Firoza Haffejee1, MW Khan1, K Ports2, M Mosavel2 The use of HIV positive health care volunteers to provide information about HIV/AIDS in low socio-economic communities Firoza Haffejee1, MW Khan1, K Ports2, M Mosavel2 1Department of Basic Medical Sciences, Durban University of Technology, South Africa 2Health and Behavior Policy unit, Virginia Commonwealth University, USA

Background Epicentre of the HIV pandemic – KwaZulu-Natal, South Africa (SA) Prevalence of HIV = 16.9% SA – DOH has made the reduction of new infections part of its health care strategic plans Scaling up of ARV Reduced progression of HIV to AIDS However Still an increase in new infections There is a need to increase voluntary counselling and testing (VCT)

Large numbers of voluntary health care workers employed Promote VCT Promote the uptake of ARVs Many people are still unable to access these health services Emergence of many voluntary health care workers Provide educational services and emotional support

Aim To explore the factors that drive a person living with HIV to provide voluntary health care services

Methods Quantitative and qualitative data were collected Part of a larger study Quantitative and qualitative data were collected from voluntary health care workers Study site – Kenneth Gardens A low income community in Durban, South Africa Ethical clearance (IREC 056/13) Written informed consent Interview was conducted with HIV+ health care volunteer To protect identity – name changed Ms Jones

Results / The interview Diagnosis with HIV ± 20 years ago By boyfriend who knew he had HIV Unable to afford ARVs No drug trials New program for ARV rollout at a local tertiary hospital Sponsored half the cost of the ARVs Remained on the program for 2 years

Education Approached a professor from local Medical School Enquired about HIV in nursing curriculum Given permission to attend lectures at no cost Also visited the medical wards Enquired from patients about their illness Enrolled for HIV short courses

Treatment & care in Kenneth Gardens Numerous obstacles Cannot access care at local hospital due to municipal zoning Travel expenses Elderly Waiting time in queues = long Patients numbers are large Patient-practitioner interaction is suboptimal Insufficient ARVs

Stigma Seen as a disgrace Gossiping Neighbourly jealousy Affects decisions to seek care

Education to remove stigma Was introduced at a meeting as “This is Ms. Jones and Ms. Jones has AIDS” Disease is thus seen differently to other chronic conditions People need to see someone with HIV as a person with a chronic condition who requires compassion and care

Educating the community Involved in community engagement & education Creates awareness about HIV in surrounding schools Open about her status Receives a different attitude from school children & community Reduces the stigma Positive reaction School children willing to ask questions and interact with her

Helping those living with HIV Many live in denial “They don’t want to hear about it, until they get sick….then they get TB and it’s too late” Recalls carrying 2 neighbors to her cars and taking them to the hospice where they later died of AIDS

Other social issues Drug abuse Role in HIV transmission through sharing of needles Increases risky sexual behaviour Counsellors in the community are not properly trained Medical treatment is a last resort Rather “pray it away”

Qualities required by community care givers Positive about life Be able to speak with conviction Be knowledgeable Be able to answer questions Need to “switch off your own emotions” Can be emotionally draining

Conclusion Need for more voluntary health care workers More people living with HIV can be trained Provide basic HIV education and support Reduce the stigma surrounding HIV/AIDS We hope that in the near future, funding can be provided for these health care workers

Acknowledgements This study was funded in part by: Virginia Commonwealth University’s International Partnership Major Initiative Award National research Foundation of South Africa (NRF, Grant number 99315)