Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 12019
Country/Region: Central America Region
Year: 2011
Main Partner: Training Programs in Epidemiology and Public Health Interventions Network
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: HHS/CDC
Total Funding: $355,000

The Global AIDS Program (GAP) in Central America and Panama region focuses its assistance activities primarily on improving the capacity of Central American countries to plan for, implement and evaluate surveillance programs, with a special emphasis on second-generation surveillance. Given the mix of resources available to the Program, the GAP regional office has initiated work at different levels in order to implement its assistance activities. CDC/GAP-CAP through its implementing partner Tephinet/TaskForce, supports the Central American MOHs with resources for key personnel, strategic information activities and support to the national HIV/AIDS Laboratories. The Tephinet/Task Force's mission in Central America and Panama is to provide technical and program management expertise, coupled with collaboration skills, to transform public health practice and significantly improve outcomes. Tephinet/Task force has demonstrated its commitment to assist the CDC/GAP Central America office in meeting its goals and objectives. Tephinet/Task force has adapted well to the various needs expressed by the region, and has identified mechanisms to provide appropriate technical assistance as needed, and has efficiently mobilized to respond to the dynamic and demand-driven commitments of the regional office.

Tephinet will continue to support the implementaiton of an MSM HIV/STI multilevel combination prevention intervention in Guatemala. Tephinet will continue to support an STI control for HIV prevention intervention among sex workers and MSM in Honduras, Nicaragua and a TBD country. The pilot for provider initiated testing in Guatemala and a country TBD will be completed and results disseminated to stakeholders. Tephinet will continue to facilitate the implementation of regional (Panama, Guatemala, Honduras, Nicaragua, Costa Rica, El Salvador, Belize) workshops on strategic information and the travel of consultants and workshop attendees. Tephinet will continue to support the implementation of a BSS+ study in Honduras. Data from qualitative studies in Honduras, Nicaragua, Belize, Panama, and El Salvador will be analyzed and reports disseminated to inform prevention strategies and the BSS+ implementation. Population size estimation studies will continue in Honduras, and Panama. Tephinet will continue to support the creation and implementation of a national system to monitor the care of patients living with HIV/AIDS is in Panama and Honduras.

Health systems strengthening is a cross-cutting issue for all Tephinet activities. Treatment, counseling, laboratory, and other guidelines are prepared together with National HIV Programs. Prevention services are provided through public facilities and staff is trained, equipment provided, and infrastructure development is provided through this mechanism. Information systems developed either to monitor the impact of prevention interventions or to support surveillance, monitoring, and evaluation are integrated into the national health systems.

There is currently unequal access to primary health services for men and women in the Central American region. Health services-- in general-- are mainly tailored to serve the needs of women and children. MSM have greater barriers to accessing health facilities due to homophobia, stigma, and discrimination. Tephinet will work towards equalizing access for men, and especially MSM. Previous studies have documented high rates of gender-based violence for MSM, male and female sex workers. Prevention programs will document levels of gender-based violence and include counseling and referral services to address these problems. Data from BSS+ and other special studies will help design strategies to reduce discrimination towards MSM, male and female sex workers.

Funding for Strategic Information (HVSI): $200,000

BSS+ and Special Studies Tephinet will continue to support the implementation of a BSS+ study in Honduras. Several qualitative studies will be conducted to inform the BSS+ study and prevention activities such as the VICITS strategy and other prevention interventions for MSM. Population size estimation exercises will be linked to BSS studies. Capacity building for analytic interpretation of BSS+ and other M&E instruments for program planning will be provided and help increase the use quality, collection, analysis and use of data . Tephinet will also assist in evaluating different recruitment methodologies (Respondent driven sampling, time location sampling, cluster sampling, etc) in order to identify the best strategy in terms of cost, precision and feasibility and provide informed recommendations to countries. Activities will include, stakeholder meetings, protocol development, IRB approvals, data analysis and report preparation and dissemination of findings.

MoniTARV- HMIS to Monitor HIV Care Tephinet will continue to support for a national system to monitor the care of patients living with HIV/AIDS is in Panama to achieve the best possible health services for HIV-positive patients especially in the provision of antiretroviral therapy. MoniTARV is a system which will provide the necessary information to monitor compliance with standards of care at the patient, clinic, and national level. The electronic software tool that is part of the information system will be developed on OpenMRSa community developed, open-source, enterprise electronic medical record system platform. Support for a national system for patients on HIV care will also continue in Honduras.

TA for Strategic Information Tephinet will continue facilitating the implementation of regional workshops on strategic information and the travel of consultants and workshop attendees. Tephinet will also implement a strategy to facilitate the dissemination of lessons learned and best practices including meetings, bulletins and web exchanges.

Funding for Health Systems Strengthening (OHSS): $15,000

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $140,000

STI/HIV Prevention for SW & MSM

VICITS (Vigilancia y control de VIH, ITS y comportamiento sexual en poblaciones vulnerables HIV/STI/ surveillance and control among most at risk populations) is a comprehensive HIV and STI prevention program linked to the analysis of surveillance data in Central America. VICITS is an HIV prevention strategy that combines sexually transmitted infections (STI) diagnosis and treatment among most at risk populations, condom promotion, behavioral change and an information system to monitor the impact of the project. Due to high infection rates and a high number of sexual partners, sex workers (SW) and men who have sex with men (MSM) have been identified as a core group in HIV transmission in Central America. The presence of sexually transmitted diseases and difficulty in safe-sex negotiation makes this group more sensitive to acquire, and more prone to transmit, HIV. Evidence supports that timely treatment of STIs may reduce HIV transmission, especially in concentrated epidemics and in groups with a high rate of bacterial infection - such SW and MSM.

Tephinet will support an STI control and HIV prevention intervention among sex workers and MSM in Honduras, a TBD country and other countries as requested. The intervention will include strengthening STI etiologic and syndromic management through training of health personnel, strengthening counseling for risk reduction and condom promotion, improving laboratory STI and HIV diagnostic capacity through training and provision of equipment and reagents. The project will support provision of reproductive health services and outreach activities to improve coverage and compliance with follow-up visits. An information system to monitor HIV, STI and condom use trends will allow evaluation of the project's impact. The strategy was designed with the participation of the Ministry of Health and implemented in government facilities and selected NGOs.

Subpartners Total: $0
Center for Medical Research and Evaluation Partner: NA
Fundacion Marco Antonio: NA
To Be Determined: NA
Cross Cutting Budget Categories and Known Amounts Total: $140,000
Gender: Gender Based Violence (GBV) $40,000
Human Resources for Health $100,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services