Senior U.S. Congressional staff led by Senator Lindsay Graham, Ambassador Dr. John Nkengasong of the Office of Global AIDS Coordination and U.S. Ambassador to South Africa, Reuben E Brigety II visits HIVSA Supported Sites

Background: HIVSA and its two sub-partners Ratang Bana Future for Children and Ikageng Itireleng AIDS Ministry together with the President’s Emergency Plan for AIDS Relief (PEPFAR) South Africa hosted a delegation of 30 Senior U.S. Congressional staff led by Senator Lindsay Graham of South Carolina on 23rd and 24^th of February 2023. Ambassador Dr. John Nkengasong of the Office of Global AIDS Coordination and U.S. Ambassador to South Africa and Reuben E Brigety II and their staff members also participated in the site visits.

Ms. Lindiwe Zulu, the Minister of the Department of Social Development (DSD), Mr. Linton Mchunu, Director General of DSD, Mr. Nkere Skosana the Chief Director of the HIV/AIDS unit at the National DSD, Ms Bongi Buthelezi the Social Work Manager of HIV/AIDS unit at the National DSD, accompanied the delegation to showcase the successful collaboration between the South African Government and PEPFAR-funded and USAID-implemented Orphans and Vulnerable Children (OVC) Program in the City of Johannesburg (CoJ) across two Townships (Alexandra and Soweto).

Objective: The chief objectives of the visit were to assess the impact of U.S. Government investments in the United States President’s Emergency Plan for AIDS Relief (PEPFAR) as PEPFAR celebrates its 20th anniversary and in anticipation of PEPFAR funding reauthorization. The delegation was able to engage with key stakeholders from the Preventing HIV/AIDS in Vulnerable Populations (PHVP) Program implemented by HIVSA and sub-partners Ratang Bana and Ikageng Itireleng, in collaboration with the DSD. They were also able to meet with program beneficiaries (adolescents and their caregivers) to learn how U.S. government (USG)-supported programs and resources have improved their health and well-being.

Context: South Africa has the largest HIV epidemic in the world, with an estimated 7.8 million people living with HIV (PLHIV), accounting for 21% of PLHIV globally. While incidence is declining each year, the HIV burden in South Africa continues to grow, particularly for children and adolescents. Nationally, there are approximately 198,311 new HIV infections estimated to occur between mid-2021 to mid-2022 with women over 15 accounting for 62.7% of all new HIV infections. While only 174,295 children and adolescents living with HIV (C/ALHIV) know their status; 54% are on treatment, and 38% are virally suppressed. South Africa needs to increase the number of children that are on Antiretroviral Therapy (ART) by 86,626 to meet the 95:95:95 target. The PEPFAR South Africa OVC Program which HIVSA is a prime partner provides a platform for effective pediatric and adolescent HIV case finding and linkages to treatment; evidence-based interventions for the prevention of HIV and sexual violence; family strengthening interventions for adolescent girls; as well as first-line support and referral for gender-based violence.

Program implementation: HIVSA and its sub-partners have been implementing the PHVP Program in collaboration with the DSD and the Department of Health (DoH) in Gauteng Province (Johannesburg, Tshwane, and Sedibeng Districts). The goal of the program is to contribute towards HIV epidemic control by enhancing the quality, comprehensiveness, and sustainability of care and support services to improve the resilience, health, and well-being of OVC, in line with the South African Government (SAG) strategic goals for health and social development. HIVSA’s implementation model is embedded in capacitating and strengthening DSD funded Community-Based Organizations (CBOs) like Ratang Bana Future for Children and Ikageng Itireleng AIDS Ministry through Technical Assistance and mentorship so that they can provide holistic service delivery to children, families, and communities they serve. To date, HIVSA has capacitated 67 CBOs/sub-partners and over 100,000 children have benefitted from the program since 2012.

The program is carried out using three distinct models: OVC Comprehensive, OVC Preventive, and OVC DREAMS Family Strengthening.

• The OVC Comprehensive model focuses on providing intensive case management to priority sub-populations such as C/ALHIV, children of PLHIV, HIV Exposed Infants (HEI), newly diagnosed or newly on ART, interrupted treatment, not virally suppressed, Children of Female Sex Workers (CoFSW), child survivors of sexual violence, double orphans, and those with escalated vulnerability due to parental HIV infection.
• The OVC Preventive model focuses on boys and girls aged 10–14 years old. The model offers the Vhutshilo 1 curriculum and focuses on a short, evidence-based programming approach that prevents sexual violence, delays sexual debut, and prevents HIV. The model does not include case management and is not tracked against benchmarks.
• The OVC DREAMS Family Strengthening model is part of the secondary package of services to support adolescent girls aged between 10-17 years by improving their well-being, building HIV prevention knowledge and skills, and strengthening the mental health of adolescent girls and their primary caregivers through the provision of the Let’s Talk intervention.

Site one: Ratang Bana Future for Children: Ratang Bana is a non-profit organization that was established in June 2010, and based in Alexandra Township. It is mainly focused on supporting and empowering vulnerable children, especially those affected and infected with HIV/AIDS. It provides psychosocial support services to children (financial, nutritional, material, counselling, prevention of drug abuse, and educational support). The organization has approximately 50 staff members led by a dynamic Manager, Ingrid Maredi.

