Living Hope is rolling out the IACT (Integrated Access to Care and Treatment) programme in the Western Cape and is responsible for training suitable support group facilitators and to monitor and mentor the sites where the IACT programme is implemented.

With such a large burden of disease, services such as support groups have become a critical component in the continuum of care. As more is learned about how to support individuals after they receive an HIV positive test result, attention is being focused on strategies designed to lessen ‘loss to follow-up.’ A 2006 study examining loss to follow-up in South Africa, for example, identified three stages when vulnerable PLHIV were likely to be lost to the system:

(1) patients with known HIV who need assessment and decisions on treatment,
(2) patients in the first four months of ARV treatment, and
(3) patients on long-term ARV therapy.

Lawn, et al. noted that “Stages 2 and 3 have received the most attention to date, but Stage 1 is also a major point of failure, with 46% of deaths in that study occurring prior to the start of treatment.”

Integrated Access to Care and Treatment (I ACT, previously known as the Basic Care Package) is intended to support PLHIV in all three stages, with an emphasis on Stages 1 and 2, as identified by Lawn, SD, et al., reaching newly diagnosed PLHIV who are not yet eligible for treatment. Through the development of a care of well-trained peer lay support group facilitators and a network of community-based I ACT support groups, I ACT focuses attention and resources on newly diagnosed individuals, providing them with psychosocial support to enable them to come to terms with their diagnosis, gain the knowledge, confidence, and support to manage their health care, live longer and healthier, and join with their peers to advocate for service delivery improvements. Equally important, IACT helps to strengthen relationships between health facilities and community-based organizations.

The goal of IACT is to promote early recruitment and retention of newly diagnosed PLHIV into care and support programs. In addition, IACT strives to reduce the high rate of loss to follow –up from the time of HIV diagnosis to successful commencement of ART. Although IACT primarily focuses on newly diagnosed HIV positive individuals, it was designed to include HIV positive individuals, it was designed to include HIV positive individuals in general and individuals who are affected by HIV and need a support group.

 The basic principles of IACT are to:

• Increase PLHIV knowledge and skills;
• Strengthen referral systems and complement care services;
• Keep PLHIV connected to care and support structures;
• Promote and strengthen HIV prevention messages
• Empower PLHIV to be their own health advocates; and
• Encourage communities to take responsibility for health care improvement.

I ACT support groups differ from most HIV and AIDS support groups in a few important ways. In addition to providing traditional psychosocial support, IACT support groups include an educational component on pertinent topic areas. Unlike long-term drop-in groups, the IACT support groups were designed as a series of six closed sessions to provide the pertinent information, networking and support that newly diagnosed PLHIV need to begin accepting their status, keep healthy, and continue accessing care.

Thus far Living Hope has held 2 pilot trainings : the first training with 6 health counsellors and 3 Support Group Facilitators and the 2nd training we did with 15 Support Group Facilitators all who were running different support groups in their communities already. Both groups came into this training reluctantly and feeling, “ oh my word more HIV training” but as they went through it got challenged personally in many areas of their own lives and by the end of the training felt much differently from how they started the training. The training is aimed at the HIV sector but so many of its components can be applied to so many other things in our personal struggles.Out of this training we have 2 Health counselors running I ACT groups in False Bay Hospital and 4 Support Group Facilitators. These facilitators are real stars, running groups in Masiphumilele with 1 Group having completed all 6 sessions.

(seen above Tony Diesel (Head of I ACT), Avril Thomas (GM for Living Right), Chantal Delcarme (Living Hope), Nathan Panti (Living Hope) and Thobi Finger (USAID)

Pumla and Nathan recently started a support group with clients at the Living Hope Health Care Centre and for these clients a support group was something foreign. They did not know what to expect but were open to participate and eager to learn more about the disease.

We are currently in the process of approaching other NGO’s and offering this training opportunity to them and hoping that they would respond positively.