The Anova Health Institute is very excited to announce that it has successfully launched the first South African, nurse drive and state-clinic based PrEP project for men who have sex with men (MSM), at it’s Ivan Toms Centre for Men’s Health in Woodstock. A second PrEP site at our Yeoville clinic in Gauteng will come on board in February 2016. The project is sited within our Health4Men Initiative for gay men and other MSM.
Background and context
Anova has received funding and support from the Elton John Aids Foundation (EJAF) to provide PrEP to 150 gay men or other MSM in Cape Town, and another 150 in Gauteng. This funding has allowed us to make sponsored (free of charge) PrEP available for approximately one year to men who attend our clinics and utilize our services. This is not a “clinical trial” or a “clinical study” to investigate whether PrEP works or not – we know that PrEP is effective, science has spoken and the power of PrEP has been indisputably proven!
We have a few reasons for running this project. The major motivation is that the Anova Health Institute fully supports the potential of this new HIV prevention intervention, and we want to provide access to it for MSM in South Africa.
A second motivation is that we want to ensure that nurses in state healthcare clinics are able to successfully offer and provide PrEP, to which end we have developed and implemented topical training materials and clinical tools. Information gleaned from this demonstration project will help the Department of Health (DOH) integrate PrEP into their national health plans.
Importantly, PrEP is not being offered as a stand-alone intervention from our clinics; it is but one choice among a range of possible HIV prevention options that should ideally be used in combination to ensure HIV safety. We are offering PrEP together with HIV testing, screening for and treatment of sexually transmitted infections (STIs), supplying condoms and lubricants plus counselling to support correct use of PrEP and ways of reducing sexual risk.
What will happen to men who choose to join the project for PrEP?
Anyone who attends our clinic for any services, for example HIV testing or STI screening or treatment, or to collect condoms and lubricant, will be offered the chance to join the PrEP demonstration project. The project is of course optional and men are welcome to use all the services we offer without accessing PrEP; there is no pressure to join and those who do not join will still be able to access our clinics as usual. We will also be able to provide prescriptions for men who want to access PrEP in the private sector, or we could link them with PrEP-savvy private GPs to assist.
The PrEP landscape is changing rapidly in Africa and a national policy on PrEP is being developed by the DOH. Our demonstration project complies with PrEP guidance from the World Health Organization, the Unites States CDC, the South African HIV Clinicians Society and future South African government policy. The project is designed to be simple for nursing staff to implement and for clients to access.
In order to access PrEP via this project, men will need to complete a few simple procedures:
1. Sign a permission form to join the project
2. Undergo HIV testing on two occasions to confirm HIV negativity
3. Have safety bloods done to ensure normal kidney function to guard against possible PrEP side effects
4. Undergo viral hepatitis B screening (we will provide free vaccination if needed to people who join the project)
Once these processes have been completed and men are confirmed as eligible for PrEP, they will be able to access the medication within approximately two weeks. PrEP users will be asked to return after one month to discuss their experience of being on PrEP, and to have a safety monitoring blood test. We’ll work with guys to help them with correct pill taking and to address any unexpected side effects (which are very unlikely to occur).
Over the next year, participants will see us regularly to ensure their PrEP is working safely, and to collect medication refills. We will be able to provide a minimum of 12 months of sponsored medication and are working with the DOH to ensure ongoing access free access.
Meet the Ivan Toms PrEP team:
Dr Kevin Rebe
Kevin is an Infectious Diseases and HIV specialist doctor. He has been working with MSM in South Africa for the past decade. He has a passion for ensuring quality HIV and STI prevention and care for MSM communities in South Africa. Kevin has been part of the committee that wrote the South African HIV Clinician’s Society PrEP Guidelines and has published widely on gay and other MSM health issues. He helped design the PrEP demonstration project and will be assisting in ensuring that PrEP is provided correctly.
Mr Ben Brown
Ben is a social scientist with extensive PrEP experience. He has worked with communities and researchers on PrEP for the last 8 years. Ben is also a PrEP user and has made this public in order to support MSM who want to access PrEP. He helped design the project and has developed training modules and clinic tools for nurses to provide PrEP.
Sister Mimi Daki
Mimi is the co-ordinating nursing sister on our PrEP project. She has extensive experience in working in the HIV field. She previously managed a large HIV program at a local Community Health Centre. Mimi is the front line person on this study and will be at the Cape Town clinic to welcome anyone interested in PrEP.
Sister Melphy Bebe
Melphy is an experienced HIV clinical nurse. She is highly qualified and practices independently. She is one of the nursing sisters that will prescribe and supply PrEP in our Cape Town Clinic.
Sister Veli Ndyalvane
Veli is an experienced registered nurse who has been working with gay men and other men who have sex with men in our clinic for the past year. She is one of the nurses who can guide you through the medication initiation process.
Doctor Johan Hugo
Johan is an extremely experienced HIV clinician who has been working with MSM for 5 years. Johan is an expert in sexual health of MSM and conducts both clinical work and research activities. His is currently conducting a research project on PEP. Johan is one of the doctors you will meet at the Cape Town clinic.
Check back early in the new year for detail about the start of the PrEP project at Yeoville Clinic in Johannesburg.
For people wanting more information about services (including PrEP) from our Health4Men clinic, please contact us on:
Tel: 021 447 2844
Tel: 072 654 0816