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Ending New HIV Infections by 2022

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Ending New HIV Infections by 2022 Royal Eswatini Police Service Health and Inclusiveness Training Manual December 2018 Royal Eswatini Police Services, 2018 ©Royal Eswatini Police Service This training manual is a publication of the Royal Eswatni Police Services (REPS) in collaboration with Eswatini National AIDS Program (ENAP)-Ministry of Health, Eswatini and other partners. The text of this publication may be freely quoted or reprinted with proper acknowledgement. Recommended citation for this manual: Royal Eswatini Police Service (2018). Royal Eswatini Police Service Health and Inclusiveness manual, Learner manual. Mbabane, Eswatini. Disclaimer The opinions expressed in this document do not necessarily represent the officeial position or policy of Royal Eswatini Police Services or Eswatini National AIDS Program. ii Foreword As a Royal Eswatini Police Service, we remain unrelenting in our commitment to make an effective contribution in the fight against the HIV and AIDS scourge in the country. To that effect, we cherish and are humbled by the recognition accorded by the Ministry of Health, that our organization is one of the key stakeholders for broader success in reversing the frontier of this nemesis. To further escalate our efforts, as well as hearken to the call by His Majesty The King for all sectors in Eswatini society to join hands to put an end to new HIV infections by 2022 in consonance with the macro National 2022 Vision of a “First World Eswatini”, we have developed a multi-prolonged HIV and AIDS counteracting Strategy. The Strategy aside from addressing issues relating to the holistic support for members of the Police Service and their families who may be afflicted and affected by HIV and AIDS, also focuses on the critical aspect of creating a non-stigmatisation and non-discriminatory environment. The implementation of the Strategy remains on course and is yielding tangible results. To complement the aspirations of the Strategy, especially with hindsight of the law enforcement responsibilities of Police officers which more often than not, means that they interact with marginalised groups in society, Health and Inclusiveness Training Manual has been conceptualized. The Manual seeks primarily to improve how Police officers respond to their health needs through providing information on sexual reproductive health (SRA), prevention, care and treatment for HIV, sexual transmitted infections (STI’s), tuberculosis (TB), and selected cancers as well as mental health and related health services. It is also designed as a tool of furthering service provision towards vulnerable and marginalised groups including key populations (KPs) within the obligations of the Police under the relevant country’s regulations. It is our fervent hope that this training manual will provide the requisite guidance and impetus for Police officers in their diverse operational capacities, to make a meaningful contribution towards ending HIV and AIDS. W. W. Dlamini ACTING NATIONAL COMMISSIONER OF POLICE iii Acknowledgements The Kingdom of Eswatini has made major strides in its HIV response, reducing new HIV infections through initiating those people living with HIV (PLHIV) on antiretroviral therapy (ART) both as a measure for reducing new infections and for improving the quality of life of those infected. However, more work still needs to be done as the epidemic has shifted from what is commonly known as a generalised epidemic to a micro-epidemic impacting different groups in different ways. The sub-populations who are most affected by HIV have previously been left behind in the response for HIV, including vulnerable and marginalized groups including KPs. In response the government of Eswatini has engaged a multi-sectoral response to HIV, in accordance to His Majesty’s call. We would like to thank the Royal Eswatini Police Services (REPS) for taking a lead in responding to HIV in accordance wtih His Majesty’s call. Special thanks goes to the The National Commissioner of Police as well as the police executive committee; the police officers from the regions, stations and posts; the police health department; the basic training and in-service division; the faculty of management and leadership; the curriculum design and examination unit; and the domestic violence, child protection and sexual offences unit. We would also like to thank all partners who have supported in developing this training manual. We would like to thank African Men for Sexual Health and Rights (AMSHeR) through the KPREACH programme for their technical and financial support; FHI 360; council of Assemblies of Nongovernmental Organizations(CANGO); Fammily Life Association of Swaziland (FLAS); Key populations (KP) Community-bsed Organisations; and the