1. The National HIV Counselling and Testing Campaign and Treatment Expansion in South Africa: A return on investments in combination prevention XIX International AIDS Conference, Washington DC 26 th July 2012 Abstract Reference No: THPDE0304 Presented by Dr Thobile Mbengashe Chief Director, HIV/AIDS Cluster, National Department of Health, South Africa

2. Background Population of 50,590,000 5.6 million people living with HIV in South Africa – A quarter of the disease burden in sub-Saharan Africa – One fifth of the global disease burden The national HCT campaign was launched in April 2010 and ended in June 2011 Objectives: – To promote comprehensive combination HIV prevention and – increase access to early treatment Target: 15 million to be tested in 15 months

3. Methods Age 12-60 years HCT, Condoms distribution TB, BMI, Hb, cholesterol screening; MMC, PMTCT, CD4 count, TB & ART referral Communities, Work places, malls, farms, correctional services WHO What Where National Population: 50 million District Hospitals 9 Provincial Nerve Centres National Nerve Centre Monitoring Coordination & Supervision

4. Results: by April 2011 Counselled: 15,018,720 people Tested : 13,269,746 people HIV positive: 2,155,312 (16%) CD4 tests: 48% had counts over 350 Initiated on ARVs: 400,000 57,000 pregnant women Total: 1,7 million on ART Budget: $3.5 billion Wellness Screening TB- 8 million HB Cholesterol BP Condoms 524,000 Female condoms 185 million male condoms Circumcision (MMC) 237,000 males circumcised 50% ARV price reduction 10,542 nurses trained 80% of 3,686 health facilities providing ARVs MTCT reduced to <5%

5. Conclusion South Africa has succeeded in implementing a comprehensive HIV combination prevention model that optimizes treatment for prevention and improves quality of life to reduce new HIV infections. The HCT Campaign created a shift from testing for treatment to testing for prevention and promoting combination prevention. The Treatment Expansion programme contributed to preventing new HIV infections. 50% ARV price reduction & economies of scale resulted in a highly cost effective intervention The outcome was a reduction in the incidence of new HIV infections.

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