HIV Care and Treatment in Private Networks Project

USAID is funding a five-year activity with Asociación Pro Bienestar de la Familia (APROFAM) to implement activities in a consortium with Asociación Hondureña de Planificación de Familia (ASHONPLAFA) and Asociación Panameña para el Planeamiento de la Familia (APLAFA) in three Central American countries (Guatemala, Honduras and Panamá). Interventions will focus on supporting the adoption and implementation of the HIV continuum of care, including provider-initiated testing, index testing, as well as test and start, as a means to achieve the second and third UNAIDS 95-95-95 targets, so that 95% of people who know their HIV status access treatment, and 95% of people on treatment achieve viral suppression. 

The emphasis of the activity is on strengthening HIV care and treatment services for key populations (KP) and priority populations (PP) through private health networks, and in particular, on the diagnosis of HIV, and early initiation and adherence to treatment to improve quality of life. However, actions to reduce HIV morbidity and mortality, such as management of opportunistic infections, early diagnosis of cervical cancer and other comorbidities that jeopardize the quality of life of people living with HIV (PLHIV) will also be addressed. The activity will support continuous quality improvement in all services where an HIV clinic exists, as well as strengthen the use of data for programmatic and financial decision-making. All strategies and interventions must be evidence-based, context-specific and cost-effective. 

The proposed activity will contribute to the Regional Development Cooperation Strategy's objective 3: Improved resilience and response to regional environmental and health threats, specifically towards achieving Intermediate Result 3.2: Improved prevention and responses to current and future health threats in the region. The activity will support Strategy 3.0 of the President's Emergency Plan for AIDS Relief (PEPFAR) with a focus on sustainable control of the epidemic and ensuring that effective treatment is available and accessible to those who need it most. 

GEOGRAPHICAL AND DEMOGRAPHIC APPROACH

The geographic scope and network of services includes clinics and hospitals in the USAID catchment area of each project country - Guatemala, Honduras and Panamá. The populations that benefit from the project are key populations: men who have sex with men (MSM), people living with HIV (PLHIV), ethnic groups in Panamá (Ngabe-Bugle) and Honduras (Garifuna), other indigenous groups and migrant populations in Guatemala, Honduras and Panamá, as well as people transferred to clinics from Ministries, Secretariats, National Social Security and people who access the health services of the clinics who are referred for HIV services due to their risk profile.

CONTEXT AND CHALLENGES

The Consortium (APROFAM, ASHONPLAFA and APLAFA), will have a gradual and scalable implementation, that will allow facilities and services to implement HIV prevention, promotion and treatment activities through the development and adaptation of strategies, protocols and quality standards that ensure and guarantee the implementation of services that respond to the needs of patients, in a context free of stigma and  discrimination, with confidentiality and privacy, and with a social care cost, but from a private service environment. This will be gradually expanded over the five years of the project.

APPROACH AND RESULTS

Comprehensive approach: the activities implemented will focus on providing comprehensive care to all PLHIV through actions in each pillar of the HIV care continuum. The actions respond to the objectives and outcomes of the project and will be implemented and monitored under a quality approach that seeks patient satisfaction using a patient-centered model, and ensuring confidentiality and privacy. In addition, the actions will consider support for victims of gender-based violence. 

Activity objective: to strengthen the capacity of Guatemala, Honduras and Panama to achieve improved HIV service delivery systems and contribute to the achievement of targets 95-95-95 and ultimately control of the HIV epidemic.
 
Objective 1: strengthen host country capacity to provide sustainable, high quality HIV diagnosis, care and treatment  services, free of stigma and discrimination. 

Objective 2: optimize performance and quality (OPQ) methodology in HIV care and treatment services in four countries in the region.