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OIG Representatives visit CPUT

Representatives from the Office of Inspector General (OIG) for the US Government are currently being hosted at TB HIV Care’s Head Office in Cape Town.  Their role is to conduct audits linked to work completed in COP16 and COP17 under the PEPFAR (CDC) grant.  The OIG is keen to witness outreaches, conduct site visits and gain insight into processes as part of the 3-week audit.

On Wednesday, 23 January, Jafar A Ballard and Diani Popoca, both senior auditors, accompanied Dr Gareth Lowndes (COO) to the Atlantis VMMC site.  The site played a crucial role in assisting TB HIV Care exceed VMMC targets (162 400) in COP16.  The site visit provided an opportunity to discuss the benefits of Voluntary Medical Male Circumcision, associated process flow and data reporting.

A week later, on the 30th of January, the OIG joined Gareth Lowndes at the Cape Peninsula University of Technology (CPUT). In partnership with the Department of Education, THC has been complementing CPUT wellness initiatives for about ten years. There are usually four interventions annually and this visit was aligned to orientation week (O-Week).

CPUT has approximately 35 000 students across ten campuses, and the target is to test a minimum of 10% of those students annually.  Sr Bonita (CPUT HIV/Wellness coordinator) estimated the HIV incidence on site was 4%.  The TB HIV Care crew provided HIV testing, TB-screening, PrEP education and condom awareness/distribution on the day. The Department of Social Development was there to talk about gender-based violence and drug use in communities.

The OIG team interacted with TB HIV Care staff, three PrEP ambassadors, as well as CPUT students.  OIG took the opportunity to ask a number of questions, including why students wanted to test for HIV, why they are considering PrEP and their knowledge and experience of HIV within the South African context.  Of eleven young women attending an HIV briefing, seven had previously tested for HIV and knew their status. It was fantastic to see curious students milling in and around the TB HIV Care gazebos and mobile clinic, asking questions, chatting to our team and accessing services. Thank you!

Minister of Health visits TB HIV Care’s Drop-in Centre in eThekwini

Submitted by: Mfezi Mcingana (Key Populations Programme Manager)

TB HIV Care’s Drop-in Centre in eThekwini provides support, healthcare services and treatment to sex workers within our community.

Over the years we have worked hard to ensure that the centre is a safe space for sex workers, where their needs are met and their voices are heard. On the 10th of January 2019, we were able to allow sex workers the chance to voice their fears and daily challenges to a delegation of government representatives.

In attendance were the Minister of Health, Dr Aaron Motsoaledi, Deputy Minister of the South African Police Services (SAPS), Bongani Mkongi, KZN Health MEC, Dr Sibongiseni Dhlomo, CEO of SANAC, Dr Sandile Buthelezi, police and Department of Health representatives, civil society and the sex worker community. Aiming to eliminate violence against women in general and sex workers in particular, this dialogue had our centre filled to capacity with sex workers who had come to engage with the government and SAPS about their grievances.

The pain and suffering of the community was visible as they took full advantage of the opportunity provided to voice their fears and discuss the hardships that they face on a daily basis (at times as a result of police brutality).

In his address, Dr Motsoaledi highlighted that in eThekwini, the Department of Health is working closely with TB HIV Care, Global Fund and PEPFAR to provide services to the sex worker community, noting that “they are not only providing additional services through mobiles, but are also assisting the department to improve the services that we provide in public clinics.”

He told the audience that “we are testing a fair number of sex workers, but are still not reaching everyone”. He also reiterated that those individuals that are testing negative and are being offered PrEP, are not accepting the service even though they know it will prevent the transmission of HIV.

He highlighted the fact that of all those individuals that test positive, only 55% are on ARVs.  He went on to say that ARVs are “good for the health of people living with HIV and one can enjoy a long healthy life if one continues the medication. However, we also know that those that take their medication are virally suppressed and will not transmit the virus to others.” Dr Motsoaledi went on to say that “it means that we have to work harder to test for HIV and STIs and screening for TB.  Everyone gets access to contraceptives and when one tests positive they are placed on treatment immediately. Secondly, it means consistent use of condoms and if offered, use of PrEP for the duration of the practice of risky sexual behaviour.” The Minister of Health therefore humbly requested that sex workers encourage their colleagues in eThekwini and elsewhere to get tested regularly.

The Minister of Health (MOH) acknowledged that sex workers experience much stigma and discrimination, both at the hands of health workers and some members of SAPS. The Deputy Minister of SAPS and the MEC are working together to ensure that sex workers are not abused by the system.  He encouraged sex workers to report any form of abuse.

In his conclusion, the MOH spoke about drug use. He stated that he understands that many sex workers use drugs to cope with their work and working conditions. However, this increases the chances of violence as well as HIV transmission and forgetting to take medication like ARVs and PrEP. In addition, some sex workers also inject drugs and we know that sharing of needles is the cause of transmission of both HIV and hepatitis. He asked that    “you don’t share needles if you are injecting drugs – rather come to TB HIV Care and request needles and ensure that used needles are disposed of safely, as this can be another major challenge if they are left lying around on the ground. I am sure that colleagues from TB HIV Care will say more about how to deal with these issues safely.”

Massive congratulations to everyone involved!

The 2018 Global State of Harm Reduction Report

The Global State of Harm Reduction Report (2018) has just been released – it shows progress and challenges around accessing evidence-based interventions for people who use and inject drugs, including needle and syringe services and opioid substitution therapy, including progress and challenges in South Africa and work done by TB HIV Care, OUT, Anova and COSUP.

The Chapter on sub-Saharan Africa is accessible here.

The full document is at: https://www.hri.global/files/2018/12/11/global-state-harm-reduction-2018.pdf

It includes many of the positive developments and remaining challenges in South Africa.