HIV and AIDS

In the Dominican Republic and in Guyana, HIV prevalence rates among key populations are significantly higher than those in the countries’ general population. This disparity highlights the disproportionate vulnerability of populations such as female sex workers (FSW), men who have sex with men (MSM), transgender (TG), migrant and mobile populations to HIV. High HIV prevalence among these key affected populations also suggests the potential for continued spread of the virus. In both the Dominican Republic and Guyana, Advancing Partners & Communities’ (APC) efforts are geared towards contributing to a sustainable reduction in HIV transmission among key populations and an improved quality of life for people living with HIV. By strengthening the technical and organizational capacity of NGOs and community-based organizations through sub-grants, monitoring, and mentoring, APC enables grantees to establish the foundations for increasing the quality of HIV services and reduce stigma and discrimination. APC provides technical and organizational capacity building for USAID-supported NGOs implementing HIV prevention, counseling and testing (HCT) and care and support programming, as well as technical assistance (TA) to the Ministry of Health (MoH).

Photo credit: This child is HIV-positive and has come to the Muranga District Hospital in Kenya for treatment from a USAID-backed program run by the International Center for AIDS Care and Treatment Programs, Columbia University School of Public Health. Photo credit: Casey Kelbaugh, International Center for AIDS Care and Treatment Programs, Columbia University School of Public Health

Below are select resources related to key issues within gender.

Gender-Based Violence

Gender-based violence is pervasive worldwide. Violence against women in particular has implications for community health programs, especially those that address family planning. Women and girls who experience sexual violence and coercion have an urgent need for family planning, including emergency contraception, to prevent unintended pregnancies. Women experiencing intimate partner violence may have lower demand for family planning, are more likely to use contraception in secret, and have higher rates of both unintended pregnancies and unsafe abortions.

Gender-based violence also increases during pregnancy, which has serious implications for maternal health. Children of women who experience violence during pregnancy also suffer poor health outcomes.

Community health services present an opportunity to screen women and girls for gender-based violence and to refer them to appropriate services for support.

Flowchart: Integrating GBV Screening Within HIV Support Services in Guyana
November 2017 | Infographic

This flowchart breaks down the process for GBV screening within HIV support services in Guyana.

Gender-Based Violence & You: Know Your Rights
November 2017 | Brochure

This brochure provides information on how to get help for gender-based violence.

Gender-Based Violence Screening Tool
November 2017 | Training Guide

This screening tool was developed by APC Guyana to screen gender-based violence.

Guyana Gender-Based Violence Services Resource Directory
November 2017 | List

This directory from Guyana provides a rating system that is geared towards collecting information on how acceptable GBV services of each organization are for members of the key population.

Addressing Stigma and Gender-Based Violence to Improve HIV Service Delivery to Key Populations
November 2017 | Assessment

This rapid assessment was conducted to gather information on the programmatic and capacity needs of the NGOs supported through APC to implement services for key populations as well as the structural challenges faced by these NGOs.

Integrating Gender-Based Violence Screening Into HIV Services Provided by Non-governmental Organizations in Guyana
November 2017 | Toolkit

The following protocol was created to assist community-based nongovernmental organizations in Guyana with implementing gender-based violence screening. Social workers can use this tool to understand ways to detect GBV and to better prepare themselves for implementation of GBV screening.

HIV and AIDS

Civil Society Organizations Forge a Place within the Dominican Republic’s HIV Response
June 2018 | Brief

In the Dominican Republic (DR), HIV-focused civil society organizations (CSOs) developed a platform to expand access to primary health care (PHC), including HIV services, for key and vulnerable populations.

Family Planning and HIV Integration: Important Contributions to the Global HIV Goals
January 2018 | Infographic

Integrating FP into HIV services can help ensure that people living with HIV, young women, key populations, and male partners can access critical information and services that empower them to fulfill their reproductive health needs and goals.

Family Planning/HIV Integration Quality Assurance Tool
January 2018 | Toolkit

This tool is designed to assess the extent to which facilities offering integrated family planning (FP) and HIV services are meeting basic minimum standards for the provision of quality FP services, identify any gaps in the provision of integrated services, and serve as a starting point for improving FP service delivery.

