Living with HIV in South Africa: Support Groups that Promote Health

SA Partners is working on an exciting initiative to support individuals newly diagnosed with HIV. By offering Healthy Living Support Groups linked to Counseling & Testing sites, SA Partners is addressing a need for information that can help individuals delay the need for medication. Additionally, the groups keep individuals in dynamic contact with health facilities capable of offering medical attention, should they need it.  Support groups are being organized in five health districts of the Eastern Cape: Cacadu, Chris Hani, Ukhahlamba, Alfred Nzo and the Nelson Mandela Bay Municipality.  The initiative has grown out of our partnership with the Eastern Cape Department of Health, the Masihlanganeni Network of People Living with HIV/AIDS (MANEPHA), and JRI Health.  Funding is provided by the NASTAD Global Program with Emergency Plan (PEPFAR) funds provided by CDC South Africa.:

The target population for the support groups consists of newly diagnosed HIV positive individuals. Currently, approximately 70 percent of newly diagnosed people living with HIV (PLHIV) fail to attend his/her follow-up medical appointment. This high percentage poses grave consequences, as loss to follow-up can cause increased morbidity and mortality. When ARV treatment is accessed when someone is severely ill, there is a poorer prognosis once on ARV treatment.

Healthy living support groups will fill a real need.  Limited human resources in South Africa often restrict the provision of comprehensive care services; limiting care to symptom management.  At the same time, referral systems are weak and there is an overarching need to empower local communities to increase their participation in health care delivery.

The support group initiative is part of a Basic Care Package program being developed by the South African National Department of Health in partnership with CDC South Africa. The groups will assist newly diagnosed individuals tackle important issues such as the acceptance of HIV status, disclosure, prevention with positives, opportunistic infections, adherence counseling, treatment literacy, and nutrition assessment and counseling.

Acceptance of status represents the first step in empowering PLHIV to take charge of their health. Disclosure builds a support base for the individual, strengthens the relationship between health care providers and family, builds a base for adherence support, helps de-stigmatize HIV, and encourages partners, family and friends to get tested.

The session on “preventions with positives” stresses the need for PLHIV to practice safe sex; reducing secondary prevention, highlighting dual protection and family planning options, emphasizing primary prevention, focusing on symptoms of TB, and emphasizing prevention of other sexually transmitted infections.

Opportunistic infections are covered in another session, examining the definition of opportunistic infections (OIs), common OIs, simple TB screening tools, treatment of opportunistic infections (prophylaxis), and the importance of keeping appointments. Sessions will also focus on issues such as treatment literacy and adherence, which addresses progression of the HIV disease (what to expect) and AIDS, treatment options for HIV infection, CD4 count and viral load, adverse drug events, reporting adverse drug events, and treatment adherence.  Other areas of focus include nutrition & infection, nutritional support, assessing nutritional needs, and the preparation of food.

To kick-off what will eventually become a national program, SA Partners is facilitating a pilot project in which 15 MANEPHA members are being trained as support group leaders working within 15 local service areas of the Eastern Cape.  A Support Group Coordinator will serve as liaison to the Counseling & Testing sites, while providing clinical supervision for the support group leaders.
 
SA Partners is excited to be playing a role in developing these support groups, which will certainly foster an empowered community of people living with HIV and AIDS.  Additionally, the Healthy Living Support Groups will provide PLHIV with access to valuable information and support to ensure that they live a healthy and prolonged life through accessing health care in the early stages of HIV infection.