“Jozi Ihlomile”: A unique model of HIV and AIDS Intervention in Johannesburg Meisie Lerutla

1. “Jozi Ihlomile”: A unique model of HIV and AIDS Intervention in Johannesburg Meisie Lerutla

2. Regions of the Johannesburg City Council

3. 3.2 million people in 791 367 households; Earn more than R28 billion, one fifth(18.12%) survive on less than R500 per month, almost half of these have no regular income whatsoever; Unemployment rate of about 29%; African population (70.2%) lives mainly in the large urban townships; 14% of households use paraffin or candles; 13% use a pit latrine or bucket latrine; Background on Jo’burg

4. HIV and AIDS infection in the City of Johannesburg - 1 out of every 5 young people under the age of 30 years is infected by HIV - 1 out of every 10 adults in the City has HIV - Prevalence of HIV in Joburg was 33% in 2003 among women attending public antenatal clinics - 50% of TB patients treated at City’s health facilities HIV positive

5. Joburg response to the HIV and AIDS problem • The Mayor launched HIV and AIDS Council in 2001 • Joburg AIDS strategy adopted in 2002 • Community and workplace programme in place • VCT provided in health sites • HIV support groups – NGO’s • Peer education programme including CSW • Jozi Ihlomile concept- HIV ands AIDS programme conceived in 2004 • An inter-sectoral response to AIDS is being formulated

6. Where to from here? • Implement a sustainable integrated developmental programme that addresses HIV and AIDS prevention, care and support • More responsive programme to the community’s needs • Increase access to basic social, and heath care services –identification of problems, and referrals to appropriate services • Improve support for people infected and affected by HIV and AIDS • Enable/support communities to actively participate

7. Implement the ‘Jozi Ihlomile’ Programme!

8. A unique model of HIV and AIDS intervention Model to assist COJ to translate HIV and AIDS awareness into action Development of the targeted areas as vibrant communities Attempt to create communities where HIV negative people strive to remain negative Environment that supports HIV positive people on healthy life styles Attempt to create communities that strive keep HIV negative people negative Strengthen families to care, educate and support those infected and affected by HIV and AIDS What is Jozi Ihlomile?

9. Initial phase of programme implementation in 6 informal settlements Areas - Implementation

10. Targeted Areas

11. Project Concept • Working in partnership with relevant role players within the COJ in the coordination of preventative, and supportive programmes that will have a positive effect, changing people’s sexual behavior's lifestyles and perceptions • Reduce the incidence of HIV and AIDS in identified areas. • Increase support for those affected • Volunteers identified from the 6 identified areas

12. Project concept • To work towards developing informed communities that can take care of HIV,AIDS and Tuberculosis issue;, educate one another, support and care for one another, fight HIV and AIDS stigma and discrimination Market VCT services provided in health facilities and non-medical sites in each of the eleven administrative regions of the COJ, leading to increased utilization of services and a decrease in new HIV infections

13. To implement targeted youth out of school programme in the targeted areas using the Love life Model To improve the quality of life of those affected and infected through the provision/referrals to HBC, and support groups for people living with HIV and AIDS Decrease the incidence of sexually transmitted infections in an effort to decrease HIV transmission To train community leaders (including ward committees in all targeted areas/communities in HIV and AIDS Objectives (1)

14. Objectives (2) • Strengthen relationships and partnerships with sectors, including FBOs, NGOs, CBOs in order to strengthen the community capacity to take care of their needs • Increase access to health and social services through referrals to appropriate services • To contribute in the moral regeneration programme in the fight against HIV and AIDS (promoting abstinence in the youth at family and peer educator level)

15. The implementation in different phases as part of the best practice model that the City aims to implement in the fight against the HIV and AIDS epidemic, in identified vulnerable communities Components of the Project

16. Phase 1 Phase 2 Phase 3 Phases - implementation

17. Consultative meetings/workshops with the ward Clrs, ward committees, departments and other leaders Consultative meetings/workshops with the NGO’s, Internal communication (officials and politicians Phase 1 - Preparatory

