The South African government will launch the world’s largest HIV testing drive in mid-April, with thousands of new testing sites, a national media campaign and over 4000 health workers brought out of retirement to counsel and test, health minister Dr Aaron Motsoaledi announced today.
South Africa is aiming to testing 15 million adults and adolescents aged twelve and over by June 2011 in what Dr Motsoaledi described today as a `revolution` in the national approach to HIV and AIDS.
"This is the largest testing and counselling campaign in the history of the Aids pandemic around the world," said Mark Heywood, the deputy chairperson of South Africa’s National AIDS Council (SANAC).
The campaign will begin on Thursday April 15th, when President Jacob Zuma and Deputy President Kgalema Motlanthe are expected to take HIV tests at Natalspruit Hospital in Gauteng province.
All final-year medical students will be asked to volunteer at least a week of their time to take part in the testing drive, and the government hopes that testing sites will be available at every university and further education establishment in the country.
The Ministry of Health has also written to all retired nurses, doctors, pharmacists and social workers asking them to take part in the campaign.
Mobile testing units will visit villages and rural areas, and a private pharmacy group will make 470 pharmacy clinics available as free testing sites. More than 2000 community pharmacies are also likely to provide testing facilities, along with general practitioners, hospitals and health clinics.
South Africans who take up the offer of an HIV test will also receive a blood pressure check, a blood sugar test for diabetes and a test for anaemia. They will also be asked five questions to screen for tuberculosis – a positive answer to any question will result in a sputum sample and an X-ray in order to rule out tuberculosis.
Everyone who receives testing and counselling will receive 100 condoms (a total of 1.5 billion condoms are available), and the government will distribute a further one billion condoms through public facilities, and to hotels prior to the World Cup. South Africa expects at least 450,000 visitors during the World Cup in June and July 2010.
The testing drive is likely to identify huge numbers of people eligible for HIV treatment and TB prophylaxis under new South African guidelines due to be introduced in April. Previous guidelines recommended treatment for people with CD4 counts below 200, although the average count at the initiation of treatment is currently between 100 and 140, and is similarly low at HIV diagnosis. More extensive testing is likely to mean that people will start treatment earlier.
The new guidelines will expand treatment to the following groups:
- Pregnant women with a CD4 count of 350 or below will receive treatment, as will any pregnant woman with HIV who shows symptoms, regardless of CD4 count;
- Children below one year who are HIV positive will start treatment, regardless of their CD4 count;
- All pregnant women whose CD4 count is above 350 will start PMTCT at 14 weeks, instead of 28 weeks as is the practice now;
- All TB and HIV co‐infected people will start treatment at a CD4 count of 350 or below;
- All other people diagnosed with HIV infection will start treatment at a CD4 count of 200;
- Everyone with HIV who does not have active TB will be encouraged to take isoniazid prophylaxis to prevent the development of TB.