Pilotaje RIE República Dominicana
August 2016 | Publication

Lecciones aprendidas de una estrategia de colaboración entre la Dirección Regional de Salud V, organizaciones comunitarias, organizaciones nogubernamentales, y la sociedad civil.

DIAGNÓSTICO DE LAS NECESIDADES DE SALUD DE LAS POBLACIONES TRANS DE LA REPÚBLICA DOMINICANA
August 2016 | Study

En la República Dominicana, la epidemia del Virus de Inmunodeficiencia Humana (VIH) se caracteriza por estar concentrada en poblaciones como la de hombres que tienen sexo con hombres (HSH) y las mujeres trans. La prevalencia del VIH en HSH es de un 5.2 % , mientras que en algunos estudios en poblaciones trans, el VIH oscila entre 12 y 17 % .

Webinar: Strategies to Increase Male engagement in eMTCT of HIV and Syphilis
May 2016 | Webinar

Please join WHO and the Human Reproduction Programme on June 10, 2016 from 1530-1700 (Geneva Time) / 9:30-11:00 (Washington Time) for a webinar discussion on Strategies to Increase Male engagement in eMTCT of HIV and Syphilis.

This is the first instalment of a new RHR Webinar series focusing on male engagement in SRHR.

Understanding and Challenging HIV and Key Population Stigma and Discrimination: Caribbean Facilitator's Guide
February 2015 | Guide

Developed by the USAID- and PEPFAR-funded Health Policy Project, this guide is a training tool that provides a standard for stigma reduction. It is a resource for facilitators seeking to train participants to reduce HIV and key population stigma and discrimination, and for leaders of community dialogue and policy development in this area. The guide has been piloted in the Caribbean and other settings and can be readily adapted for other contexts.

Delivery of Integrated Family Planning and HIV Testing and Counseling Services by Community-Based Health Workers
October 2014 | Brief

To increase access to and use of HIV testing and counseling (HTC), FHI 360 and the Uganda Ministry of Health developed an innovative model to add HTC services to the family planning services provided by government-endorsed community health workers, known as village health teams (VHTs), in two districts in Uganda. 

Policy brief: Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations
July 2014 | Brief

This policy brief provides an overview of key findings, data and figures of the new consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. In addition, it offers an overview of the comprehensive package on interventions and a table summarizing WHO recommendations concerning key populations.

Abriendo Puertas: Feasibility and Initial Effects of a Multi-Level Intervention among Female Sex Workers Living with HIV in the Dominican Republic
February 2014 | Study

This study aims to assess the feasibility and initial effects of an integrated prevention and care model for female sex workers (FSW) living with HIV called Abriendo Puertas and to assess the feasibility of engaging the male regular partners of FSW living with HIV in prevention and care services.

AIDSTAR-One Project Highlight: Integrating and Mainstreaming HIV Services
December 2013 | Series

This project highlight combines key resources from AIDSTAR-One related to the Global Health Initiative and the U.S. President’s Emergency Plan for AIDS Relief priority of integrating and mainstreaming HIV services to improve access to prevention, testing, treatment, and care.

Exploring the Positive Health, Dignity and Prevention (PHDP) Needs of Female Sex Workers, Men Who Have Sex with Men and Transgender Women in the Dominican Republic and Swaziland
March 2013 | Report

This report describes the current social and structural context of FSW, MSM, and TW in the DR and Swaziland, particularly as it relates to stigma and discrimination among PLHIV. It also examines the specific PHDP needs of FSW, MSM and TW who are living with HIV, including challenges to accessing ongoing prevention, treatment, care and support service. Finally, it identifies ways in which PHDP interventions and services can be tailored to meet the needs of FSW, MSM, and TW, including specific program models and communication messages.

A Global HIV Stigma Reduction Framework Adapted and Implemented in Five Settings in India
January 2013 | Report

This report synthesizes the lessons learned from the process, including the feasibility and relevance of the framework for use by the NACP and other global stakeholders in informing stigma reduction interventions and measurement.

Below you will find links to resources created by APC and other organizations.

