​Zoliswa Nzeku
 
In a significant step towards fighting HIV/AIDS, the Tambo Memorial Hospital has established a Virological Failure Specialised Clinic dedicated to supporting HIV positive patients struggling with unsuppressed viral loads and challenges in adhering to treatment and appointment schedules. This specialised clinic represents a targeted intervention to improve patient outcomes and curb the spread of the virus within the community.
Initially focused on children who were experiencing high viral loads due to inconsistent treatment adherence and social issues, the clinic quickly expanded its reach.
 "When we started, we primarily worked with children whose viral loads were not decreasing due to irregular treatment and social challenges," explained Serengwane Lethuba, HIV/AIDS, STI's and Tuberculosis (HAST) Manager. 
The clinic soon identified a growing number of adult patients on first and second line of Antiretroviral Therapy (ART) regimens who were also experiencing unsuppressed viral loads. Alarmingly, many of these patients were being moved to the more advanced third-line regimen, demonstrating the urgency for intervention. To better address this, the clinic conducted a focused sampling involving 89 patients with persistent virological failure.
Operating every Tuesday, the clinic is staffed with an advanced clinical team that includes a Doctor, a Clinical Nurse Practitioner, and an HIV Testing Services (HTS) Counsellor. The team's approach ensures comprehensive care fit to each patient's needs. One of the critical insights uncovered by the clinic was the role of non-disclosure of HIV status in contributing to unsuppressed viral loads. 
Recognising this, the hospital has integrated the Social Work Department into the clinic's Multidisciplinary team. Social Workers play a crucial role in addressing the psychological and social barriers that hinder treatment adherence, facilitating disclosure, and offering continuous support. This approach has led to substantial improvements in patient outcomes. After addressing the psychological and social challenges, many patients have achieved viral suppression within just three months data and results show.
The clinic utilises a system where the Nurses thoroughly review patient results and initiate a telephonic tracing to remind and encourage patients to attend their appointments. Upon visiting the clinic, patients receive coordinated care from the entire team, including medical evaluation, counselling, and psychosocial support. 
The establishment of this clinic is aligned to the "Close the Gap" Campaign recently launched by the Minister of Health, Dr Aaron Motsoaledi together with MEC for Health and Wellness, Nomantu Nkomo-Ralehoko to trace patients who have defaulted on their HIV treatment, those who are newly diagnosed but not yet on treatment, and those on treatment but failing to suppress the virus. 
In addition, this initiative highlights the hospital's commitment to localise the campaign to bring patients back to care while treating them with dignity and creating an environment that supports adherence and viral suppression.
The Hospital has urged HIV positive patients within the community of Boksburg, Benoni and surrounding areas facing challenges with their treatment or viral load suppression to visit the Virological Failure Clinic every Tuesday. 
"Our specialised clinic is a safe space where patients are empowered and supported to fight HIV effectively," concluded Mr. Lethuba HAST Manager. The clinic is located inside the facility and ca be reached on 011 898 8331