Key Populations Programme for Sex Worker and Transgender Individuals

Key Populations Programme for Sex Worker and Transgender Individuals

During the first year of the 5-year USAID Award for advancing the South African HIV Response for Key Populations, Sex Workers, and Transgender individuals, the Wits RHI Key Populations intensified services at 4 existing sex worker sites and opened 4 new transgender sites. The latter provide the first USAID-funded services for the trans community in Africa. The integration of gender-affirming hormone therapy and psychosocial support within a primary health care and HIV prevention/ treatment package serves to increase uptake of services and retention in care. In its first 6 months of operation, the transgender programme reached 1,566 individuals, achieving a 57% PrEP uptake rate among those who tested HIV-, a 25% HIV+ testing yield, and 68% linkage to ART. The sex worker sites provided outreach services to 33,149 female sex workers nationally, achieved a 38% PrEP uptake rate, a 19% HIV testing yield, an 89% linkage to antiretroviral therapy, and reached a 92% viral load suppression rate among the sex worker ART cohort. The transgender programme launch held in Cape Town in December 2019 was attended by the Head of Ministry, Western Cape Ministry of Health and the U.S. Consul General.

About The Programme

HIV epidemic control in South Africa pivots on the success of services for key populations such as sex workers (SWs), their clients, and transgender (TG) people. Wits Reproductive Health and HIV Institute (Wits RHI), has provided reproductive and sexual health services to sex workers in inner-city Johannesburg since 1996, making us a national leader in the provision of accessible clinical interventions for SWs. Our most recent highly successful PEPFAR-supported 5-year sex worker and male clients program was implemented from 2013-2018 in five provinces of the country. In the face of remarkably high HIV risk within this key population, we have interventions to address risk-taking behaviors, and demonstrated innovative service delivery models for HIV care, treatment and prevention that are SW-led and effective in both clinic and community settings. Wits RHI’s strong community-driven SW program model, together with the organization’s clinical expertise, will be applied and tailored to develop a transgender-friendly and transgender-competent outreach programme and clinical service package.

The Key Population Programme’s Primary Objectives:

- To increase demand for and availability and access to comprehensive prevention, care and treatment services and interventions for sex workers
- To increase capacity of civil society and other key stakeholders to advocate for and implement HIV activities
- To strengthen systems for planning, monitoring, and quality assurance of sex worker programs

The Key Populations Programme for Sex Worker and Transgender individuals started on 01 October 2018

.The programme targets set by PEPFAR for the first year of the programme (FY19) were as follows.

- Outreach and Prevention Interventions: Reach13,580 sex workers in Johannesburg, 9,061 in Tshwane, 2,206 in Vhembe, and 5,361 in Ekurhuleni. Reach 1,946 transgender individuals in Johannesburg, 1,206 in Cape Town, 630 in Buffalo City, and 415 in Nelson Mandela Bay.
- HIV Testing: Provide HIV Tests to 5,093 sex workers in Johannesburg, 3,398 in Tshwane, 827 in Vhembe, and 2,010 in Ekurhuleni. Test 3,503 transgender individuals in Johannesburg, 2,171 in Cape Town, 1,134 in Buffalo City, and 747 in Nelson Mandela Bay. The aim for testing yield (proportion of tests with HIV+ result) is 15% for sex workers and 20% for the transgender population.
- PrEP: Initiate PrEP for 886 HIV-negative sex workers in Johannesburg, 578 in Tshwane, 141 in Vhembe, and 342 in Ekurhuleni. Initiate PrEP for 397 transgender individuals in Johannesburg, 246 in Cape Town, 128 in Buffalo City, and 85 in Nelson Mandela Bay.
- ART: Initiate ART for 687 HIV-positive sex workers in Johannesburg, 459 in Tshwane, 112 in Vhembe, and 271 in Ekurhuleni. Initiate ART for 631 transgender individuals in Johannesburg, 391 in Cape Town, 204 in Buffalo City, and 134 in Nelson Mandela Bay

For more on the Key Populations Programme for Sex Worker and Transgender Individuals please email rhicomms@wrhi.ac.za