The Meeting Targets and Maintaining HIV Epidemic Control (EpiC) Project is a five-year global project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID), managed by FHI 360 and dedicated to achieving and maintaining HIV epidemic control.
In Thailand, the EpiC Project focuses on reducing HIV transmission among key populations, including men who have sex with men and transgender women, by using social media to reach key populations, providing community-based testing and treatment, promoting lifesaving care through same day anti-retroviral treatment (ART) initiation, and fostering and enhancing domestic health financing schemes to sustain community-based organizations as part of the national HIV response. These approaches are contributing significantly to Thailand’s HIV strategy. To ensure local ownership and sustainability of successful approaches, USAID and EpiC have successfully advocated for the National Health Security Office to financially support an increasing proportion of the costs of service delivery for EpiC community-based partners.
KEY POPULATION-LED HEALTH SERVICES
The Key Population-led Health Services, EpiC Thailand’s primary intervention model, emphasizes that key populations themselves are in the best position to design and deliver services for their own members. EpiC community partners operate 12 key-population-led community-based clinics across seven provinces. These clinics provide friendly and easy access to HIV testing, HIV pre-exposure prophylaxis (PrEP), ART care and support services, viral load monitoring, and testing and treatment for other sexually transmitted infections. These services adhere to national standard guidelines for health service delivery developed in partnership with the Thailand Ministry of Public Health. Local healthcare providers and provincial health offices are playing a key role in facilitating referral and ongoing quality monitoring of HIV services and improvement.
ENHANCED PEER MOBILIZATION AND USE OF SOCIAL MEDIA
EpiC Thailand supports innovative approaches to reaching high-risk individuals and efficiently and effectively referring them to key population-led health services. Enhanced Peer Mobilization extends activity recruitment beyond traditional outreach by mobilizing program clients to refer their friends and partners for HIV services. By analyzing activity recruitment patterns in real time using mobile data collection, implementing organizations can proactively target networks of individuals with high HIV prevalence for more targeted interventions. EpiC has also developed an innovative online reservation application to track clients from online interactions into health service sites where they can receive services.
DIVERSIFIED TESTING MODELS
USAID support has been a key to expanding availability of community-based HIV testing in Thailand. Under the key population-led health service model, EpiC is further expanding to include rapid HIV self-testing using an oral fluid test kit available from project outreach workers, home delivery via online ordering, as well as through a network of trained, key-population-friendly private-sector pharmacies. By closing the gap between infection and diagnosis, EpiC helps prevent additional people from becoming infected.
STRENGTHENED COMMUNITY-BASED ARV AND PREP SERVICES
Diagnosing HIV infection is most useful when clients are linked to HIV treatment, which protects their health and prevents onward transmission. EpiC is supporting the scale-up of a clinical model where clients who meet clinical criteria can initiate treatment on the same day they receive their HIV diagnosis. EpiC is also piloting community-based same day treatment so that clients can start ART in the community settings where they are diagnosed. In addition, to reduce new infection cases, EpiC is scaling up the community-based PrEP services in 10 high burden provinces by collaborating closely with the National Health Security Office to demonstrate the feasibility of community-based PrEP services under the universal health coverage scheme.
