by 2m quilts tell the stories of the people who made them – people involved in the organisation’s programmes, including people who inject drugs, sex workers and prison inmates, as well as those dedicated to supporting them.

All of the quilts will be submitted to the international HIV Quilt Project to be sewn on to the main quilt of more than 100,000 quilts from all over the world.

TB/HIV Care was only one of several organisations SANAC approached to create quilts to highlight the progress made in the response to HIV since 2000. At that time, antiretroviral treatment was not yet widely available in the country, stigma and discrimination were widespread and the outlook was bleak.

These quilts tell a very different story.

South Africa now has the largest antiretroviral treatment programme in the world, a mother-to-child-transmission rate of less than 2 percent and has witnessed an increase of more than 10 years in life expectancy over the past decade.

Zolani Barnes, ACSM Manager for TB/HIV Care, “Quilts have long been used as a medium for storytelling and these visual stories provide valuable insight into the lives behind the statistics.”