On the 3rd September, TB/HIV Care launched a fixed site wellness centre with a different focus. This wellness centre in Observatory, Cape Town, will concentrate on providing health care services to ‘key populations’; people who are ‘key’ to the response to the HIV and TB epidemics. This includes sex workers, people who inject drugs, men who have sex with men, and transgendered people.
Key populations often face high levels of discrimination, even at health centres, and therefore may have challenges accessing care. Catherine Williams, a professional nurse counsellor at TB/HIV Care Association explains why mainstream health facilities may not be the first choice for key populations, “Most people are not comfortable because they either get judged by health workers as immoral or, in the case of injecting drug users, there’s often a great deal of fear that health workers will report their illegal drug use to law enforcement and get them into trouble.”
The new wellness centre in Observatory will provide HIV counselling and testing, screening for TB and sexually transmitted infections (STIs), syndromic management of STIs, viral check-ups, and pap smears, among other services. It is believed key populations are more likely to access services at the wellness centre because it is a ‘judgement-free space’. TB/HIV Care’s outreach teams are also actively building connections within key population communities to help establish trust within these ‘hidden’ communities.
Providing an alternative point of health care is not the only or a complete solution to improving access to health care for key populations however. TB/HIV Care’s key populations programme also runs sensitization workshops with mainstream health facilities to improve the way vulnerable people are treated by health workers. It is hoped that ultimately improved service at mainstream health facilities will increase their use by key populations.