The Enhancing Care Foundation (ECF) says more health services are needed for South Africa’s lesbian, gay, bisexual, transgender and/or intersex (LGBTI) community amid concern that many remain unaware of their HIV status.
“The South African response to HIV/AIDS has mainly focused on programmes preventing heterosexual and vertical transmission of HIV. However, recent research has shown a disproportionate burden of HIV among Men who have sex with Men (MSM) and Transgender people. HIV prevalence rates of between 25.5 to 52.2% have been documented in this population with a general lack of access to confidential and appropriate LGTBI-friendly sexual health services. The Centers for Disease Control (CDC) published that 27.7% of transgender women tested positive for HIV infection but, alarmingly, up to 73% who tested HIV-positive were unaware of their status. We need specific tailor-made prevention packages that consider the complex and sensitive issues which these individuals face,”says the Foundation’s programme director, Dr Rosie Mngqibisa.
A recent dialogue on the issue by the foundation also raised concern over the stigma many in this group continue to face.
“I have to fight a lot of battles as a black and gender non-conformist in South Africa, such as limited access to health-care, the stigma and discrimination. I organised the dialogue as a platform for transgender and gender diverse people to come together, share experiences and possibly come up with innovative solutions for their day to day struggles. My dream is to alleviate all forms of discrimination against queer bodies even though I am aware that we still have a long way to go as South Africa is a culture and religion orientated country,” said ECF health facilitator and LGBTI activist, Nkokheli Mankayi,
Through funding from organisations like Right to Care (RTC) – Principal Recipients for a Global Fund for AIDS, TB and Malaria grant, the Enhancing Care Foundation implements activities addressing the HIV epidemic in South Africa and key population programme interventions in Cape Town.
“Experiences of LGBTI clients in South Africa’s public health sector have been troubling, and indicate a lack of knowledge and sensitivity in addressing the health issues of MSM and TG. This is mainly a result of the limited amount of research done on HIV in these key populations. The basics on HIV prevention and health promotion such correct usage of condoms and lubricants needs to be reinforced with this community. Our project intends to offer such support in safe spaces for MSM and TG, through door-to-door, street outreach, community partnerships, campaigns, events and social media/eHealth activations, through compassionate services and accurate information,”adds Mngqibisa.
Some of the key activities of the foundation include:
- Outreach and behaviour change communication
- Clinical services for STIs and Primary Health Care
- Commodity procurement and distribution
- Creating an enabling environment
- Community engagement
- Linkages to care, treatment and social services
The project has also been developed to include key areas of activities as follows:
1. Engagement with key stakeholders:
Identify, engage and collaborate with key stakeholders in Cape Town Metropolitan area including:
- The South African Department of Health – provincial and district Local NGOs
- Tertiary Institutions
- Sectors of Media, Sports and Recreation and Arts
- Local businesses
2. Identification of Hot Spots
- To identify MSM and TG ‘Hot Spots’:
- Review of mapping and epidemiological data will be conducted to identify these areas
- Engagement with stakeholders – Including the Department of Health – to assist identification of hot spots
3. Recruitment and continuous training of Peer Educators
- ECF uses community Peer Educators to drive the HIV Testing and Prevention Campaign.
- ECF training on the National HIV Testing Services Guidelines and Policy
- ECF coaching on soft skills to ensure that they create an enabling and non-discriminatory environment for the target population
- Additional training on Health Awareness and Promotion, Community de-stigmatisation and attitude change
4. HIV Testing and Prevention Mass outreach Campaign includes:
- Peer Educator in identified hot spots, venues and events to offer onsite HIV testing and prevention services. Door-to-door outreach will also be dispatched when relevant.
- Prevention services include distribution of pamphlets and other items and pre-packaged MSM and TG condom packs
- Extended working hours, including evenings, weekends and holidays. Our office will function as a drop-in centre for HIV testing for people who do not feel comfortable testing at campaign events
- Spend a minimum of one week per month conducting rural outreach.
- Continuous engagement with those we reach and test, via SMS and social media.
- Multi-Media Campaign to publicise services
- Explore innovative ways to reach and test MSM and transgender people in Cape Metro and surrounds
5. Linkage to care
- Identification of MSM/TG-friendly health care facilities within the Cape Town Metropolitan area
- Referral of all HIV infected, and those identified with STIs, TB and other OIs
- Conducting follow up activities for clients who are linked to care
SA LGBTI HIV Plan