For Transgender (TG) people

Beyond Zero was awarded a Global Fund grant to oversee prevention programmes for TG people that aim to reduce the number of new HIV infections and further spread of HIV through provision of recommended comprehensive package of services. TG are part of the broader key populations that have been shown to be at high risk for HIV infection. Various studies have shown that key populations are disproportionately affected by HIV compared to the general population. HIV prevalence among adults aged 15 to 49 years in South Africa is 19 percent, (STATSSA 2018)

A recent Human Sciences Research Council (HSRC) (2019) HIV prevalence survey conducted amongst transgender women in South Africa showed high HIV prevalence rates in 3 study locations namely Buffalo City metro (46,1%), Cape Town Metro (45.5%) and Johannesburg (63.4%). Against this backdrop, the South African National Strategic Plan (NSP) for HIV, Tuberculosis and Sexually transmitted infections (STIs) 2017 – 2022 prioritised key populations. Beyond Zero, under the Global Fund grant, is tasked with rolling out a combination prevention intervention for TG as advocated by the NSP.

    Combination HIV prevention combines all three of the following types of interventions into a single integrated approach to HIV prevention.

    • Behavioural interventions to promote and sustain safe behaviours among individuals and social units using a variety of educational, motivational, peer education and skills building interventions focusing on knowledge, attitudes, skills and beliefs.
    • Biomedical interventions to block or diminish HIV infectiousness or reduce susceptibility to HIV infection. Such interventions include condoms and lubricants, sexual and reproductive health services, antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV testing and counselling.
    • Structural interventions to promote an enabling environment by addressing political, economic and sociocultural factors that are the drivers of vulnerability to HIV infection. The intervention seeks to bring to scale community empowerment and other programmes that have been proven to reduce stigma, discrimination and marginalization, including in health care settings.

    The transgender module is implemented in the following operational areas:

    Province District SR
    Free State Mangaung Tholwana e Molemo
    Limpopo Capricorn ANOVA Health
    Mpumalanga Gert Sibande IHPS
    Western Cape Eden SHE


    The transgender module is implemented in the following operational areas:

    TG SRs identify key populations, reach key populations with a defined package of services that include risk reduction counselling, gender-based screening and awareness, TB and STI screening, sexual and reproductive information, commodity distribution and HIV testing services. HIV negative clientele are continuously re-engaged on regular HIV testing, enrolled on Pre-exposure prophylaxis (PrEP) as appropriate and offered combination prevention. HIV positive clientele are channeled to care and treatment facilities where they are initiated on ART and supported to stay on treatment and achieve viral suppression. Comprehensive M&E systems are in place for monitoring and reporting of all activities elaborated here.