The wrath of HIV and AIDS has devastated communities across South Africa, rendering approximately 5.4 million people HIV positive. This highlights the necessity to invest in prevention and treatment of HIV and AIDS.
Humana People to People in South Africa (HPP SA) is actively involved in the fight to turn around these statistics through its HIV and AIDS prevention, care and support programme known as Total Control of the Epidemic (TCE). TCE was first implemented in 2000 in Southern Africa. HPP-SA currently operates 19 successful TCE Areas (reaching 1,900,000 people) in South Africa, and has successfully completed 8 TCE areas.
What is TCE?
Founded on the ethos that “Only the people can liberate themselves from HIV”, Total Control of the Epidemic (TCE) is a unique and systematic approach to empower communities to fight the challenges of HIV and AIDS and TB, with the aim of reaching every single person in an operational area of 100,000 people (100, 000 people = 1 TCE Area) through door-to-door campaigns, individual counselling, and community mobilisation.
It involves recruiting and employing community members and training them as peer educators and counsellors responsible for carrying out a campaign of community sensitization about, and mobilization against, HIV and AIDS.
This systematic intervention reaches every single person within a target area with information, education, counselling and mobilization to take control of HIV and AIDS.
Equipped with a map, a household register, an individual assessment tool (PES), the trained Field Officer walks through their field of 2,000 people, talking, listening, answering questions and facilitating decisions about safe sexual behaviour as well as mobilizing people to become volunteers, training peer educators, setting up microenterprises.
The TCE programme can be described in the following three main elements:
1) Raising Awareness: The Door-to-Door Campaign - Field Officers conduct the 3-year person-to-person/door-to-door campaign involving every household in a TCE area during which each Field Officer is mandated to visit 2,000 people (+/- 400 households). The objective of the visits is to mobilize individuals in each household towards TCE compliance. Field Officers use a TCE Risk Reduction and Decision Making Tool called The Perpendicular Estimate System (PES) which is designed for them to estimate the status of the TCE Programme in achieving its goal - Total Control of the Epidemic – as well as assessing the status of every person in the Field in terms of reaching TCE Compliance. The PES builds on each person assessing their own progress in knowledge and ultimately control of HIV and AIDS. The TCE Field Officer assists individuals in making individual risk reduction plans with each person with regards to them becoming TCE compliant.
2) Mobilization for HCT, PMTCT, ART and TB screening - TCE conducts community mobilization for HCT at designated HCT sites in collaboration with local health authorities or other NGOs that carry out HCT, as well as encourages mobile testing actions at TCE sites. The Programme shares best practice and provides a strategy for improving the integration and linkages with key health services, such as PMTCT, ART and TB treatment services. TCE thus educates pregnant women about PMTCT and HCT before referring them to antenatal clinics for testing and support. PMTCT advice and encouragement will be given to both the pregnant woman and her partner. Post-test support and counselling is offered by Field Officers. Once people have been referred for examination/treatment services, Field Officers keep regular contact with both the service providers and the patients throughout the programme duration.
3) Supplementary Interventions - TCE also initiates specific interventions tailored to the specific needs of each area. Many of the interventions will be carried out by the Passionates (community volunteers) who work with Field Officers to organize communities to promote prevention, reduce stigma and provide care for people infected by HIV, including AIDS orphans and other vulnerable children.
Among the various interventions are:
TRIO System: Field Officers institute the TRIO system by facilitating that patients on ARVT to identify two other people (close friends or family members who become Passionates) to support them to cope with their respective medical regimes.
Youth Clubs: Youth Clubs combine traditional youth activities (e.g. sports/arts) with HIV and AIDS prevention and awareness. Youth Clubs also offer training for peer educators and encourage youth participation in HIV and AIDS campaigns and events.
Schools Programme: This Programme targets learners and teachers in both primary and secondary schools. The aim of the programme is to create awareness and behaviour change amongst the youth in schools especially promoting abstinence.
Communities Forward HIV Counselling and Testing Programme
The Communities Forward - HIV Counselling and Testing Program is a USAID-funded initiative led by Foundation for Professional Development (FPD) with Society for Family Health, FHI360 and Humana People to People South Africa as sub-partners. The program as a whole is implemented in 14 priority districts in Limpopo, Mpumalanga, Kwazulu- Natal, Eastern Cape, North West and Gauteng.
The program aims to contribute to reduced HIV incidence by linking key populations (KP) and high incident communities to HIV and TB prevention, care and support services.
The goal of the program is to expand high quality community-based HIV Counselling and Testing (CBCT) models supported with innovative and effective referral systems.