Additional Information on MOSAIC Men’s Health Initiative

South Africa has the world's highest number of people living with HIV, almost 1 out of every 5 people between the ages of 15 - 59 years is HIV infected. Furthermore, the distribution of HIV varies across different regions and between groups of individuals. A combination of structural, social, biological and behavioural factors contribute to the disproportionately higher HIV burden among men who have sex with men (MSM), sex workers and drug users in South Africa - collectively defined as most at risk populations (MARPs) or key populations. HIV prevalence among these groups is estimated to be 30%, 60% and 12% respectively . Almost 25% of new HIV infections in South Africa are estimated to be among sex workers and their clients and among MSM - who make up 5% of the population at risk for contracting HIV.  This high HIV burden is indicative of the failure of the HIV response to meet these people's needs.

As a result of global recommendations for an AIDS free generation and based on local knowledge, the South African National Strategic Plan on HIV, STIs and TB (2012-2016) explicitly includes key population programmes. ICAP's MOSAIC Men's Health Initiative forms part of South Africa's evidence informed HIV response to address the needs of key populations.

ICAP South Africa, through the MOSAIC Men's Health Initiative, will increase coverage, access and quality of HIV-related services for MSM, resulting in a reduction of HIV infections and improved health outcomes for MSM in South Africa. 

Scope of activities
This 5 year initiative will facilitate the coordinated and integrated provision of comprehensive HIV-related services for MSM in the following provinces:

Province City District (s)
Eastern Cape Port Elizabeth Nelson Mandela
Free State Bloemfontein Motheo
KwaZulu Natal eThekwini eThekwini and uMgungundlovu
Limpopo Polokwane Capricorn
Free State Bloemfontein Motheo

ICAP South Africa, through support from the United States Centers for Disease Control and Prevention (CDC) under the President’s Emergency Plan For AIDS Relief (PEPFAR), facilitated the establishment of Communities of Practice (CoPs) in each of the 5 provinces of operation. Each CoP is comprised of government (provincial and district level) and strategic implementing partner representatives responsible for coordinating the delivery of a package of evidence-based interventions for MSM, inclusive of:

  1. Peer-based outreach and education
  2. Condoms and lubricant distribution
  3. HIV counselling and testing (HCT)
  4. STI and TB management
  5. The provision of HIV prevention, treatment and care services
  6. Access to additional support services (mental health, psychosocial support and substance control services)

Training and capacity building around MSM sensitisation and competent clinical service provision will also be provided to enable stakeholders to provide MSM appropriate services.

For more information regarding the MOSAIC Men’s Health Initiative:
Jacques Livingston (MARPS Technical Advisor)
ICAP South Africa
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

1 Desmond Tutu HIV Foundation. Key Populations, Key Solutions. Report. 2011. Cape Town: Desmond Tutu HIV Foundation.
  Note that little
research has been conducted among drug users in South Africa, and the HIV burden may be even greater.
2 SACEMA. The Modes of Transmission of HIV in South Africa. Report. 2009. Stellenbosh: SACEMA.

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