APC Resources

Pilotaje RIE República Dominicana
August 2016 | Publication

Lecciones aprendidas de una estrategia de colaboración entre la Dirección Regional de Salud V, organizaciones comunitarias, organizaciones nogubernamentales, y la sociedad civil.

DIAGNÓSTICO DE LAS NECESIDADES DE SALUD DE LAS POBLACIONES TRANS DE LA REPÚBLICA DOMINICANA
August 2016 | Study

En la República Dominicana, la epidemia del Virus de Inmunodeficiencia Humana (VIH) se caracteriza por estar concentrada en poblaciones como la de hombres que tienen sexo con hombres (HSH) y las mujeres trans. La prevalencia del VIH en HSH es de un 5.2 % , mientras que en algunos estudios en poblaciones trans, el VIH oscila entre 12 y 17 % .

Dominican Republic Results: October 2015 to March 2016
June 2016 | Project Highlight

In the Dominican Republic (DR), APC project serves populations with the highest HIV prevalence by expanding coverage and improving the quality of HIV-prevention, care, and support services.

CHW Central - A Global Resource For Community Health Workers
April 2016 | Website

CHW Central, launched in 2011, is an online community of practice managed by Initiatives Inc. that provides a forum for online discussions and exchanges with public health professionals and program managers, policy makers and CHWs in the U.S. and across the globe.

FACT
June 2015 | Video

FACT (Family, Awareness, Consciousness, and Togetherness) is an NGO that supports the entire family. Ms. Annette Jaundoo, Executive Director and her dedicated team are proud of FACT’s accomplishments in strengthening families. Since January, FACT has assisted over 500 families.

Hope For All
May 2015 | Video

Hope for all is located in Region 2 at lot 6 Belfield Suddie, Essequibo Coast. Hope for all offers HIV testing and counseling and care and support services, as well as STI, gender-based violence, and substance abuse counseling and information in a professional and comfortable environment and operates with the highest level of confidentiality.

Peace Corps Maternal and Newborn Health Training Package
February 2015 | Toolkit

This training package introduces Peace Corps Volunteers to the fundamentals of maternal and newborn health and exposes them to key concepts and global trends. The training package highlights the latest evidence-based practices that can be implemented by Volunteers and their counterparts at the community level to improve maternal and newborn health outcomes. These modules were developed with support from APC.

The Local Capacity Initiative
December 2014 | Fact Sheet

The Local Capacity Initiative (LCI) was established by the U.S. Government in 2013 to strengthen sustainability of national HIV and AIDS responses through increased advocacy capacity of local civil society organizations (CSOs).

Local Capacity Initiative Facilitated Discussion and Capacity Assessment Tool: Facilitator’s Manual
December 2014 | Manual

The purpose of this manual is to help determine technical assistance needs and to conduct an assessment of an organization’s policy, advocacy, and organizational systems capacity. The assessment consists of a facilitated self-assessment as well as optional stakeholder interviews. The tool is divided into five major sections (LCI outcome areas); four of these areas focus on critical elements for advocacy and one focuses on overall organizational capacity. Additionally, there are in-depth domains associated with each larger outcome, which can be used to further review capacity.

External Resources

Colaborativo de Mejora de La Calidad
May 2018 | Summary

El objetivo de este medio, es compartir las experiencias, lecciones aprendidas y buenas practicas, generadas por via de los Colaborativos que, bajo el liderazgo del Servicio Nacional de Salud funcionan en los 11 Servicios de Atencion Integral al VIH/sida priorizados de las provincias de Santo Domingo, La Romana, Santiago y Puerto Plata.

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Guyana Trans United’s main goals are to improve the quality of life of trans Guyanese and to ensure that their rights are recognized and upheld in all domains. GTU hosts monthly support group sessions for our members, their families, other loved ones, and conducts outreaches in the ten (10) administrative regions of Guyana. We also work with other lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) communities, human rights and social justice groups on advocacy and awareness raising initiatives.

Health through Walls works with prison authorities in resource-poor countries to implement replicable and sustainable systems to develop their capacity to provide prisoners with meaningful health services such as medical screening, treatment, and discharge planning leading to continuity of care upon release. Our priority is the prevention, identification and treatment of infectious and contagious disease -- particularly HIV, AIDS, and tuberculosis.

