Counting the need Living with AIDS # 456

518154066c1e.jpgTshwane is the first municipality to conduct such a survey. It assesses current HIV and AIDS services in the area and provides an overview of how many people need which services. Over seven weeks in May and June, researchers conducted phone interviews with 450 service providers. Questionnaires were also sent to the service providers who ranged from those rendering AIDS treatment to those caring for orphaned and vulnerable children, commonly referred to by the acronym, ‘€œOVC’€.

‘€œFor 2010, the estimated number of maternal AIDS orphans under the age of 18 in the city of Tshwane is a bit more than 82 000. In 2009, we came to an estimation of 75 000’€, says epidemiologist Dr Annette Gerritsen, who led this study by the Foundation for Professional Development (FPD).

Gerritsen says the study shows that the number of services providing care for orphaned and vulnerable children has steadily increased over the last four years.

‘€œThere were only 82 (services) in 2007 and in 2010, 212 service providers were identified, which results in the ratio of 389 children per service provider for OVC care’€.

It was also found that non-governmental and faith-based organisations are responsible for caring for the vast majority of the orphans.                    

‘€œThe total number is almost 24 000, of which 95% are cared for by NGOs, 4% by FBOs, 0.5% by the public sector and 0.01% by the private sector’€ says Gerritsen.

The study also sought to gauge the need for HIV testing services in the area of Tshwane, which has an estimated adult population of 1.3 million.  

‘€œThe numbers of adults in need of HCT is then estimated to be 1.1 million. This is based on the assumption that the adult population ‘€“ 15 to 49 years ‘€“ should be tested, at least, once a year. This estimation is actually considered a maximum estimate as those adults who already know that they are HIV-positive do not have to be tested anymore. A minimum estimate is also calculated, assuming that all those who are HIV-positive in this age group, for which we use provincial data from the HSRC study, do not have to be tested’€.                  

Over 120 centres that provide HIV counseling and testing services were identified by the study. But Gerritsen says the service providers do not see as many people as they should.  

‘€œPer month each site would have to counsel and test at most 866 people. But, currently, the 129 service providers counsel and test only an average of 247 people per site’€, she says.

The survey also identified how many people were in need of antiretroviral therapy.

‘€œThe need for ART in the city of Tshwane was estimated by applying national data on the number of adults older than 15 years in need of ART and those already receiving ART from the Statistics SA mid-year population estimates to the proportion of the national population living in the city of Tshwane. Based on this data, the total number of adults over 15 years who are in need of ART is 75 000. Those that are in need for the first time or should be initiated on ART is about 30 000’€.

There are over 60 centres where people can access AIDS treatment in Tshwane. With the available facilities it is projected that each centre treats this number of people.

‘€œThe ratio will become 1 213 people in need of ART and 481 first time need per service provider’€, says Gerritsen.

It is expected that the need for antiretrovirals will increase due to the Health Counseling and Testing campaign which aims to test 15 million South Africans for HIV and the new treatment guidelines for AIDS. The study also calculated the number of pregnant women who need antiretroviral therapy.  

‘€œThe number of women in need of counseling and testing is calculated to be 30 000 for 2010. Based on the ANC HIV prevalence survey of 2008, it’€™s estimated that 26% of these women would be HIV-positive and, therefore, in need for ART. This comes down to 7 854 pregnant women’€, Gerritsen says.

No other municipality in the country has carried out a study that provides up-to-date information on its HIV/AIDS-related services. This study in Tshwane has been conducted consistently for four years. By investigating the trends in service delivery and what the needs are, it is hoped that the data assists with adequate planning and strategies for service delivery.

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