South Africa is experiencing a concentrated HIV epidemic among MSM. Evidence suggests that it is rapidly advancing, with HIV prevalence estimates between 13-49%, and very high incidence.
DTHF was the only site in Africa for the Chemoprophylaxis for HIV Prevention in Men Study (iPrEx ). This was the first study to definitively prove that pre-exposure prophylaxis as a concept works. Other key studies have included recruiting and maintaining a MSM cohort and investigating preferred HIV prevention methods. The Division is currently involved in the HPTN 083 trial. This involves examining the safety and effectiveness of a long-acting injectable PrEP as opposed to a daily pill.
Qualitative research has focused on piloting community based HIV prevention interventions as well as researching health care workers’ attitudes and practices while providing health care to MSM. DTHF has developed training manuals and has implemented a training programme for health care workers to ensure LGBTIQ (lesbian, gay, bisexual, transgender, intersex and queer) competent and responsive health care provision.
The involvement of key population-led groups is a crucial element for successful responses to the HIV epidemic. The backbone of DTHF’s community engagement programme is the network of safe spaces for MSM and LGBTIQ community members. They are located in a number of townships within and around Cape Town.
The Community Liaison team based in Philippi Village, supports the safe space leaders in the management and coordination of the programme. Apart from providing an entry point for recruitment of participants in DTHF’s clinical trials, the safe spaces provide HIV education, address stigma and behavioural risks, and link individuals into HIV testing or care. The Community Liaison team also supports the communities in organising their own activities, such as netball, debates, drag shows, hiking and pride parades.
The DTHF has established an LGBTIQ advocates’ forum for community stakeholders working in the same MSM community networks in order to coordinate activities and maximise our impact.