As the only NGO in Region 2 of Guyana, Hope For All serves the area’s most vulnerable populations through three departments. The organization offers voluntary counseling and testing (VCT), prevention services, and care and support for individuals infected with or affected by HIV. The care and support division of the NGO houses community, home, and palliative care as well as programs for orphans and other vulnerable children (OVC).

The Hope Foundation provides community-based health and social services in support of Guyana’s national goal to reduce the spread of HIV. The organization reaches out to key populations through educational programs and services. Based in Bartica, the Hope Foundation provides services in Cuyuni-Mazaruni (Region 7) of Guyana.

Working in a team with a clear vision, the IDEV expects to continue providing health services to all patients who require it, obeying our values as an institution of equality and quality of services. The IDEV, committed to science, will continue its work in the area of research, with clinical trials in the fight against HIV/AIDS. It is an IDEV mission to teach and update all health service providers and the community in general in the comprehensive management of HIV/AIDS.

El Instituto Nacional de la Salud (INSALUD) is a public health organization in the Dominican Republic. It was created in 1978 as one of the Managing Bodies of the Social Security; charge of the management and administration of health services Social Security System.

Lifeline Counseling reduces the impact of HIV on individuals and families through education, counseling, care and support services, and trainings. The organization offers voluntary counseling and testing (VCT), programs for orphans and other vulnerable children (OVC), as well as home-based and palliative care. Through partnerships with other private and public organizations, Lifeline reduces HIV-related stigma and discrimination for people living with or affected by HIV.

The Linden Care Foundation emerged from the Regional AIDS Committee in 2001 to work towards the prevention and reduction of HIV/AIDS and sexually transmitted infections (STI). Through the implementation of several youth-targeted awareness programs, the Linden Care Foundation aims to reduce the spread of HIV in Region 10 of Guyana. The organization also provides care and support services for people living with HIV (PLHIV), including children living with or affected by HIV.

The Nyanza Reproductive Health Society (NRHS) is active in conducting reproductive health and HIV prevention research and the implementation of HIV intervention services in Kenya. NRHS is comprised of three main projects: The University of Nairobi, Illinois, and Manitoba (UNIM) project, and the Male Circumcision Program (MCP). 

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July 18, 2016 to July 22, 2016
| Event

Nicholas Persaud of Advancing Partners & Communities Guyana is presenting an abstract at this year's International Aids Conference in Durban, South Africa.

June 29, 2016 | Announcement

The Advancing Partners and Communities project is helping 16 health facilities in Uganda to integrate family planning into HIV services.

March 23, 2016 | Announcement

The Eastern Regional Health Services Department celebrated the reopening of the HIV Comprehensive Care Clinic at the Dr. Teófilo Hernández Hospital in El Seibo Province, Dominican Republic, on Tuesday, March 15th, 2016. Claudia Allers, Director of the Advancing Partners and Communities (APC) project in the Dominican Republic, led the ceremony with the Regional Director of Health, Dr. José Rodriguéz.

February 24, 2016 | Event

Join STOP AIDS NOW!, the International HIV/AIDS Alliance, and UNAIDS for Communities Deliver: The Critical Role of Communities in Ending The AIDS Epidemic, on Wednesday, February 24, 2016 from 10:00 am - 12:00 pm at the Organization of American States. Please RSVP to Simret Teame at teames@unaids.org.

December 03, 2015 | Event

On Friday, November 4, The Advancing Partners & Communities (APC) project is hosting a dissemination meeting to present to key partners the findings and recommendations from an assessment of the health and social needs of trans persons in the Dominican Republic. The assessment was carried out in collaboration with the Center for Integrated Training and Research (COIN) with academic support from the Iberoamericana University (UNIBE), and the active participation of community-based organizations representing trans communities in the Dominican Republic.

The meeting will include work group sessions to encourage partners to use the assessment findings and begin planning follow up activities. Approximately 75 representatives from government, civil society, and donor agencies are expected to attend the event.

Join us as we work to integrate the needs of trans people into the national agenda.

