www.aids2014.org

Les Ong

Program Adviser

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

www.aids2014.org

• 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

www.aids2014.org

Strengthening the Care Cascade

Prevent new infections

Accelerate case

detection

Early enrollment in Pre-ART/ART

Maximize retention in

care

www.aids2014.org

Tailored Programs

Men who have sex with men

Transgender people

Entertainment Workers

www.aids2014.org

Linkage to Care HC

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 ManagementHC

DIC

Peer outreach worker

Community level

Implementing Partner NGO

www.aids2014.org

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 infections Accelerate case detection

HC

DIC

Peer outreach worker

Community level

Implementing Partner NGO

www.aids2014.orgEarly enrollment in Pre-ART/ART Maximize retention in care

Linkage to Care HC

CD4, pre-ART/ART, ANC, VCCT, TB, STI, MMT, VL

+Key Populations

Active Case Management

- Follow-up- Accompanied referrals- Health services liaison

HC

DIC

Peer outreach worker

Community level

Implementing Partner NGO

www.aids2014.org

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.