LINKAGE OF IDENTIFIED CASES TO HEALTH FACILITIES SERVICE PROVISION TO KEY POPULATIONS KABUSUNZU HC

Geographic overview Kigali City, Muhima District Hospital Catchment area Serves Urban and semi-urban residential areas. Urban population mainly made of families with modest revenue Total population (all ages):25 835* Women in reproductive age: 6097* Children Under 5 years:4131.5* (* June, 2014)

HIV Services at the facility IEC/BCC for HIV prevention, (in the facility & community). HIC counseling and Testing PMTCT : - ANC - HIV exposed infant follow up - Pregnant and breastfeeding mothers follow up Care & treatment for people living with HIV Care & treatment for discordant couples ART clinic

Care & treatment for Key populations Group targeted: MSM Start up of activities: July 2010, under technical and financial support of ICAP One of three (3) key populations’ friendly corners in Kigali. Size of the group at the beginning: 21 MSM

Services offered to KP IEC/BCC for VIH prevention HIV Counseling and Testing (each 3 months) STI Screening (each 3 months) Supply of Condoms Supply of Lubricants ART for HIV positive clients Psychosocial support

Organization of services: At the facility Services coordinated and funded by ICAP  Service offered at convenient hours (evenings) - Education session HIV & STIs prevention - HIV Counselling and testing, - STI screening sessions - Condom & lubricant distribution campaign - Mutual Support associations (“Groupes de soutien”).

Support given to the facility Provided by ICAP Training to all staff (awareness) Training of nurses, counselors and social workers on specific follow up. Medical materials for screening, examination and lab consumables Transport facilitation to clinical staff and clients

Organization of services: non clinical support Peer educators identified among MSM -Contribute in inviting other MSM for follow up -Serve as focal point in sensitizing their peer to adopt HIV prevention behavior -Contribute in locating and encouraging clients with troublesome adherence and /or lost to follow up -Serve as focal points for their peers income generating associations

Key achievements Clinical staff capacity building on care & treatment for key populations (Trainings) Respect of human rights for MSM Improved self esteem and openness to discuss HIV risks related to their sexual orientations Improved access and utilization of HIV services Facilitated access to condoms & lubricants

Challenges Program initiated and coordinated by ICAP: no preparation to take over by the health center. The program was running with incentives to staff and clients Most of MSM are also prostitutes ICAP coordinated activities in the health facility, but with minimal involvement of the facility in non-clinical activities (Home visits, Community recruitment of MSM,…)

Recommendations Need of a technical & financial partners to resume effectively the program Encourage MSM to utilize HIV services without a focus on incentives earn Uninterrupted supply of commodities specific to key pop (condoms (female) & lubricants) Establish a sustainable follow up system run by the health center (follow up registers & files, IEC & didactic appropriate tools, mentorship and M&E system)

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