February 27, 2015 | Event

Stigma and discrimination is an obstacle for vulnerable populations to access HIV prevention and treatment services. The project Advancing Partners & Communities in the Dominican Republic (DR) is committed to reduce stigma and discrimination against vulnerable populations.

February 25, 2015 | Article

The HIV Prevention efforts of a number of local Non Governmental Organisations (NGOs) recently came under strategic evaluation with the aim of bettering the crucial services that they offer.

February 24, 2015 | General News

As a result of Youth Challenge Guyana's (YCG) efforts, the past year saw an increased number of persons seeking to be tested for HIV. Additionally there have been reports of greater consistency in the number of sex workers using condoms during their sexual encounters, while more miners have been asking for YCG field officers to visit their sites to conduct Voluntary Counselling and Testing activities. 

November 25, 2014 | Blog

Over the next 15 days, the Advancing Partners & Communities Project in Guyana will be doing a series of blogs to highlight different aspects of gender-based violence.

July 21, 2014 | Blog

The One Million Community Health Worker (1mCHW) Campaign’s blog post discusses the 20th annual International AIDS Conference and the importance of community health workers in the eradication of HIV/AIDS in Africa.

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Check back again for related photo galleries or videos.

Manuel

Clínica de Familia’s HIV clinic in La Romana province of the Dominican Republic is helping gay men like Manuel get tested for HIV.

counselling group

Aashish is a 43 year old men who have sex with men (MSM), an alcoholic, and a chain smoker. On his initial visit to FACT, Aashish was enrolled in a support group for MSM. In group discussion, he was educated on the benefits of consistent condom use as well as the importance of good nutrition and healthy food choices.

two women talking in the steet

The HKN program is modeled after a door-to-door sales approach for a line of health products including condoms and oral contraceptives pills. The HealthKeepers go the last mile—right to the doorstep—to sell the basic health-promoting products, especially for women and children.

Ramona, a navegadora for Haitian clients, reviews a pamphlet in Creole.

In October 2017, the HIV clinic at Ricardo Limardo, a public hospital partnered with APC grantee, the Center for Human Promotion and Solidarity (CEPROSH) and the community-based organization Grupo Clara to improve the quality of their HIV services.

Regional Health Service personnel going over the satisfaction survey with a patient in the Hospital Doctor Antonio Musa, in San Pedro de Macoris.

Key populations in the Dominican Republic have HIV prevalence rates that are six to twelve times higher than the national average of 0.8 percent. Although there are multiple players committed to tackling the concentrated HIV epidemic, large gaps in coverage and access to HIV prevention, care and treatment services remain.

Doctor Martha Cruz, HIV physician at Hospital Lotes y Servicios, and her patient Richard.

Implementation of Test and START at the six PEPFAR/USAID-supported HIV clinics has reduced the patient treatment initiation window from 30 days in early 2017, to an average of seven days by September, extending the benefits to patients and the health system.

In the Dominican Republic (DR), transgender (trans) persons experience stigma and discrimination in many different ways and are denied the same opportunities as other Dominicans. In recent years, more efforts have been directed at improving the quality of life for the trans community. However, these initiatives focus mainly on HIV prevention and treatment, ignoring the multiple socioeconomic and health needs of these marginalized individuals.

Michelle talks with a client about ways to minimize ART side effects.

Michelle, a client advocate associate with the APC project in Guyana, links people who are newly diagnosed with HIV to care and treatment, and helps people who have stopped coming for care to return.

Photo of Queenie

Queenie, or Q as she sometimes goes by, is an HIV positive, transgender (trans) person living in Guyana. When Q fell ill after defaulting on anti-retroviral therapy (ART), she was hesitant to resume her treatment. Given the stigma and discrimination Q had experienced in the hospital as a trans person, she was not looking forward to going back alone. So she reached out to Guyana Trans United (GTU), an organization that supports the trans community, for assistance.

APC’s Key Population Focal Point conducting a session on gender identify and sexual orientation.

As part of its efforts to overcome stigma and discrimination challenges, APC conducted quarterly sensitization sessions at Guyanese HIV care and treatment sites. In 2017, 66 people, including medical doctors, nurses, community health workers, auxiliary staff, and security personnel, participated.

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