What we do
TB HIV Care’s programmes are designed to prevent, find and treat TB and HIV.
Ultimately, only prevention will bring an end to the global HIV and TB epidemics. The UNAIDS HIV Prevention 2020 Road Map (which aims to reduce new infections by 75%) requires that all people at risk of HIV infection have access to comprehensive HIV prevention services. TB HIV Care works hard to answer this call, and focuses on the following prevention strategies:
Condoms are still the most effective way of preventing HIV and other sexually transmitted infections (STIs). Distributing condoms, and explaining the importance of correct and consistence condom use is an important part of the work that we do. In the past year, TB HIV Care distributed more than 16 million condoms. We also run campaigns promoting condoms (for example, on Valentine’s Day) and produce materials to encourage and inform people about condoms.
Voluntary Medical Male Circumcision (VMMC) is a procedure that reduces a man’s chance of contracting HIV from a female partner by up to 60%. Since 2007, the World Health Organization (WHO) has recommended VMMC as an important prevention strategy, particularly in countries with high HIV prevalence.
A one-time intervention, VMMC provides men life-long partial protection against HIV as well as other sexually transmitted infections. TB HIV Care works hard to educate men (and their female partners) around the benefits of VMMC as well as providing the actual procedure at healthcare facilities or specialised wellness centres in the Western Cape, Eastern Cape and KwaZulu-Natal.
Pre-exposure Prophylaxis (PrEP)
Pre-exposure prophylaxis (PrEP) is a new, safe, HIV prevention method for HIV-negative people. PrEP pills, if taken daily, can reduce the risk of HIV by more than 90%. As a prevention strategy, PrEP is particularly valuable for high-risk groups, including men who have sex with men (MSM), sex workers and adolescent girls and young women (AGYW).
TB HIV Care offers PrEP to sex workers at our eThekwini, uMgungundlovu and uMkhanyakude sites and is now rolling out PrEP to young women in the general population too.
Over a third of all new HIV infections come from the 15 – 24 year age group (HSRC National HIV Prevalence, Incidence and Behaviour Survey) and the incidence among young females is three times higher than their male counterparts. This makes AGYW a high-risk group, requiring urgent attention.
Information, Education and Counselling
Myths and misinformation around both TB and HIV still persist. Knowledge is power. And although knowledge alone may not mean that people adopt safer behaviour, educating people on TB and HIV and counselling people on their options can assist in changing behaviour.
TB HIV Care’s counsellors inform and counsel clients pre-testing, help clients create a risk reduction plan tailored to them and their HIV status post-testing – as well as providing information around other health issues (including, TB, STIs, hypertension and diabetes).
Many of our programmes also train peer educators, who are well-positioned to provide information, support and affect behaviour change.
The first step in providing care for people with HIV or TB is to find them. For this reason, TB HIV Care is committed to a highly successful testing and screening programme.
TB HIV Care’s strategy is to test and screen people where they are, whether at a clinic, taxi rank, workplace, farm, high school or university. TB HIV Care has both facility-based counsellors (i.e. in clinics or hospitals) and mobile teams that can move around in the community. The mobile teams use customised caravans, mobile units and gazebos to ensure a client’s comfort and privacy.
TB HIV Care has now conducted more than two million HIV tests. But our testing services also offer a range of wellness services, including screening for TB, STIs high blood pressure and diabetes.
Once a person has tested positive for either HIV or TB it is important that they receive the appropriate treatment and care – as soon as possible. TB HIV Care is dedicated to linking clients to care and supporting them to adhere to their treatment where necessary.
Treatment is also an important part of prevention. An HIV positive individual, who is adhering to their treatment and virally suppressed (has an undetectable viral load) has almost no chance of passing on the virus. Antiretroviral therapy (ART) allows individuals to reduce their viral load, take control of their health and enjoy a normal life expectancy.
TB patients also benefit from early intervention. And although TB is infectious, once a patient has been on treatment for two weeks, they are no longer infectious and can return to work and everyday life.
Unfortunately taking treatment can be a difficult journey. People living with TB take treatment for at least six months (with drug-resistant TB requiring up to two years of intensive treatment), while those who are HIV positive or living with other chronic diseases, must take treatment for the rest of their lives. Having support can make the difference between continuing treatment or stopping.
TB HIV Care provides this support through facility-based staff and community health workers (CHWs) – who are often an invaluable link between clinic and client.
TB HIV Care’s goals and targets are aligned to the collective 90-90-90 targets set by UNAIDS in 2014, whereby 90% of all people living with HIV know their status, 90% of all people diagnosed with HIV receive sustained antiretroviral therapy and 90% of all people of on antiretroviral therapy achieve viral suppression.
All our programmes aim to achieve this – while establishing best practice in terms of identifying, treating and supporting all those at risk. This includes people in the general population or in key populations (for example, inmates and officials in correctional facilities, people who use drugs and sex workers), because, most importantly, all our programmes answer the call of goal three of South Africa’s National Strategic Plan on HIV, STIs and TB – that no one is left behind.