18. Identification of the volunteers Identification of the service provides to do training Training of community volunteers Allocation blocks to volunteers NB. JAC advise, support, coordination Phase 2 -Preparatory Cont

19. 1. Volunteers collect information about the community and upgrade it on a monthly basis for better understanding of the area they serve (including mapping of available services) Phase 3 -Situational Analysis

20. 2. This exercise will assist in the implementation of other projects, the (COJ) will know the extent of the HIV and AIDS problem in the identified communities for planning purposes Situational Analysis (Cont)

21. 3. Information gathered will include: Number of houses in the area, number of people, number of children staying with relatives, unemployed, orphans, people on social grants, people chronically, deaths natural/accidental social problems identified by community, level of HIV and AIDS understanding, and knowledge on available services Situational Analysis (Cont)

22. Adopt a Block VCT Community Education Home Based Care Services Indigent Burials Nutrition Programme vegetable gardens (already available in some regions as part of PWA support activities) Support for PLWHA- referrals to available services Interventions

23. Interventions for the Jozi Ihlomile HIV and AIDS programme Voluntary Counselling and Testing Community education Support for PLWHA Community action groups Jozi Ihlomile HIV and AIDS programme Home-based care services Nutrition programme Indigent burials Men as partners Adopt-a-block

24. Trained volunteers will adopt a block and attend to the identified needs and refer the clients Each family will be visited at least once a month and being followed up to provide support, education and referrals to necessary services according to identified needs Families with sick members who require Home Based Care services will be visited at least once a week HIV and AIDS education is done per family, therefore providing an opportunity to raise questions in a non-threatening environment Adopt a block

25. Trained volunteers will conduct door-to-door and face-to-face education on basic HIV and AIDS, Voluntary Counseling and HIV Testing, Prevention of Mother To Child HIV transmission, Ante-retroviral Treatment programme and available Social Services to the community to be able to deal with the AIDS epidemic Community Education

26. Work with community leaders in establishing community action groups for support, education of one another (street committees concept) Dissemination of information on HIV Testing, Prevention of Mother To Child HIV transmission, Ante-retroviral Treatment programme and available Social Services to the community- mitigation of the AIDS epidemic Community Action Groups

27. Trained volunteers will give counseling support for those on ART and TB programme to promote adherence to treatment, which is significant for treatment success and refer to available services for continued support Support for people living with HIV and AIDS

28. During the education visits, trained volunteers will provide immediate basic home where there is a need, and refer to the relevant service providers Home Based Care Services

29. The project is aimed at reaching out to individuals, families - community in the identified vulnerable groups Beneficiaries

30. Informed communities regarding HIV and AIDS, which are more able to support one another Reduction of new HIV infections Increased family dialogues/discussions on HIV and AIDS issues, more informed children, ? Delayed sexual relations ? abstinence Expected Results

31. 4. Increasing number of needy people accessing available services including social grants 5. Increasing support for people on Tuberculosis and Antiretroviral treatment to ensure compliance to RX Expected Results

32. 6. A system that provides an opportunity for high % of community members to be more informed on the HIV and AIDS epidemic, therefore contributing in decreasing stigma and discrimination for people infected and affected by HIV and AIDS Expected Results

33. Allocation of Volunteers

34. Total number of people reached between March and June 2005 is 58 300 in all six areas Achievements to date: March 05 – June 05

35. Region 2 Orphans identified – 45 Referrals to Home Based Care (HBC) services – 166 Referrals to Social Services – 316 Referrals to Clinics - 49 Achievements(Cont.)

36. Region 5 Orphans identified – 23 Referrals to HBC – 86 Referral to Social Services – 150 Referrals to Clinics – 88 Referrals to Hospital – 13 Referrals to Home Affairs - 39 Achievements (Cont.)

37. Region 11 Referrals to HBC – 45 Referrals to Social Services – 67 Referrals to Clinics – 25 Referrals to support indigent burial – 4 Referrals to Child Abuse – 2 Referrals to Home Affairs - 39 Achievements (Cont.)

38. JOZI IHLOMILE, an opportunity for Joburg to win the war against HIV and AIDS!

39. THANK YOU! REA LEBOGA! HIKHENSILE!