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Sensitivity Training

Key Populations Integrated Sensitivity Training Programme

Key Populations Integrated Sensitivity Training Programme

The Key Population Research Department leads the development of a health care worker sensitization training manual and programme focused on supporting health care workers in providing better services to not only MSM but also sex workers and people who use drugs.

The manual was developed in order to support the sensitization of health care-workers who are providing services to key populations.

In this manual we focus on men who have sex with men (MSM), sex workers (SW) and people who use drugs (PWUD). These people are often stigmatized, excluded from society, and some of their behaviours may be illegal. These factors contribute to their vulnerability to HIV.

MSM, sex workers, and PWUD in Africa experience a disproportionately high burden of HIV but face multiple barriers when accessing health care. The provisional Operational Guidelines for HIV, STI, and TB Programmes for Key Populations in South Africa identify health care worker sensitization training as an essential intervention to address these barriers. Health workers sensitized around the issues affecting MSM, SW and PWUD will be empowered to appropriately engage with other key populations. Future training material and tools for other key population groups are planned. The manual was designed as part of a full sensitization training programme, but can also be used as a stand-alone resource.

To download pdfs of the manuals, click on the links below:

Key Populations Integrated Manual
People Who Inject Drugs & Other People who Use Drugs Sensitivity Training Manual
Sex Workers Sensitivity Training Manual
MSM Sensitivity Training Manual

The full training programme includes audio-visual material, mentoring, and in-person training. This programme is now being implemented by the Department of Health in South Africa nationally.

The Tutu Tester

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The Tutu Tester mobile unit provides a free comprehensive health service to under serviced communities. It is in the field daily offering nutrition and healthy life-style education, HIV counselling and testing, point of care CD4 testing, screening for tuberculosis, and a range of general health screening tests. The aim is to improve the health of individuals in vulnerable communities and to normalise HIV testing.

The project is in line with the National Department of Health Health Sector Strategic Framework that includes:

  • Accelerated implementation of the HIV & AIDS and Sexually Transmitted Infections National Strategic Plan 2012 – 2016
  • Mass mobilisation for a healthier population

Since the unit’s inception in May 2008 almost 40 000 individuals have been seen by the dedicated Tutu Tester team; 30 – 50 people are seen each day.  Philip Smith is the project coordinator and Jacqui Dalimore is the nurse practitioner in the field with her team of three counsellors, a driver, and an enthusiastic intern from the US.

The primary focus of the project is to reduce the risk of HIV acquisition and transmission in all tested clients irrespective of positive or negative HIV status. The unit has covered many areas servicing the public at transport hubs, farms, factories, hotels, gay bars, and sporting events to name a few.   Currently the unit is operating in the Mitchells Plain/Klipfontein substructure at the request of the local health department.    The team plays an important role in linking patients who need care to public health services, following up with cell phone calls where necessary.

Clients register at the unit through a finger print biometric system ensuring confidentiality.   A Pima analyser measures the CD4 count of clients who test HIV positive giving a result within 20 minutes. The latest innovation is a GeneXpert machine donated by the Life Healthcare Foundation.   This is fitted into the Tutu Trailer towed by the Tutu Tester.  This diagnostic machine gives a rapid, accurate diagnosis for tuberculosis; altogether making the Tutu Tester an efficient and effective one-stop-shop for clients.

The President’s Emergency Plan for AIDS Relief (PEPFAR) and Agénce Francaise Developpment provided the funds to build the unit and Metropolitan Health assisted with running costs for the first years.

We are proud that the service is now South African funded through a new partnership with Metropolitan and Discovery Health. We are most grateful to both companies for their commitment to public health enabling this vital service to continue.

We are actively seeking additional partners for the on-going support of this project.

Tutu Treater

The success of the Tutu Tester piqued the interest of the Rotary Club of Claremont. Together with the Rotary Club of Kirkkudbright, Scotland they funded building the Tutu Treater with the purpose of reaching communities in the rural areas of the Western Cape.

The DTHF does not have the infrastructure to run a distance project so we happily gave Right to Care, a non-profit organisation in the Hermanus area, the opportunity to operate the Tutu Treater in the Overberg.

This project continues and has been favourably received by the farming community

Adult HIV Educational Programme

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The manual for this distance learning course for doctors and nurses was updated in July 2015 to reflect the latest policies and guidelines on ARV treatment. The aim of the programme is to improve the care of men and women who are infected with HIV in all communities of South Africa.

Although the programme was written as a distance learning course for both doctors and nurses, it may also be useful in the training of medical and nursing students as well as counsellors who educate and mentor patients commencing antiretroviral treatment.

The authors of the Adult HIV Education Programme consist of doctors and nurses who have an active interest in the management of adults with HIV. This ensures a balanced, practical and up-to-date approach to clinical problems.

