Presentation by Thato Chidarikire at the National Sex Work Symposium, in the second session of Day1; 'Recommendations for South Africa' (Boksburg, 22 August 2012).

1. Update on the development of
the HIV prevention plan for key
populations in SA
National Department of Health
Thato Chidarikire
22 August, 2012

2. THE SOUTH AFRICAN EPIDEMIC
• Generalised epidemic with several
concentrated epidemics.
• 5.6m people are HIV positive (total population
is 50m)
• 30% prevalence among women using ANC
clinics
• 17% prevalence in the general population
2

3. Key Populations in South Africa
• Key Populations include truckers, men who have
sex with men (MSM), female sex workers
(FSWs), long haul truck drivers, IDUs, prisoners
etc
– 9.2% of and 19.8% of new HIV infections are
related to MSM and Sex work respectively
• Since the beginning of the epidemic, key
populations have been disproportionally
affected by HIV.
• To date services have failed to address the needs
of these individuals
• The National Strategic Plan (NSP) on HIV, TB and
STIs (2012 - 2016) outlines the need for
interventions targeted at key populations

4. South Africa National Strategic Plan for HIV,
STIs and TB - 2012-2016
• Built around a 20-year national vision of “Zero new
HIV infections”
• Reduce new HIV infections by at least 50% using
combination prevention approaches
• Ensures an enabling and accessible legal framework
that protects and promotes human rights
• Emphasis on evidence-based planning and
prioritization of interventions for implementation
• Recognition that HIV services should be provided for
Key Populations based on risk and need
4

5. HIV Prevention Strategy
• Still under development
• Recommends a minimum package of combination HIV
prevention service for key populations is South Africa.
• This includes HCT/PICT, syndromic management of
STIs, promotion, MMC provision, demonstration and
distribution of male and female condoms, peer
education and referral to health services to accessible
facilities.
• Scaling up services adequately for key populations is
essential to halt and reverse the epidemic at a
population level.

6. Objectives of the Prevention plan
• Provide guidance on developing,
implementing, monitoring and evaluating
HIV/STI/TB programmes for key populations
• Present evidence informed programmes in a
user friendly manner to allow for programme
implementation and making progress towards
the NSP targets.

7. Target Users
• The primary audience is provincial, district and
facility health planners and managers.
• The secondary audience includes service
providers (doctors, nurses, counsellors,
community outreach workers).

8. Progress to-date
• 28 September 2011: Meeting of key stakeholders to discuss how the development of national guidelines for key
populations could address some of the recommendations of the Key Populations Key Solutions gap analysis (2011).
– At this meeting, organizations serving and representing key populations endorsed the concept of developing national
guidelines and volunteered to join a TWG that would begin drafting guidelines.
• 14 December, 2011:National Department of Health (NDOH) hosted meeting with relevant stakeholders to
discuss way forward with regards to support for key populations in the country.
– Recommendation to form a technical working group to focus on the needs of key populations, map the available services and
develop a national guideline for key populations.
– Concept note drafted
• 12 March, 2012 : TWG meeting was convened at the NDOH to discuss the concept, proposed timeline and draft
outline of prevention, care and treatment guidelines for key populations.
– The need for a consultant to provide technical and logistical support to this process was raised, and in April, Andrew Schiebe
(Desmond Tutu HIV Foundation) was brought on board (funded through ICAP-Columbia/CDC) as a temporary consultant to
assist with the development of the National guidelines.
• April 24, 2012: NDOH convened the second TWG meeting to monitor and discuss progress and to introduce Andrew
to the group.
– The writing teams of the various chapters discussed their progress and challenges;
– It was decided that a writer be nominated for each group to ensure adherence to deadlines;
– It was agreed that the participation of SANAC is essential and will be actively engaged in this process
• 30 April 2012: Jabulile Sibeko, Technical Officer for Key Populations was seconded to the NDOH under the
supervision of Ms Eva Marumo. (funded through FHI 360/Bill and Melinda Gates Foundation)
– Ms. Sibeko’s priority tasks are to support the development of the national guidelines for Key Populations and be the liaison
between NDOH and the TWG in this regard.

9. Progress to-date cont.
• 1 May, 2012: Draft 1 developed
– Guideline s circulated within steering committee.
• 29 May, 2012: Draft 2 developed and circulated for external peer review
– 24 Peer reviews
– Peer reviewers included local and international representatives from civil society organisations, academia
and development agencies.
• 27 June, 2012: Draft 3 developed
• 11 July, 2012: TWG workshop to improve guidelines and brainstorm improvements
• 26 July, 2012: Draft 4 circulated, 2nd round of peer review
– Circulation to National and Provincial Department of Health, including HTA and HAST coordinators
– Circulation to external peer reviewers
• 1 August, 2012: Regional Stakeholder Consultation in Pretoria
• 6 August, 2012: Regional Stakeholder Consultation in Pietermaritzburg
• 8 August, 2012: Regional Stakeholder Consultation Cape Town
– Stakeholder engagement and workshopping on guidelines, incorporation of input

10. Next steps
• Integration of consultations (underway)
• Integration of peer comments (underway)
• Draft 5 complete and circulated 27 August 2012
• Target user focus group in Free State 3 Sept 2012
(planned)
• Development of Quick guideline
• Refining, editing, layout and design (Sept)
• Printing & launch (end of Sept)