1st Nurses & Health Care Workers Drug Resistance Workshop

Authors: Lungani Ndwandwe, Tulio de Oliveira

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One of the major challenges of any breakthrough in medical research or medical intervention is drug resistance. It should be pointed out that drug resistance in itself is complex and even more difficult to treat. HIV is no exception; SATuRN's research has proved the unfortunate fact that HIV drug resistance in adults and children in rural areas is very high. In order to generate awareness of this subject, we organized and hosted our first nurses and health care workers HIV & TB drug resistance workshop.

This workshop was organized by the Africa Centre and SATuRN HIV drug resistance teams, with the support of a pediatrician, dietician, and social workers and in partnership with the Department of Health (DOH). The workshop presented on 22nd May 2012 was targeted at nurses and health care workers from 17 clinics around the Hlabisa sub/district and aimed at equipping them to deal effectively with HIV drug resistance. The workshop was very well attended with 58 participants, which meant that we ran at our auditorium full capacity. The main focus of this workshop was to give nurses and health workers the necessary knowledge to handle HIV drug resistance in children. The programme ranged from the scientific background of HIV drug resistance, from nutrition and growth in children and its correlation with HIV drug resistance, to a more practical session with role-plays, where the teams produced a theater play out how to deal with drug resistance from a clinical, social and psychological point of view.

In addition, Dr. Siva Danaviah (Africa Centre, Durban) delivered a very impressive presentation on how drug resistance develops in a patient. This was followed by a series of drug resistance clinical cases presented by Prof. Ruth Bland (Pediatrician and clinical research leader of Africa Centre). The issue of disclosure ranked high in the discussions and a disclosure section was led and presented by Dr Tamsen Rochat (Psychologist) and Dumo Mkhwanazi (PhD candidate). During this section, they presented helpful steps on how one can go about disclosing the child HIV status.

One of the main focuses of the workshop was to highlight that a detectable viral load result is an emergency situation and that a detectable viral load while on ARVs means that resistance is likely to develop. The workshop generated great discussion and increased awareness of this subject. "This workshop has been helpful to me, especially since I work closely with patients on ARVs and my task is to educate patients about the importance of taking ARVs and most importantly let them know that taking ARVs is a long term commitment", said Mthunzi Mlambo, a clinic HIV counsellor. He continued on to say "This workshop has changed the way I will now deal with my patients, in particular on issues of disclosure and their viral load results".

This comes after a successful meeting between SATuRN and South Africa Department of Health at the end of April, where HIV drug resistance ranked as one of the highest priorities of the DOH. Consequently, the DOH is seeking to upscale HIV resistance testing and SATuRN will continue to host more workshops of this nature among the 17 clinics decentralized across the Hlabisa sub district as well as in the Free State province. The HIV drug resistance team has been working tirelessly to identify patients failing ART, organizing ART failure camps in the 17 clinics, and now hosting workshops, which will continue throughout the year. For this, the resistance team would like to thank the DOH and the DOH staff for their continued support for this initiative. The good news are that we have already seen more patients responding to treatment since this collaboration started.

Interested in training and capacity building? Please visit our annual SATuRN workshop webpage:

7th South African HIV & TB Drug Resistance and Treatment Monitoring Workshop, Cape Town International Conference Centre, 28 to 29 November 2012, Cape Town, South Africa.

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