Many colleagues at other South African universities and health services were also consulted with a view to reaching consensus on the management of most adult HIV problems. Every attempt has been made to comply with current national management protocols.

The training manual consists of six modules covering all aspects of patient care and antiretroviral management.

Topics include HIV testing and staging, the management of HIV-infected adults at primary-care clinics, preparing patients for antiretroviral treatment, ARV drugs, side-effects and drug interactions, starting and maintaining patients on ARV treatment, adherence, resistance and treatment failure and an overview of important opportunistic infections.

It includes case studies and has a multiple choice question and answer self-assessment component. It is a practical guide that is intended to provide primary health care workers, either individually or studying together in groups, with the knowledge they need to manage patients infected with HIV efficiently and effectively.

The course can be studied alone or in small groups managed by a course convener. The training manual costs R220.00 incl vat and can be ordered from Bettercare at info@bettercare.co.za. It is also freely available online at the Bettercare Learning Station.

Participants can be examined for certification and 18 CPD points are awarded for doctors who achieve the 80% required passmark in an invigilated Bettercare Adult HIV exam.

Sizophila Counselling Programme

SizophilaThe Hannan Crusaid Treatment Centre is situated at the Gugulethu CHC.  It is a primary health care ART programme which was established in 2002 by the Desmond Tutu HIV Foundation and the Western Cape Provincial Department of Health with the assistance of a UK charity, Crusaid through a donation bequeathed by Katy Hannan.

From the start of the ART programme, the DTHF initiated an innovative adherence strategy called the Sizophila Project.  Sizophila which means “We shall Survive” in Xhosa, was started to provide education and support for patients on TB and ART through the provision of individual counselling, group training sessions and home visits.

This programme employs 7 facility counsellors and 18 adherence community care workers most of whom are undergoing HIV treatment themselves. These lay workers are able to empathize with the fears and concerns of their patients and are living proof that the HIV and TB drugs do work.  The Sizophila counsellors were recruited and initially trained by the DTHF Training Department to provide the following services: treatment readiness assessments, treatment preparedness education and treatment support though conducting home visits.

The Sizophila model formed the basis of the adherence support system for the TB/ART integration project which was piloted at the Nyanga CHC. In 2011, this model was incorporated in the Western Cape policy document on Integrated TB/HIV Community Adherence Support.

In 2008 the Sizophila Counsellors were recognised for their outstanding work and received the Plantinum Impumelelo Award for their exceptional commitment and contribution to the community of Gugulethu.

Family Planning Integration

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Improving family planning services for people living with HIV in the Western Cape Province

The Family Planning Integration into HIV Care and Treatment Services (FPI) project aims to increase the uptake of effective family planning (FP) services and improve contraceptive coverage to reduce unmet FP needs, and the number of unintended pregnancies among people living with HIV in the Western Cape.

Through intensive workshops, onsite mentoring and support, and distribution of educational materials, the FPI project is enabling doctors, nurses and NGO counsellors at HIV treatment and wellness clinics to address clients’ FP needs during routine HIV consultations, thereby ensuring integration of the two services for the benefit of the client.

The FPI project emphasises the need for healthcare providers to:

  • Create a space for clients to make their own informed family planning choices.
  • Promote long-acting reversible contraceptive (LARC) methods such as Implants, Intrauterine Devices (IUDs) and injectables which are prioritized by the Department of Health.
  • Stress the importance of consistent, dual protection (using condoms in addition to a non-barrier method) for all clients as a way to prevent unintended pregnancy and Sexually Transmitted Infections (STIs), including HIV.
  • Prioritise the promotion and use of emergency contraception.

Who is involved?

The FPI project is a partnership between the Desmond Tutu HIV Foundation, the Western Cape Department of Health and the University of Cape Town’s School of Public Health and Family Medicine. The initiative is funded by the Department of International Development’s Global Poverty Action Fund in the UK.

A successful pilot

The FPI project is a three-year project which launched in September 2012. It was successfully pilot tested at HIV care and treatment clinics in urban Klipfontein and Mitchell’s Plain, and in the rural Overberg.

As a result of its overwhelmingly positive preliminary results, Provincial Department of Health officials approved the initiative in May 2013, to roll out to other HIV care and treatment clinics in the Western Cape.

The FPI project model also became an integral component of the Women’s Health Directorate’s, Contraception and Fertility Planning Programme to further contribute towards strengthening contraceptive services.

