Www.aids2014.org Les Ong Program Adviser Community-based service delivery across the continuum of prevention, care & treatment for Key Populations.

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Presentation transcript:

Les Ong Program Adviser Community-based service delivery across the continuum of prevention, care & treatment for Key Populations

Epidemic Concentrated in Key Populations Goal: Zero new HIV infections by 2020 Cover 17 out of 22 provinces Reach 49, 396 KPs (70% of estimated population size) with prevention, care and support services through community-based program

Strengthening the Care Cascade Prevent new infections Accelerate case detection Early enrollment in Pre-ART/ART Maximize retention in care

Tailored Programs Men who have sex with men Transgender people Entertainment Workers

Linkage to Care HC CD4, pre-ART/ART, ANC, VCCT, TB, STI, MMT, VL CD4, pre-ART/ART, ANC, VCCT, TB, STI, MMT, VL + + Key Populations BCC, Condoms/ lubricants, NSP, oral/emergency contraceptives, HTC, STI& TB screen, risk tracing Prevent new infections Accelerate case detection Early enrollment in Pre-ART/ART Maximize retention in care Active Case Management HC DIC Peer outreach worker Community level Implementing Partner NGO

Key Populations BCC, Condoms/lubricants, NSP, oral/emergency contraception HTC, STI screen, TB screen, Risk Tracing Peer Driven Intervention mHealth Finger Prick Testing Social Marketing Prevent new infectionsAccelerate case detection HC DIC Peer outreach worker Community level Implementing Partner NGO

Early enrollment in Pre-ART/ARTMaximize retention in care Linkage to Care HC CD4, pre-ART/ART, ANC, VCCT, TB, STI, MMT, VL CD4, pre-ART/ART, ANC, VCCT, TB, STI, MMT, VL + + Key Populations Active Case Management - Follow-up - Accompanied referrals - Health services liaison - Follow-up - Accompanied referrals - Health services liaison HC DIC Peer outreach worker Community level Implementing Partner NGO

Lessons Learned Community-based approach brings services closer to KPs and improves linkage to, and retention in, the care cascade. Institutional and capacity building of “specialist” implementing partner NGOs and task shifting to KP members are critical. Challenge to reach KPs with highest risks and partners of KPs. We may need to consider modification of the outreach strategy – eg PDI, 24 hour drop outreach, GIS mapping. OWs experience significant burden, low motivation and a high turnover, compromising quality of service delivery. ‘Professionalize’ to improve conditions and quality? Community based approach needs to continue to evolve to reflect the needs of KPs. More resources are needed for research and to generate evidence of cost-effectiveness to stimulate investment.