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#Mandela100: Mobile HIV clinics hit the road

Given the increased focus in South Africa on identifying people living with HIV who remain undiagnosed, and on improving uptake of antiretroviral treatment (ART), Shout-It-Now has designed a new community-based HIV screening and immediate ART initiation service that dovetails with the goals and services of the public health system in Gauteng.
A six-month pilot of this new test-and-treat programme of semi-automated mobile HIV testing and immediate ART initiation clinic will offer free, fast HIV testing, counselling and treatment from a pair of customised vehicles, giving the programme increased flexibility to target high risk patients and offer those with HIV immediate and seamless access to treatment. The mobile clinic consists of two trucks working in tandem: one dedicated to HIV testing and a second to ART initiation.

Shout-It-Now will make use of public health data and mapping tools to identify neighbourhoods and populations in greatest need of the mobile clinic’s services. The community testing locations will primarily be social and residential areas that are currently underserved by public health clinics in the area, with the test-and-treat service designed to see up to 250 clients per day with an HIV incidence of 10-15%.

How it works

The set-up time for the test-and-treat mobile clinic is 15 minutes. A powerful generator, lighting and awnings ensures the capability for round the clock operation in communities that need the service most.

Onboard, the testing van features seven touchscreen kiosks with the latest audio-visual interface and needs only three healthcare advisors (HCAs) to perform all the functions including the physical tests and reading. The instructional AV aids are concise, engaging, and available in Zulu, English and Sepedi, while sophisticated biometric equipment ensures highly accurate and efficient identification and tracking of clients.

The testing process varies according to each client’s needs and can take as little as five to 10 minutes, results being shared via SMS. Those who test positive on their initial HIV test proceed to the ART van. Here a qualified doctor or Nimart nurse and HCA provide confirmatory testing, assess whether the client is eligible for immediate ART initiation and if so, issue a one-month supply of ARVs.

90-90-90 targets

“HIV and AIDS remain the biggest social issue facing South Africa. As a stakeholder, we take our role in ensuring the national 90-90-90 targets are met seriously. We have found that first and foremost, our clients want convenience – fast, free and friendly service at a time and location that suits them.,” says Bruce Forgrieve, chairman, Shout-It-Now.

“For this reason, we have extended our focus to what is now needed - convenient testing and treatment solutions, incorporating ART initiation into our model thus addressing the second component of the common 90-90-90 goal.”

Clubhouse concept

Shout-It-Now will also pilot a clubhouse concept adjacent to a partner government clinic to improve clinic linkage and retention rates. The clubhouse will be the first port of call for Shout-It-Now clients who, after their first month of ART, need integration into the government clinic system. HCAs at the Clubhouse will escort clients to the partner clinic and walk them through the transfer and registration process. As a further service to the adjacent public health clinic, walk-ins to the clubhouse can also get tested and the facility is equipped to provide pre-ART initiation to clients.

“We continue to invest heavily in technology and tools needed to drive innovation in linking clients to the best care available at zero cost to the community. As a reliable and trustworthy partner of the government, we remain committed to our founding ethos of providing free, fast and friendly service to the community,” says Forgrieve in conclusion.
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