Andy Still in America: October 2010

Press Release:

Selebi-Phikwe & Bobirwa Voluntary Counseling and Testing Outreach Project

Brings Services Closer to the People

BOTUSA/MOH Outreach project reaches an ADDITIONAL 800 people per week with voluntary HIV counseling and testing in community settings. So far 23,749 community members have been mobilized and received comprehensive HIV prevention messages through the project.

Humana People to People Staff at testing tent,

Distance, Selebi-Phikwe, September

After more than 5 years of planning and pilot testing, the counseling and testing outreach project led by the US based Academy of Educational Development (AED), with local partners Tebelopele and Humana People to People, finally reached the implementation stage, signaled by a project launch ceremony held in Phikwe on July 31st. Expectations were set very high from the outset of the project– it had an ambitious goal of reaching 20,000 residents of Selebi-Phikwe and Bobirwa district with HIV counselling and testing services over a 4 month period.

The methodology involves a combination of 20 teams providing mobile counseling and testing services (one such tent pictured here) throughout the two districts, with house to house community mobilization and HIV education – designed to both increase awareness regarding the drivers of the epidemic, and encourage families to receive HIV testing and counseling. Each counseling site is usually located near a busy shop, main road, or other gathering place, where they will remain for a few days before moving elsewhere. Already several villages outside of the main urban areas have been visited by the teams, including Semolale, Gobojango, Mabolwe, Tsetsebjwe, Molalatau, Mothabeng, Mathatane, Moletamane and Sefophe. Those testing positive are referred to HIV care and treatment sites in the district for follow up assessments and care. The project team is working closely with clinic/hospital staff and collects referral slips every week to monitor that clients are receiving proper care and treatment following testing.

At the half way stage of the project, over 6,000 people had received testing services, which on average means that each of the 20 counselors is providing services to 8 clients per day. These figures compare favorably with the 3 people per day counseled and tested through actual door to door testing in the 2007 pilot, and with similar projects in neighbouring Southern African countries, where counselors test an average of 5-8 clients per day. With approximately 20,000 people accessing HIV counseling & testing services in Phikwe alone in 2009, these figures demonstrate that although testing coverage rates are quite high, there are still a significant proportion of the population who do not access these services through government and non-government sites, and will use the services if they are closer to home.

Preliminary results indicate around 27% of those tested to be first-time testers, and over 70% of all those tested were doing so for the first time in 2010. Reports have also emerged of the mobilization efforts having follow on effects including increased utilization of testing services at Tebelopele’s centre in Phikwe and government hospitals and clinics in Bobonong and Mmadinare.

Pitching large black and yellow tents

Bobonong, September

Tebelopele sign around small green tent,

Mmadinare, October

Key to the project’s success so far has been the support and involvement of district health authorities, other government officials and traditional leaders, which was secured through extensive planning and coordination meetings leading up to the project and involving the Ministry of Health, respective District AIDS Coordinators traditional leaders, Members of Parliament, and District Health Management Teams regarding referral issues, community participation and the composition of community advisory boards.

It was the wish of the District Multi-Sectoral AIDS Committee (DMSAC) that residents of the two districts be involved in the study as much as possible, and to this end, people from Bobirwa and Selebi-Phikwe were employed both as community mobilizers and Tebelopele peer educators, as well as appointed to the study Community Advisory Boards. Strategies such as this ensure the communities are left with improved capacity to address the HIV pandemic using their own resources.

The counselling and testing outreach project has 4 weeks remaining. We invite all members of the public who do not currently know their HIV status to visit one of the mobile sites. There they will be greeted by one of Tebelopele’s best counsellors and a peer educator who will explain the process and make them feel comfortable. In November, the testing locations include Selebi-Phikwe, Bobonong, Mmadinare, Tobane, Tshokwe, and Damachujena. Please check with the Tebelopele centre in Selebi-Phikwe (ph: 2600513) for exact information on locations and dates.

A brief overview of training and counseling and testing results follows:

70 people (many residents of Phikwe, Bobonong, and Mmandinare) were trained:

· 10 data collectors were trained and conducted a pre-intervention survey of 500 individuals from randomly selected households;

· 20 community mobilizers were trained and conducted door to door education and mobilization reaching 23,749 individuals;

· 20 peer educators were trained to provide further education and assist with pre-test counselling; and

· 20 counsellors were trained and conduct

23,749 community members were mobilized:

· All individuals mobilized for testing received a comprehensive HIV prevention interpersonal communication session from the Humana People to People team members. The Ministry of Health approved comprehensive communication guide was used at each house, and focused on key drivers of the epidemic such as MCP, GBV, SMC, and alcohol usage.

6,809 people received VCT in first 10 weeks:

· Most testing in tents, moved often for easy accessibility to different locations outside of shops and community gathering areas.

· Particularly successful in smaller villages, where people normally have to travel further to access services.

AED together with its partners on the project express our sincere appreciation to the leaders and residents of Selebi-Phikwe and Bobirwa districts, and encourage all stakeholders to support a coordinated response aimed at helping Botswana reach the goals of the second National Strategic Framework for HIV/AIDS, 2010-2016.