Lesson from HIV counselling and testing drive

ABOUT 15million South Africans were targeted for HIV testing in the government's HIV Counselling and Testing (HCT) campaign, but the effort got slightly more than 10million people to test.

The campaign has challenged South Africans and the health system in significant ways.

The campaign has been described as ambitious. Never has any country in the world targeted such a huge population - 15million citizens to test for HIV - and had 10,2million people accepting the HIV test. But the campaign was not without any flaws.

There are reports that some of the tests were obtained in a manner that violated the human rights of people.

"We are hearing stories of people being tested without their consent," says Mark Heywood deputy chairperson of the South African National Aids Council, which is responsible for coordinating the HIV Counselling and Testing campaign.

Heywood says in carrying the campaign forward there needs to be systems to identify human rights violations as they occur and there also needs to be better education of health workers and the public around issues relating to human rights.

"If we are having a big campaign among rural people, what do we do to make sure that those people who test positive have support, that they are not isolated and victimised in their community? If we're targeting men who have sex with men we can't just test men who have sex with men for HIV," he says.

"We also have to be educating health care workers to make sure that clinics and hospitals are friendly - not discriminating against, not stigmatising men who have sex with men."

From April last year, the Health Department aimed to test 15million South Africans for HIV by this June. So far, the campaign has tested 10,2million people. This is out of 12million citizens who were counselled for HIV testing since the start of the campaign.

The enormity of the effort, which came into an already over-burdened health sector, has "tested the totality of the health system", says Dr Thobile Mbengashe, the chief director of the HIV and Aids and STIs unit in the national Health Department.

"We learnt that it is possible to provide ART services and provide quality using nurse practitioners who are actually trained to provide this. We had about 290 nurses who were actually qualified to provide ART. We trained and we have now 1700. Those are actually providing services in those health facilities which were not there. And all that was done during this time," Mbengashe says.

Heywood says: "This is learning as we go, it's about doing things differently.

"Some people might argue that you should not undertake a campaign like this at all until you are absolutely sure the system can support that sort of campaign."

Of the 10,2million people who tested for HIV in the campaign, about 1,7million were found to be HIV positive. About 1,4million people have been put onto the government's Aids treatment programme since April last year. But it's not clear as to how many are receiving treatment as a result of testing in this campaign.

The formal run of the HCT campaign officially ended in June. The Health Department is yet to communicate the final achievements of the campaign, which it says will continue being offered to encourage as many South Africans as possible to know their HIV status.

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