Programme sets gold standard
• Aid for Aids is global leader in HIV management, writes Lynette Dicey
The AfroCentric Group’s Aid for Aids (AfA) was the first HIV disease management programme to be rolled out by a medical scheme in SA in 1998 at a time when the global response to HIV was still in its infancy.
In the past 20 years, AfA’s programme has evolved to become a highly successful initiative, partnering with treating doctors, laboratories, employers, medicine dispensaries and healthcare funders to successfully treat those diagnosed with HIV. The programme has been shaped by years of clinical research and extensive expertise to the extent that today AfA’s methods are considered the gold standard by healthcare professionals both locally and abroad.
In 2022, AfA was awarded PMR’s Diamond Award in the disease management category in recognition of its commitment to transforming healthcare.
“There is no question that AfA has become the global leader in HIV management,” says Ayesha Kriel, head of Disease, Medicine Management and Aid for Aids at Medscheme, part of the AfroCentric Group.
“We bring measureable value to our stakeholders by offering a holistic solution to all aspects of HIV and chronic disease care, ensuring HIV patients live longer, healthier lives.”
AfA’s clients have, over the years, included medical schemes, business-funded workplace programmes and donor-funded healthcare programmes run by NGOs in SA and other African countries.
The AfA administers 15 medical schemes and seven companies on its corporate programme. To date, close to half-a-million people have been registered on AfA’s care programme with about 237,000 registered and supported.
Medical scheme members are supported through the promotion of HIV programme benefits and the authorisation of effective antiretroviral therapy which is based on best practice clinical protocols and optimal cost containment principles.
Kriel explains that treatment support for patients is provided through various integrated communication strategies including ongoing counselling and education via AfA’s inbound and outbound call centres and addressing barriers to care, adherence monitoring and management which focuses on targeted viral load suppression and active pathology claims management.
In addition, clinical policy making and support for complex cases is provided through a dedicated independent clinical committee comprised of SA’s leading HIV clinicians such as Prof Gary Maartens, Prof Graeme Meintjies and Prof Marc Mendelsohn, among others.
Healthcare providers are supported via the call centre and provided with online HIV training and support. They are sent quarterly newsletters with all the latest clinical updates.
When appropriate for specific clients, says Kriel, AfA leverages off the capabilities of other AfroCentric Group companies to deliver solutions which significantly enhance their members’ experience and provide cost savings to members and clients. She says during these tough economic times, as consumers we do not need unforeseen or additional costs when it comes to treatments and medication.
“We partner with Pharmacy Direct, a courier pharmacy in the group, to provide convenient and uninterrupted medicine delivery with a wallet-free experience and with AfroCentric Wellness to provide onsite wellness screening services, health risk assessments and HIV voluntary counselling and testing at wellness events through our extensive nursing network.”
Key to the success of the AfA programme is the ability to support the patient holistically rather than just focusing on the disease. Says Kriel: “We know the majority of our current AfA beneficiaries are women. Interestingly, women tend to be more adherent to their medicine treatment than men. It is knowledge like this that allows us to tailor-make our interventions more effectively to nonadherent patients.”
She explains that medicine and treatment adherence for all chronic conditions is critically important for successful health outcomes, particularly as far as HIV is concerned.
“Taking medication as prescribed at the correct dosage and frequency helps people living with HIV to suppress their viral load. This means we prevent the HIV from multiplying, we reduce the likelihood of treatment resistance and we ultimately prevent transmission.
“The more the patient’s viral load is successfully suppressed, the lower their risk of resistance, opportunistic infections and hospitalisation.
“The greater the level of the member’s viral load suppression, the greater his/her ability to live a completely normal, healthy and productive life, which is the primary goal of our programme.”
She adds: “Starting HIV treatment is a lifelong commitment and for this reason we encourage our members to get tested, start treatment and registered on the programme as early as possible.
“In doing so, we are able to guide and support them in collaboration with their doctor and achieve much better clinical outcomes.
“Our data reflects it is primarily economically active groups that are registered on the programme with people aged 45 to 54 being the highest age group by prevalence (16.3%), followed by people aged 35 to 44 (15%). Obviously, there is a huge incentive to keep these individuals healthy and economically active for as long as possible. We enable that through appropriate access to information, treatment and care.”
Those members who are most adherent (take their medication daily as prescribed by their doctor) are currently between the ages of 55 to 64 years and tend to be the ones who have been registered on the HIV programme for the longest, she says. “Our younger age groups require the most engagements and reminders to be medicine adherent and treatment compliant so that they may manage their condition more effectively.
“Many of our HIV registered members have additional chronic diseases such as diabetes, hypertension and depression. The number of additional chronic diseases they have impacts how likely — or less likely — they are to take their chronic medication (including their HIV medication) and armed with all the aforementioned data, we are able to enhance and tailor-make our interventions more effectively and address gaps in care as required.
“With these valuable insights, we are able to view our members holistically and thus co-ordinate their care and health needs more effectively.
“This is where the AfA programme really excels, ensuring members have access to the right treatment at the right time and at the right place. Many HIV patients continue to access their medication through the state even if they are members of a medical scheme because of personal preference, a perception of greater anonymity and for fear their employer will become aware of their status.
“Sadly, social stigma continues to play a critical role when it comes to HIV and we continue to strive towards creating more awareness. Through our comprehensive HIV management programme, however, we have managed to progress and we continue to do so to support our members and our nation in this much needed space,” says Kriel.