What we do

HIV Counselling and Testing

The New Start Programme launched in 2004 in three South African citiesas an HIV counselling and testing (HCT) programme designed to take testing out of the medical setting and encourage more South Africans especially men to undergo testing. Above all it was intended to communicate the idea that knowing your HIV status enables you to deal with your health and your future in a purposeful, empowered way.

New Start's services have expanded over the course of a decade. Presently HCT services as an entry point to combination prevention services that include CD4 count testing, sputum sample collection for TB, referrals to New Start's medical male circumcision service and to a range of health and social services, as required by the individual or family.

Taking services to the people

Within months of opening its doors in South Africa, New Start adopted the innovative approach of setting up mobile testing services in busy shopping areas and transport nodes. These mobile services operating from tents, became increasingly bold in their location. Far from being deterred by the visibility of the services, people flowed in steadily. It seemed that the more in your face we were, the better the testing service seemed to work,recalls New Start's first employee and Director of SFH, Scott Billy.

In the course of a decade, more than one million HIV tests have been administered by New Start, accompanied by quality counselling and additional services, as required by the individuals circumstances.

Focusing on families and neighbourhoods

Over the years, the New Start HIV testing programme has evolved (in line with national strategies and policies) to incorporate TB screening and sputum sample collection, CD4 count testing for those who test HIV-positive, information on and referrals for medical male circumcision for men who test negative, and a wide range of other referrals to social and health services.

Home-based HCT involves teams of trained counsellors going door-to-door in residential areas offering members of households the convenience of taking a test in their own homes and incorporating the other service elements described above, as appropriate. Their approach is proactive they select an area and work systematically through it, road-by-road and then move on to the next patch and do the same. This method is known as the general population HCT model.

HCT teams also use the index client model, where they reach out to the families of individuals who have undergone testing at a local clinic and are HIV-positive. The main purpose of this service is to ensure that the individual's sexual partner and children, where appropriate, are tested and to assist couples to deal constructively with the results, whether both partners are positive or the partners are discordant in terms of HIV status.

Couples counselling and testing has become a strong feature of New Start's offering. This involves the joint counselling and testing of partners.Results are given to both partners in each other's presence. The counsellor is able to assist them deal with their reactions to the results, which is especially important when one or both partners test HIV-positive.

Currently, about 80% of HIV tests performed by New Start are done in homes while 20% take place in mobile testing sites in high-traffic areas of towns.