THE COJ RESPONSE TO HIV/AIDS
CITIES NETWORK MEETING
01 November 2004Meisie Lerutla & Khosi Mashego
Table of Contents
1. Background/Introduction2. HIV & AIDS Strategy – Workplace and
Community3. AIDS Plan – Goals:
3.1 Reducing New Infections3.2 Reducing the Impact of AIDS3.3 Organise the AIDS response
4. Partnership Against AIDS5. COJ – HIV & AIDS Plan 6. Factors Driving the Epidemic7. Progress to date8. Summary/Conclusion
1) Introduction/Background• AIDS Plan developed by
o Inter-sectoral Planning Teamo Regions/UAC’s/Departmentso Gauteng Health Department
• Plan addresses overall AIDS Plan for COJ and Civil Society sectors and the workers
• The AIDS Programme is located in 3 departmentso Health: community and clinicso Corporate: Workplace AIDS Programmeo Social Services: Welfare related issues
• Budget mainly drawn from COJ, GHD
2. Factors Driving the Epidemic
• Mainly heterosexual transmission
• Unemployment – 37% COJ residents
• High levels of Commercial Sex Workers (including child prostitution)
• Illiteracy – 7% COJ residents are completely illiterate, 29% of adults have matriculated
• Low status of women, women comprise 43% of the working population
• 42% of the population is under the age of 24
• High levels of STI’s
Factors Driving the Epidemic (cont..)
• Women infected at younger age than men (10 years earlier than men)
• Single sex hostels – 23
• 22% of Johannesburg residents stay in informal dwellings
• 65% of households are headed by one person
• There are only 35 cemeteries
3. HIV/AIDS StrategyMobilisation & Communication
PREVENTION
• Education• Services
CARE “COMPREHENSIVE CARE• Support of people with AIDS• Health Care Services• Affected families & Orphans• System for coordination &
referral
ORGANISATION OF THE AIDS PROGRAMME Workplace and communityAll departments & sectors
MUNICIPAL PROVINCIAL
HIV/AIDS Strategy(Cont…)
MOBILISATION & COMMUNICATION:
To mobilise involvement and increase understanding. Reaches workers and communities through training, cultural activities, campaigns, role-models, leadership and media. Communicates progress with the programme. The content reflects the key areas of the programme: Openness, Prevention and Care; The Partnership against AIDS.
HIV/AIDS Strategy (Cont….)
PREVENTION
Education – to change behavior:
• Youth Strategy: life skills in schools. Peer education for out of school youth and on campuses.
• Peer education for special risk settings (mining, hostels, sex-workers, prisons)
• Workplace Programmes - EAP
• Door to door education campaigns
• Prevention of substance abuse & sexual violence
Services – in support of behavior change
• STI management (syndromic management)
• Condom Supply (free male and female condoms)
• Voluntary testing with counseling (VCT)
• Reduce MTCT• PEP for needle-stick
and sexual assault
HIV/AIDS Strategy (Cont….)
Support of people with AIDS
• Community support (women, religious, civics, healers, workplace programmes)
• Support groups• Counseling and VCTHealth Care Services• Comprehensive care for
HIV/TB/AIDS- clinics & hospitals/OHASA
• PMTCT/ARV treatment • Palliative – Home Care &
Hospice Beds• Immune boosters
Affected workers/families & Orphans
• EAP/Social support• Orphan support -• Welfare grants & social
services• Indingency policy
water/housing services/food
• Poverty alleviation programmes
SYSTEMS FORCOORDINATION AND
REFERRAL
• CARE- “Comprehensive Care”
HIV/AIDS Strategy Organisation of the AIDS Programme (All departments & sectors)
MUNICIPAL• Mobilisation of workers
and communities• Coordinated plans• Monitoring of Services -
SDP• Data base of services• Tracking progress
PROVINCIAL• Leadership• Coordination• Capacity Building• Strategy• Provincial Plan• Policy• Guidelines• Research• Development• Monitoring & evaluation
ORGANISATION (roles & responsibilities)
4. Partnership Against AIDS•CCentre
PoliticalJAC
Official•HHealth•SSocial Services•CCorporate (OHASA)
•RRegions Ward Committees (Health)
Regional Coordinating Committees
Also:•H Health Precinct/COE (Hillbrow)•V Vusabantu (Mofolo)• Hostel Project (George Goch/Jeppe/Denver & MBA) – Private Hostels: LTA, Murray Roberts & SAP Hostels•D Domestic Workers
Wits/RHRU, GHDCity of ParisRHRU
CHB Perinatal Research Unit & SAMP (S.A. migration project)
Aims Aims
• To create a platform to review matters related to HIV/AIDS in the City of Johannesburg.
• To enjoin all the City’s inhabitants in the war against HIV/AIDS and to visibly demonstrate the City’s support for those infected and affected with HIV/AIDS.
• To actively review, monitor and evaluate the intersectoral response to HIV/AIDS in the City.
• To advise the City of Johannesburg on ways and means of improving impacts of the HIV/AIDS Programme.
