Adult HIV/ART care

HIV-positive people are much more likely to suffer from mental illness than the general population, and as such preventing, identifying and treating mental illness in people living with HIV has come to the fore.

Management of mental illness in people living with HIV is critical because if untreated it is associated with poor treatment adherence, neurocognitive impairment and more rapid HIV progression.

Anova is supporting South Africa’s public healthcare system in taking steps to integrate mental health services into everyday HIV care, by providing training and ongoing mentoring to healthcare workers.

The training, which is currently being piloted in five Gauteng-based clinics, focuses on identification and referral, so that people living with HIV, with mental health issues, can be sent to the primary healthcare doctor or the mental health clinic in order to manage their illness.

In Limpopo province, Anova has been preparing to implement the mental health and illness training and mentoring initiative in the province by training trainers and mentors.

Anova has currently conducted one training session in Limpopo in conjunction with the Department of Health, at the request of the District Mental Health manager. The session was well attended with mental health managers, psychiatric nurses and professional nurses from various primary health clinics in attendance. Three training sessions are planned for 2015.

Eye care

With 50-75% of people living with HIV likely to be affected by an eye disease, which can cause severe visual impairment or blindness if left untreated, eye care is a key part of maintaining not only the health of people living with HIV, but also preserving people’s social and economic independence.

Anova has partnered with the Department of Viroscience, Erasmus MC and the Rotterdam Eye Hospital based in the Netherlands, to establish the Mopani Eye Project, based in Limpopo. The initiative combines clinical research with health systems strengthening at the primary healthcare and hospital levels.

With eye disease and HIV being a relatively new and developing field, the clinical research arm of the project focuses on collecting much-needed data incidence, prevalence, prevention and treatment data on two particular forms of eye disease (uveitis and keratitis). A new focus on the effects of HIV and HIV treatment on the eye has also recently been introduced as, the relationship between HIV, HIV treatment and the eye is little understood.

The project also provides practical services in the way of training and mentoring healthcare workers, providing resources and running eye care awareness campaigns within the rural community of Mopani.

A second project line started recently and is investigating the long-term impact of the HIV virus itself and ART use on the eye.

This project will provide insight in the ambiguous relation between HIV-infection and ART with eye diseases, in order to create prevention and screening programmes for individuals living with HIV. It will also give insight into the important but neglected field of eye diseases and HIV in order to improve eye care among individuals living with HIV in South Africa.

Good patient care requires clinical expertise as well as a functional health system. The WHO’s Global action plan for universal eye health, 2014-2019, calls for the generation of evidence on eye health care as well as developing plan and programs to enhance eye health with activities in line with the WHO’s framework for action for strengthening health systems.

The U.S President’s Emergency Plan for AIDS relief (PEPFAR) and USAID are the major funders of Anova. In recent years the focus of this funding has moved from emergency roll-out of treatment of HIV, to assisting in developing sustainable programmes that integrate a broader array of health demands and challenges which are presented by HIV.

In line with this Anova has conducted a baseline survey on the Ophthalmological services in primary care facilities in the Mopani District. This survey will be rolled out in two other health districts in 2015, Cape Winelands and Joburg Metro, supported by Anova. The objective is to gain insight into the determinants, barriers and challenges of the ophthalmic services.

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