Correctional Services Programme

Inmates in correctional services around the world are at a higher risk of both TB and HIV. South Africa is no different. TB HIV Care has been supporting the Department of Correctional Services since 2009. We currently offer TB screening (including chest X-rays) and HIV testing and counselling to about 46% of all South African inmates. In addition, we work with the Department of Correctional Services to strengthen the TB and HIV health services available in prison by, for example, training nurses to start eligible HIV positive inmates on antiretroviral treatment.
TB HIV Care supports 95 correctional centres, which are located in the Eastern Cape, Western Cape and KwaZulu-Natal.

TB HIV Care offers inmates TB screening as well as HIV counselling and testing services when they are admitted to a correctional centre, during biannual screening campaigns, and on release. Those inmates who show a symptom of TB are tested using GeneXpert technology. In addition to this, inmates are screened using mobile X-ray trucks, which travel to correctional centres to offer the service. If an inmate’s X-ray result is abnormal, he or she will be tested for TB using the GeneXpert.

Inmates who test HIV positive are referred to correctional services health workers for initiation onto antiretroviral treatment (ART), while those who are confirmed to have active TB, are referred for TB treatment.

TB HIV Care provides information on TB and HIV to inmates as part of HIV counselling and testing and through a peer education programme, where specific inmates are trained on TB and HIV and encouraged to share information with other inmates.

Existing Department of Correctional Services (DCS) health services are strengthened through clinical mentoring provided to DCS health workers by experienced nurse mentors as well as through training in continuous quality improvement methods. This helps to improve the quality and continuity of care of inmates. TB HIV Care also works with other partners to assess and improve methods of controlling infection within centres.


Goodwood Correctional Services Viral hepatitis service

In late 2020, TB HIV Care’s Correctional Service Programme will launch a first-of-its-kind pilot offering viral hepatitis services for inmates at Goodwood Correctional Centre.  The hepatitis services will be integrated into the existing HIV prevention and treatment programme at the correctional centre, and are being offered in partnership with the Department of Correctional Services, CDC and the Liver Clinic at Groote Schuur Hospital/ University of Cape Town. The pilot will offer 750 inmates access to point of care, rapid testing for hepatitis B (HBV) and hepatitis C (HCV). Participants will receive counselling around these infections, and will be offered a course of hepatitis B vaccine should they be susceptible to infection. TB HIV Care will support the health professionals within the Goodwood Correctional Centre to conduct additional testing to confirm viral hepatitis infection and relevant testing to guide treatment. Participants who need it will be offered treatment. Clients with complex clinical cases will be managed in consultation with the University of Cape Town, through their sub-Saharan viral hepatitis ECHO project, which allows for distant, multidisciplinary consultation. The pilot project will also include training and awareness raising around viral hepatitis in the centre. It is expected that the findings from this work will be used to inform future projects and policy around preventing and managing viral hepatitis within correctional settings in South Africa.