JOHANNESBURG AIDS COUNCIL
FUNCTIONSFUNCTIONS• To assume an advocacy role that will highlight
(continuously) issues related to prevention and care of those infected and affected by HIV/AIDS.
• To support communication efforts around all issues related to HIV/AIDS that are disseminated by the HIV/AIDS and STI Programme around prevention and awareness.
• To contribute materially towards the training of “AIDS Activists”, Home based care initiatives and other outreach campaigns.
• To jointly plan and conduct major campaigns in a calendar year such as – valentine’s; candlelight; World AIDS Day, etc.
• To coordinate and strengthen the partnership with the Gauteng AIDS Council and the National AIDS Council.
JOHANNESBURG AIDS COUNCIL (Cont..)
5. COJ – PlanObjectives for 04 / 05
• To increase availability & accessibility of condoms community/workers
• To increase condom usage targeting vulnerable groups & areas
• To capacitate health professionals in the COJ so as to provide an effective HIV/AIDS & STI service
• To capacitate workers to deal with the epidemic/peer education & support
• To capacitate CBO’s, NGO’s in the COJ to support the implementation of the HIV/AIDS programme
• To promote & increase access to VCT on site testing• To promote effective coordination of HIV/AIDS activities• To create awareness & increase level of understanding in
the community• To mobilise the community involvement & strengthen
partnerships against HIV/AIDS & STI• To provide Regions with uniform policies, SOP’s & guidelines• To develop an effective, efficient monitoring & evaluation
strategy of the HIV/AIDS & STI programme
6. Progress to date
• Preventative Serviceso + 3 million free male condoms suppliedo STI services in 95% of clinics (syndromic
management)o PMTCT services all hospital and health centers
(large clinics)o PEP for victims of sexual assault in specialised
services (CHB;JHB; Hillbrow)o VCT services at 23 COJ clinics
• Workplace programme• Health care
o 90% of clinics have infrastructure to provide care for HIV infected persons
o Need to improve clinical training of PHC nurses and doctors in treatment of AIDS
o TB cure rates in COJ improving slowly but still high average (+56% cure rate)
Progress to date (cont…)
• Social impact of AIDSo Growing more problemso COJ has approximately ?20-25000/50,000 orphans
o Access to grants still a problemo Burials have increased o Hunger, poverty, abandonment, difficulties with
burials, social distress, school attendance Note: food parcels, free uniforms, school
nutrition programme (Provincial Govt)
7. ARV’s therapy in the management
of HIVCapacity needed
• Intensive training of health professionals (58) • Doctor support inadequate– prescription of drugs• Laboratory to monitor CD4 and viral loads• Pharmacy - reliable drug supplies, safe storage • Community education – public awareness,
understanding, compliance
NB. COE – An opportunity for training of staff
8. Review of the AIDS Strategy
• Well developed but needs proper, effective implementation with monitoring, evaluation and relevant research
• Institutional capacity in department, NGO’s and communities need to be developed rapidly
• COJ have large scale implementation programmes with GHD – but needs stronger, better coordination and communication of the AIDS effort across and within department
9. AIDS Plan 2004-2006
• Reduce new HIV infections & the overall HIV infection rate
• Reduce the impact of AIDS on people living with HIV, their families & society as a whole
• Organise an effective AIDS response involving all government departments & civil society sectors
AIDS Plan 2004-2006 (cont…)
• Reduce the impact of AIDS on people living with HIV, their families (and society)
• Increase openness on AIDS• Provide access to
comprehensive TB/HIV/AIDS care in 100% of local areas
• Strengthen health systems management
• Assess the feasibility of adding ARV treatment to the package of AIDS care
• Extend access to comprehensive orphan support services to 100% of local areas
• Increase access to poverty relief
• Develop methodology for monitoring & evaluation of comprehensive care
AIDS Plan 2004-2006 (cont…)
• Organise an effective AIDS response involving all government departments & civil society sectors
• Organise all departments & sectors in a Partnership against AIDS
• Monitor & evaluate implementation of the AIDS strategy
• Strengthen capacity of departments & society sectors. Strengthen Workplace AIDS programme
• Establish local Inter-Sectoral AIDS programmes
• Coordinate & communicate the AIDS programme
AIDS Plan 2004-2006 (Cont...)GOALS• Reduce new HIV
infections & the overall HIV rate
OBJECTIVE• Improve understanding of
HIV risk, transmission & prevention amongst youth & general public & workers
• Reduce risk behaviour through implementing effective educational programmes for specific groups:o Youth o People in special risk
settingso Workplace AIDS
Programmes• Provide accessible, effective
serviceso Free male condoms/some
female condomso An STI service
10) Conclusion• Workplace Programme- All departments (and UAC’s) have HIV/AIDS
“champion”- Intensive programme in all Council Departments (and
UAC’s) familiar with workplace policy- Anonymous (voluntary) testing programme to all
Council employees (politicians and workers)- Availability of ARV’s to staff memebrs who disclose
(note confidentiality issue!)- Develop/strengthen EAP (employment Assistance
Programme) in COJ• Social Development- Strategic Plan for COJ to address issue of orphans,
(orphanages) child headed household- Improve community programme