Starter Pack for Youth

Development – Promoting
HIV Testing in SA
Saadhna Panday (PhD)
Wednesday, 23 Sept, 2009
Vienna, Austria
 Outline of presentation
• Trends in HIV prevalence
• Global direction for HIV Prevention
• SA response
• Youth development & HIV Prevention
• Life ‘Starter Pack’
• HIV testing
• Outline of project
 Need for prevention
• HIV most critical threat to health of youth
• Youth are drivers & turn-around strategy
• Global response has been emergency efforts
• Epidemic will endure for another 50 years
• Long-term sustainable plan is required
• New infection: treatment ratio is 4:1
• Halting the epidemic rests in prevention
 HIV prevalence in SA

32.7%: 25-29 year old women

25.8%: 30-34 year old men
 HIV 15-24 years

HIV prevalence: ‘02-’05: 10%

‘08: 8.7%
 HIV 15-19 years

HIV prevalence: < 5%

 HIV 20-24 years

HIV prevalence: > 15%

 HIV women 15-24 years

Half life time probability of acquiring HIV is

from 17-21 years
 HIV men 15-24 years

Half the lifetime probability of acquiring HIV is

from 19-23 years
 First signs of decline

HIV prevalence declined amongst 15-19 year olds from

16.1% in 2004 to 12.9% in 2007
Decline in incidence among
young people
Youth knowledge of HIV
Lancet series HIV Prevention
• Success stories combine
• Multiple risk reduction, strong leadership, active community involvement
• Combination prevention
• Biomedical, behaviour, structural
• Scale – 5 enoughs
• Enough people must change
• Radically enough
• Long enough
• Large enough generational shift in behaviour
• Context specific enough
 SA response
• Largely from health sector
• Small scale
• We need
• Unprecedented national mobilization
• Every sector of society
• Involve those most affected
• Innovative ideas!
 Youth development – untapped
resource
• Positive approach
• Strengths-based
• Holistic, cross-sectoral, integrated
• Agency of youth – trigger for development
• Rights-based approach
• Overly focused on political rights
• Shift needed to address social, economic,
health and education rights
• Rights-based appeal worked for treatment,
not used for prevention
 Life Starter Pack
• First form of agency is to establish legal identity
• By age 16 years youth accumulate basket of
basic assets
• Identity document
• Learners license
• Bank account
• Postal address
• Curriculum vitae
• Work experience
• Good health including HIV status should be a
critical component of basket of assets
 HIV Testing is too low

VCT increased to 51% by 2008

HIV Testing 15-24 years
Community-based testing works

75% are youth between 16-32 years

 HIV Testing
• HIV testing oriented towards those who are
positive
• Underutilized opportunity to reinforce HIV
negative status
• Low uptake – health services based
• Weak social norm for testing
• Promotional campaigns can change norms
 Aim
• Increase knowledge of HIV status amongst
15-19 year olds using youth development
approach and a rights-based appeal
 Not an efficacy study
• Effectiveness study to take small scale
intervention to scale in real life circumstances
• Confluence of
• Existing science
• Innovation of youth experts
• Advocacy of youth sector
• Multi-sectoral partnerships
 Objectives
• National mobilization campaign - reframes
HIV status as normative right & asset for
youth development
• Locate health & wellbeing within basket of
assets – youth starter pack
• Increase access to testing through novel
partnerships
 National campaign
• Campaign designed to
• Celebrate HIV negative status
• Right to health
• Routine
• Asset within Starter Pack
• Group of experts to design campaign
• Discussions with youth
• Announce campaign youth day celebrations
• Roll out in 2010
• Campaign run by consortium such as Coca
Cola Foundation
 HIV testing & Starter Pack
• Run ‘know your status’ campaign where
youth apply for other assets
• NYC to facilitate access to government
departments such as Home Affairs (ID),
Transport (drivers license)
• Approach banks, cellphone companies to
host campaign
 Access to services
• Broker partnerships with public, private and
ngos providing testing
• Companies with health services approached
to open services for youth
• NYC to facilitate access to Private Sector
Forum to access business
• Services provided to youth through a
campaign such as youth month in 2010
• Referral system to be set up for those who
are positive
 M&E
• Baseline and impact : SABSMM & DOH data
• Process – make explicit soft processes for
building political commitment and mass
mobilisation of civil society
 Outputs
• Increase uptake of VCT
• Change social norms about VCT
• Increase availability of VCT services
• Research translation process for large scale
HIV prevention through nexus of science,
youth innovation & multi-sectoral partnerships
 Outcomes
• Reduction in HIV incidence 15-19 years
• Change in behaviour
• Multi-sectoral partnerships
• Leadership by youth sector for HIV
prevention
• Mass mobilisation of youth for HIV
 Multi-sectoral partnerships
• NYC & youth sector
• loveLife -David Harrison
• HIV prevention experts -Olive Shisana, Tom
Coates, Thomas Rehle
• Youth innovators- Cal Bruns
• Government- Yogan Pillay, Busani Ngcaweni
• Business- Cheryl Carolus
• NGOs- Men on the side of the road
 Significance of the project
• Implement state of the art science for HIV
prevention
• Move beyond proof of concept
• Leadership for HIV by the youth sector
• Positions HIV testing as a normative activity
for all youth
• Fast-tracks provision of services by
stimulating demand