UN agencies, especially UNAIDS for their technical support and UNDP for their contribution in rolling out trainings based on the manual. We would also like to thank our consultant, Sibusiso Nhlabatsi, for his contribution as a consultant. In addition we would like to thank all the members of the KP Technical Working Group and stakeholders who participated in the development and validation process of the training manual. Lastly, we thank our own Key Populations Unit within ENAP for their coordination role in all our interventions, including this initiative. Dr Vusi Magagula DIRECTOR OF HEALTH SERVICES MINISTRY OF HEALTH iv Acronyms ACHPR African Charter on Human and People’s Rights AIDS acquired immune deficiency syndrome AGYW adolescent girls young women AMSHeR African Men for Sexual Health and Rights ANC antenatal clinic ART antiretroviral therapy ARV antiretroviral (drug) BMI body mass index BP blood pressure CAG community-based ART groups CANGO Council of Assemblies of Nongovernmental Organizations CEDAW convention of elimination of all forms of discrimination against women CIHTC client-initiated HIV testing and counselling CRC convention of the rights of the child DOT directly observed therapy EC expert client FHI Family Health International FLAS Family Life Association of Swaziland FTC facility-based treatment club GBV gender-based violence HCW health care worker HPV human papillomavirus HTS HIV testing Services HIV human immunodeficiency virus HIVST HIV self-testing HTS HIV testing services ICCPR international covenant for socioeconomic rights ICSER international covenant for civil and political rights KP key population LGBTQI lesbian, gay, bisexual, transgender, queer, and intersex MICS multiple indicator cluster surveys v MSM men who have sex with men MTCT mother-to-child tranmission NCD noncommunicable disease NSE Needle and syringe exchange NSF National Multisectoral HIV and AIDS Strategic Framework NSP needle and syringe program OI opportunistic infections PEP post-exposure prophylaxis PHT post-menopausal hormone therapy PIHTC provider-initiated HIV testing PLHIV people living with HIV PrEP pre-exposure prophylaxis PWID people who inject drugs REPS Royal Eswatini Police Service SARPCCO southern african regional police chiefs cooperation organisation SDHS Swaziland Demographic and Health Survey SHIMS Swaziland HIV Incidents Measurements Survey SRH sexual and reproductive health STIs sexually transmitted infections SW sex worker TB tuberculosis TG transgender people UDHR universal declaration of human rights UN united nations UNAIDS joint united nations programme on HIV/AIDS UNCAT convention against torture and other cruel, inhuman or degrading treatment or punishment VIA visual inspection with acetic acid VL viral load VMMC voluntary medical male circumcision WHO World Health Organization vi Glossary AIDS AIDS stands for acquired immunodeficiency syndrome: A - Acquired. This condition is acquired, meaning that a person becomes infected with it. I - Immuno. HIV affects a person's immune system, the part of the body that fights off germs, such as bacteria or viruses. D - Deficiency. The immune system becomes deficient and does not work properly. S - Syndrome. A person with AIDS may experience other diseases and infections because of a weakened immune system. AIDS is, therefore, a disease in which there is a severe loss of the body's cellular immunity as a result of destruction of T-cells by HIV, greatly lowering the resistance to infection and malignancy. Not every person infected with HIV has AIDS. It is only when the immune system of the person is so weakened that the person gets infections because his or her immune system is no longer able to fight them off. At this stage the person will be said to have AIDS. Alcohol This includes beer, wine, and spirits. These substances act as a central nervous system depressant. Alcohol is usually ingested orally as a drink. Anal Sex Sex that involves the insertion of the penis into the anus (penile- anal penetrative sex). Antiretroviral drugs Medication used in the prevention or treatment/management of (ARVs) HIV. Antiretroviral Antiretroviral therapy is the combination of several antiretroviral therapy/treatment (ART) medicines used to slow the rate at which HIV makes copies of itself (multiplies) in the body. A combination of three or more antiretroviral medicines is more effective than using just one medicine (monotherapy) to treat HIV. It also involves ensuring that a person adheres to treatment, attends clinic appointments, and meets other requirements of the therapy. Bisexual Having sexual partners of both the same and the opposite sex. Bisexuality The sexual orientation in which an individual has romantic and/or sexual feelings toward both males and females at a point in time. i Chancroid A STI caused by the bacterium
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