By: Lunga Memela (Communication Engagement Lead)
Ekuvukeni Clinic, situated in Ladysmith in KwaZulu-Natal's uThukela District, is proud to witness an increasing number of locals showing up for men's health services, thanks to the successful roll out of the facility's MINA Campaign – a Department of Health (DoH) initiative supported by the Health Systems Trust (HST).
The MINA Campaign has been implemented in four of the province's health districts: eThekwini, uMgungundlovu, uThukela and Zululand, offering HIV Testing Services (HTS) that strongly promote voluntary counselling and testing (VCT).
Previously, men were reluctant to visit health facilities for a number of reasons, including stigma around HIV. However, the tide is turning, say MINA Campaign Champions Thabo Nkosi (an HST Lay Counsellor) and Thuthukani Mthembu (a DoH Professional Nurse) who are based at Ekuvukeni Clinic. Their role entails explaining to the community that the MINA programme is specifically designed for men and their wellbeing. "We welcomed the programme with open arms at the facility because we found it quite fitting, and it speaks to us as men in general."
 Thabo Nkosi and
Thuthukani Mthembu.
| “[W]e like the programme because it enables us to fast-track more clients. It is important to get more men to test and know their HIV status. Because Ekuvukeni Clinic has [a presence of] health practitioners who are men, initiatives such as the MINA Campaign make it more comfortable for local men to visit the clinic; it makes it easy for men to voice their frustrations and to open up and discuss their issues around their wellbeing and relationships – there is a mutual understanding between us as men. We have those dialogues that may initially be uncomfortable but, at the end, they yield positive results in the fight against HIV and other social ills.”
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Nkosi said that they prioritise patients listed on the clinic database who are on tuberculosis (TB) treatment and antiretroviral therapy (ART), referring those who do not have food to the Department of Social Development's social relief grants. "We saw a need and a gap where we felt that as humans, we cannot take medication without having anything to eat."
Awareness of the MINA Campaign is spreading favourably by word-of-mouth among men. "Most men have felt that it's taboo to test for HIV because it is associated with stigma, or even to talk about HIV among themselves or their respective partners," Nkosi explained. "MINA encourages men to be proactive and get tested. Gone should be the days when men wait for their partners to get tested for HIV and then assume that they can rely on the partner's results to presume their own."
Since the introduction of the MINA Campaign at the facility, there has been a notable increase in the number of males testing for HIV; those found to be HIV-positive are initiated on ART. "We advertise MINA to every client who comes to the clinic," Nkosi says, "and we long for the day when School Health programmes can assist with further outreach to young and adolescent men. MINA has the potential to close the gap."
The facility team envisages that the campaign will also include index contact testing – a case-finding approach that focuses on eliciting the sexual or needle-sharing partners and biological children of HIV-positive individuals and offering them HIV testing through different modalities. Nkosi is sure that this will create an opportunity for them, as health practitioners, to talk to clients even more effectively about their sexual relationships. "If the clients disclose details of their sexual partners, it will help us to improve ways to curb the spread of HIV and enrol more infected persons on ART."
The MINA Campaign is integrated into existing izibaya zamadoda and Phila Ndoda programmes in the province. Collaboration with the DoH for distribution of the MINA materials and related training and orientation continues, and the materials are mobilised for Wellness and TB Awareness Days. Male clients are fast-tracked to Men's Corners for Primary Health Care services, and ideally, two MINA Champions per facility are assigned to maintain the momentum of the campaign.
HST's MINA Campaign is championed by the organisation's South Africa Sustainable Response to HIV/AIDS (SA SURE) Plus project, which strengthens and supports local capacity to provide sustainable HIV and TB-related care and treatment service delivery in the country through technical assistance (training, mentoring, coaching) and seconded direct service delivery. The project is in its second round of funding from the U.S. President's Emergency Fund for AIDS Relief (PEPFAR), through the US Centers for Disease Control and Prevention (CDC), Atlanta.