1. Peninah Thumbi 12 October 2010

2. The McCord Hospital’s HIV Program State subsidized fee-paying hospital in Durban Pillars: Medical Care, Response to the current epidemic, Research & Training Hospital services targeted at the employed uninsured 2004 PEPFAR Funds to expand ARV treatment The program has been responsive to the local epidemic including the integration of TB-HIV care Embraces the provision of biomedical HIV prevention as part of core responsibility (PMTCT, PEP, MMC) in addition to the curative Incorporates research & Training into its HIV program

3. McCord HIV Program: A Comprehensive Scope of services HIV TESTING OUT PATIENT / INPATIENTS: ADULTS & CHILDREN ANC CLINIC: MOTHERS HIV - HIV +HIV - HIV + Paediatric & Adult Care and Treatment Risk reduction counselling PMTCT Care: incl post natal f- up HIV Prevention: Incl MMC Pre-ART Care Risk reduction counselling Early Infant Diagnosis HIV +HIV -

4. CURRENT FACILITY BASED MMC SERVICES MMC mainly for medical reasons Referrals from the HCT services Referrals from outside- with enquiries from institutions such as SANDF MMC cost: Adult under GA: R3570 Adult under LA: R1700 Infant: R640 With sourcing out MC kits bringing the cost of adult under LA down to about R900 75 circumcisions Jan-Aug; 42 performed Jun-Jul

5. MMC PLANS/OTHER ACTIVITIES Applied for PEPFAR funds to implement a free service of High Volume MMC Ambitious plans – provide MMC and Training Target circumcisions / per target area population of males April 2010 to March 2011 – 4 481 (10% of target population) Community mobilization plans: Community partner Zoe-Life Engage with other partners PSI/FSH, OAC – MOVE model All counsellors trained to include MMC in RR counselling Engaging with and supporting district MMC plans Active participation in MMC camps in the district- sending doctors/nurses Active participation in District Task Teams for MMC

6. PLANS : FREE HIGH VOLUME MMC In association with community based partners -to generate the need ; provide counselling &pre-screening In association with partners experienced in the provision of high volume MMC- to provide training Provide space and staffing including M& E support Timelines: Pending funds---- January Meantime reduce the cost of the MMC to make it more accessible to persons that can pay for the service- offer it in our RR counselling at workplace HCT programs

7. Expectation from Meeting Learn from the experience of those who’ve implemented the service as we prepare to engage in a high volume service when funds are available