13 August 2015 Thato Chidarikire Eve Marumo Alasdair Reid Francois Venter Mariette Slabbert 13 August 2015 SWTWG Sex Worker Technical Working Group vulnerability Restricted access to healthcare services ID: 611654
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Healthcare package
13 August 2015Thato Chidarikire; Eve Marumo, Alasdair Reid; Francois Venter; Mariette Slabbert
13 August 2015 |SWTWG
Sex Worker Technical Working GroupSlide2
vulnerabilityRestricted access to healthcare servicesStigmatised by healthcare workers (HCW)Look & act differentTime is moneyHidden mobile key populations
High need for healthcare servicesRepeated STIHigh HIV prevalence - acquisition and transmissionAccess to condomsNeglected chronic diseases / family planningSlide3
Criminalisation effectsLack of identifiersBiometrics; ID; photosInstead combination of demographicsHidden populations Finding
Disclosure at health facilitiesDifficult to track and traceCarrying condoms is an offenseSlide4Slide5
Package of services
13 August 2015
|SWTWGDeliveryPackageResource needsSlide6
DeliveryClinic based servicesFixed clinics in pilot HTAsDedicated after hour SW services in PHC clinicsSensitised services in PHC clinicsMobile outreach for street-based SW
Service delivery in brothels/hotelsReferral networks
HTA guidelines, 2014Slide7
Package of services
Biomedical interventions for improved health outcomes:HIV/TB/STISexual and Reproductive healthChronic diseasesMinor ailments and violenceReferrals for further supportCondoms and lube availabilityBehavioural interventions to promote health seeking behaviours:communication; counselling; and health promotionStructural interventions to prevent:ViolenceStigma
Health rights violationsExclusionSlide8
1. PreventionAim: To prevent acquisition and transmissionPrEP: HIV acquisition & TASP: HIV transmission
Condom and lube distribution: HIV/STI/pregnancySRH: PEPFamily planning including TOPEmergency contraceptionHealth communication:Health promotion and correct condom useRisk and harm reduction counsellingAdvocacyRemove structural
barriers other than decriminalisationAccess to social services and psychosocial support Access to support for substance abuseAccess to justiceOperational Guidelines for HIV, STIs and TB for Key Populations in South Africa DoH, 2014Slide9
2. Early detectionAim: to prevent disease progressionEarly detection through health screeningHIV/TB/STISRH: PAP smears;
emergency contraception; PEPMinor ailments and PHCSubstance useTreatment plans to maintain healthOperational Guidelines for HIV, STIs and TB for Key Populations in South Africa DoH, 2014Slide10
3. Care & treatmentAim: Prevent morbidity and mortalityEarly treatmentHIV/TB/STISexual and reproductive
health Co-morbiditiesAdherence counsellingTracing, tracking, and retentionMonitoring, evaluation and researchOperational Guidelines for HIV, STIs and TB for Key Populations in South
Africa DoH, 2014Slide11
Resource needsHuman resourcesPeer educatorsClinical staffTransportMobile vansProject carsCommodities
Drugs and labsCommunication materialsNational toll-free helplineSlide12
Additional requirementsSW focused Communication CampaignHealthcare worker Sensitisation & TrainingCommunity & Stakeholder EngagementParallel services in HTATASP and
PrEP in key pop guidelinesIntegration with WBOT and SAG departmentsReferral network for overlapping problemsM&EQAOperations researchSlide13
CatalystsSensitisationPeer educator-ledMobile and flexible servicesProgram managementPrEP and TASPOperations researchSlide14
Thank you