Key FPI project achievements

  • 682 health care providers have been trained and the majority have the knowledge, attitude and skills to implement family planning during HIV care and treatment consultations.
  • 58 clinics are now offering family planning service along with HIV care, making it more accessible to people living with HIV, and data shows an increase in the number of clients who are happy with the quality of the FP received.
  • Approximately 100,000 clients have been reached through educational FP talks, posters and pamphlets.
  • At a provincial level, the FPI project has been incorporated into the 2013 / 2015 Western Cape Department of Health Contraception and Fertility Planning Programme as a direct result of the impressive results of the FPI project to date.
  • The contraceptive prevalence rate among couples seeking services in the FPI project target areas increased from 48% in the period between March 2012 to April 2013 to 62% in the period April 2013 to January 2014. This success can be jointly attributed to the FPI project and the provincial Department of Health’s efforts to prioritise FP services.

Find out more about this project:

What’s next for the FPI project?

  • The FPI project will be rolled out in other health districts of the Western Cape Province.
  • The FPI project will be developed into a replicable model that could be implemented in the other provinces in SA.
  • Ongoing monitoring and evaluation is vital to the success of the project.
  • On-site support will continue to be provided to sub-structures and districts
  • An FPI Master Trainer training package is to be developed and offered to all provincial family planning trainers during the first quarter of 2015.

Watch this website for updates on the FPI Project…

Desmond Tutu HIV Centre: Postgraduate Diploma in TB-HIV Medicine

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The Desmond Tutu HIV Centre, in collaboration with ICAP-SA and UCT are proud to present the first online postgraduate qualification from the Faculty of Health Sciences: the Postgraduate Diploma in TB-HIV Management.

Healthcare practitioners in primary care, are faced with complex TB/HIV cases on a daily basis. Thus comprehensive knowledge of TB/HIV is essential to effectively manage the large case-burden attributed to these diseases.

The postgraduate diploma aims to provide doctors and nurse practitioners with the comprehensive knowledge needed to manage HIV and TB infected patients at a primary level setting, in line with the latest South African national guidelines and best practices.

In response to the unique needs of an adult health-care practitioner working in a busy clinic outside of urban areas – this diploma is designed for online learning in the comfort of one’s own home, after the busy work day is done.  With no need to travel far distances for physical lectures, the student can access the engaging and interactive course content from their laptop over the internet, at a time that suits them.

The diploma consists of four online training courses:

Year 1

  • Clinical Management of HIV (Semester 1)
  • Clinical Management of TB ( Semester 2)

Year 2

  • TB/HIV Co-infection (Semester 1)
  • Operational Research (Semester 2)

There is also a Biostatistics component at the end of year 2.

These courses are also open to be taken as stand-alone courses for those students not wanting to complete an entire diploma.

Overview: Clinical Management of HIV Course

Topics covered: Epidemiology of HIV; Overview of HIV diagnostic tests; HIV testing & counselling in adults & children; Common opportunistic infections; ARV drugs & lifecycle of HIV; Initiating and monitoring ART in routine patients & patients with co-morbid conditions; Recognising & managing ART resistance/failure & treatment interruptions; Drug toxicity & management; Immune Reconstitution Inflammatory Syndrome.

Overview: TB/HIV Co-infection Management Course

Topics covered: TB/HIV Integration; Isoniazid Preventive Therapy (IPT); Initiation of TB Treatment; Initiating ART in Patients Already on TB Treatment; Drug Interactions between Rifampicin and ARVs; Treatment of Drug-resistant TB/HIV co-infection; Considerations for Combined TB Treatment / ART Use in Special Populations; Monitoring the Co-infected Patient; Management of Common Adverse Drug Reactions; TB-IRIS; Clinical Deterioration of HIV-positive Patients on TB Treatment; Management of Non-tuberculosis Mycobacteria / NTM.

Overview: Clinical Management of TB Course

Topics covered: TB diagnosis in adults & children, TB contact management, Signs & symptoms of TB in adults & children (including extra-pulmonary TB), Treatment & management of drug-sensitive & drug-resistant TB in adults & children, Treatment of extra-pulmonary TB, Treatment of Non-Tuberculosis Mycobacteria, and Monitoring of TB therapy.

Overview: Operational Research Course

Topics covered: Introduction to Operational research; Study designs; Error, Bias and Confounding; Data collection & Data Management; Research Ethics; Framing a research question; Writing a protocol; Choosing populations and sampling; Practical Implementation; and Writing Skills.

For more information please refer to the Faculty Handbook

To apply online please click on Online Applications

Should you require any further information, please contact the Academic Facilitator – Melissa May-Slabbert.

Email: Melissa.Slabbert@hiv-research.org.za

The diploma is  funded by the Centre for Disease Control and Prevention (CDC), USA and offered in partnership with the International Centre for AIDS Care and Treatment Programs (ICAP) – Columbia University, USA and the University of Cape Town (UCT), South Africa.