Day 1( 23 February 2023): Delegates were welcomed by the USAID site officers, Onica Diamond and Mandisi Mabika, Minister of Social Development, Ms. Lindiwe Zulu, Yashmita Naidoo HIVSA Chief Executive Officer and Ingrid Maredi Ratang Bana’ Project Manager. The delegates were able to visit four “service” stations where they were able to interact with beneficiaries and their primary caregivers, that participated in various interventions, like Let’s Talk, the Choma Café and Vhutshilo. These interactions allowed beneficiaries to freely share their stories and experiences of how the PEPFAR program impacted their lives.

“Ntando aged 15 who is one of the adolescents living with HIV shared her story about how she was bullied in the community regarding her status, she shared how the treatment literacy sessions empowered her to stand up for herself.”

Day 2(24^th February 2023): Delegates were welcomed by the USAID site officer, Jessica Mullis, Yashmita Naidoo HIVSA Chief Executive Officer and Ingrid Maredi of Ratang Bana. The second day focused on the support and services provided to Children and Adolescent living with HIV. A round table discussion with 3 adolescents living with HIV and their primary caregivers took place. Amongst them were stakeholders from the Department of Social Development and Anova. The beneficiaries took the delegates through their personal journey of living positively with HIV and highlighted the positive impact of the program on their lives. During this round table discussion, it also came out so clear how the collaboration between community partners and clinical partners was impactful to the beneficiaries and the communities serviced. It showed how the fight against HIV will be won if multiple partners/ stakeholders worked together to offer clinical and psychosocial support to the communities and individuals.

Site Two: Ikageng Itireleng AIDS Ministry

Ikageng Itireleng is a non-profit organization that was established in 2001 and based in Orlando West Soweto.  The organization is focused on improving the quality of life for OVC through psychosocial support services (nutritional, educational, health, and other social support). The organization has approximately 61 staff members led by a passionate and goal-driven Program Manager, Mpolokeng Motloung.

On 23 February 2023, HIVSA hosted Senator Martin Heinrich, Senator Chris Coons, and Senator Mark Kelly, alongside their staff and DSD Officials. The delegates were able to interact and observe beneficiaries who participated in PEPFAR-funded activities through four stations, such as Vhutshilo and the Choma Café. Beneficiaries living with HIV were able to share their stories of how the program has changed their lives in dealing with stigma and discrimination, grief, and loss. Caregivers also had a chance to take the delegates through the journey of their children from the time they were not in the program up until they joined the program. They strongly mentioned the positive changes they have noticed in their children's behavior and how they adhere to treatment.

 

 

Ntando, “it is because of Choma that I have a good relationship with my mother."

Delegates were also able to witness the strong linkages between Anova and HIVSA, as one of the stations focused on HIV testing Services.

The visit was such a success, and we thank all participants involved in the preparation of the site.

 

HIVSA has worked in the HIV space since its inception in March 2002. While our initial work focused on HIV prevention and education, the organisation shifted focus to supporting treatment initiation and adherence. In 2013, HIVSA began specifically focusing on interventions aimed at reducing HIV infections amongst Adolescent Girls and Young Women (AGYW) with the launch of its online magazine, Choma.

A magazine that focuses on love and relationships; sex and pregnancy; health; fashion and beauty and inspiration. With the added “Ask Choma” feature, girls and young women utilising the platform have access to accurate and factual information and have the opportunity to discuss their challenges with their online “Choma.” Through the 24/7 accessible platform, we reach over 30 000 AGYW a month.

In the ensuing years, it became evident that the HIV prevalence amongst AGYW was disproportionately highly and girls and young women were eight times more likely to get infected with HIV than their male counterparts. Despite the number of HIV prevention activities and referrals for Sexual and Reproductive Health services, it was clear that many AGYW were placing themselves in risky situations due to limited financial resources. This often resulted in AGYW being unable to negotiate safe sex practices or to get out of abusive and age-disparate relationships. Understanding this need, HIVSA began incorporating economic strengthening interventions in its basket of services available to AGYW. These included financial capability training, entrepreneurship, employability and supporting AGYW access to tertiary education. The obvious next step was to assist AGYW in finding employment that would immediately translate into them having access to their own income whilst gaining on-the-job training.

In 2020, HIVSA signed a Memorandum of Understanding with YES4Youth with the aim of having its existing or graduated beneficiaries placed at HIVSAs implementation sites through sponsorships received from corporates. On the 1st July 2021, HIVSA placed its first cohort of 11 female youth in its finance, digital media, monitoring and evaluation and programme departments. We will be hosting an additional 11 youth from the 1^st October 2021.

Through these placements, AGYW will gain an array of skills ranging from research, data capturing, administration, and group facilitation in the world of work that will position them well for their future career aspirations and reduce their dependency on others for financial support.

One of our youth, Mmakgotso Thejane, currently placed in the finance department shares her story

"My experience as a YES Youth at HIVSA has been very enjoyable and interesting because I get to learn new skills. The people I work with are willing to help in any way without hesitation and in that way, it is easier for me to find my way around my work. My supervisor has also been great, and I enjoy working with him. My message to unemployed youth in South Africa is to believe in their dreams; dream big”.