Wellness programmes for persons living with HIV/AIDS: experiences from Eastern Cape province, South Africa.

Columbia University's International Centre for AIDS Care and Treatment Programmes (ICAP) supports the establishment of HIV prevention, care and treatment programmes, in resource-limited countries, through the President's Emergency Plan for AIDS Relief. In South Africa (SA), ICAP has collaborated with the Eastern Cape Department of Health since 2004, to support HIV treatment and care programmes at public healthcare facilities in rural and urban areas. Adherence, psychosocial and other supportive services have been combined into Wellness Programmes that have been situated within hospital-based Wellness Centres in two rural regions, and integrated within primary healthcare facilities in a third. This paper reviews components of wellness services for people living with HIV/AIDS including: voluntary counselling and testing, disclosure and prevention, ongoing counselling, health literacy and peer education, community- and home-based care, adherence support, and associated comprehensive care continuums. It also describes local context in which the Wellness Programmes were established. Finally it describes processes, successes and challenges, with programme development, and useful indicators monitored, lessons learned and strategies to strengthen and expand such programmes. Insights provided may inform other efforts to create sustainable systems of interdisciplinary care and accessible psychosocial support for HIV-infected persons within public facilities in resource-constrained settings.