Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 7228
Country/Region: South Africa
Year: 2010
Main Partner: Montefiore Medical Center
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $540,768

Funding for Testing: HIV Testing and Counseling (HVCT): $540,768

The Montefiore Medical Center aims to eliminate missed opportunities to test youth by building the capacity of youth-serving clinics and STI clinics to more routinely provide CT using the ACTS model. ACTS ( Assess, Consent, Test and Support) is a program of rapid, simplified counseling and testing (CT) that effectively scales up provider-initiated counseling and testing (PICT).

BACKGROUND:

Engaging young people in HIV counseling and testing, prevention and care is one of the most important strategies for reducing the burden of HIV and AIDS in South Africa. Unfortunately, thousands of opportunities to achieve these goals are missed every day when vulnerable South African youth seek a variety of health care services but are not offered HIV counseling and testing (CT). By reducing pre-test counseling sessions to five minutes or less, ACTS allows nurses to incorporate CT into the other clinical services they provide, such as sexually transmitted infection (STI) care and family planning and promotes immediate follow-up and linkage to care. This frees up lay counselors via task shifting to provide more intensive counseling and support services to HIV-infected youth.

ACTIVITIES AND EXPECTED RESULTS: Using ACTS, this program will focus initially on maximizing CT services in high-prevalence youth clinics, starting with STI clients and expanding to family planning clients. TB screening will also be introduced. The ACTS program will then broaden its activities to other health care facilities and community organizations. The ACTS team will engage each new site, develop an implementation and monitoring plan and train all relevant health care providers in CT, collect PEPFAR indicators, provide quality

assurance monitoring and initial HIV care. During the five year cooperative agreement, this model will be continuously refined and successively implemented in high prevalence communities and sites throughout South Africa starting in the Western Cape and Mpumalanga.

In FY20 08, the team will continue to refine the ACTS services in two youth clinics in Khayelitsha . A monitoring and evaluation plan will be developed that includes PEPFAR indicators. A quality assurance plan will evaluate linkage to care among newly diagnosed HI-infected youth. A Project Director will be hired and trained and locations in Mpumalanga or other Province will be chosen as well as additional clinical and community sites in the Western Cape. The goal is for this partner to test 20,000 youth for HIV and link them to prevention, link 2000-4000 HIV-infected youth to improved care, screen at least 100 youth for TB,

train 180 nurses, lay counselors and peer educators to implement the ACTS CT protocol, and establish 15 new CT outlets. The integration of local staff and partners in the operation and monitoring of this program to scale-up routine testing will ensure local ownership and sustainability.