HIV Care and Treatment Project

Under the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and in coordination with other US government agencies, the USAID HIV Care and Treatment Project, implemented by IntraHealth International, supports the Ministries of Health/Secretary of Health/Social Security, of Central America to strengthen initiatives for the prevention and treatment of the HIV/AIDS epidemic in the region.

The USAID HIV Care and Treatment Project works to reduce HIV/AIDS. It focuses on supporting HIV services to ensure that all people with the virus know their diagnosis, have early and optimal access to antiretroviral treatment, and achieve viral suppression through quality services free from stigma and discrimination.

GEOGRAPHICAL AND DEMOGRAPHICAL FOCUS

The HIV Care and Treatment Project provides technical assistance to eight HIV clinics: two in Guatemala City, Guatemala; one in Antigua Guatemala, Sacatepéquez; and one in each department of Quetzaltenango, Retalhuleu, San Marcos, Santa Rosa and Izabal, to improve the quality of life of people living with HIV and other populations in vulnerable conditions.

In Central America, the HIV epidemic is concentrated in some key population groups, such as men who have sex with men (MSM), transgender women and sex workers. The region is vulnerable to a growing epidemic due to widespread misinformation about HIV, stigma, limited access to health services and migration.

APPROACH AND RESULTS

• Diagnosis: from October 2021 to September 2022, the Project has trained HIV clinic staff to use risk criteria in HIV screening, performing 17 392 HIV tests, of which 678 people were reached through the assisted contact notification strategy, 84 positives, representing 12.4% and 16,714 people per provider-initiated testing. 597 people have a positive result, representing 3.6% positivity.
• Treatment: in terms of treatment initiation, the Project has provided support to health services so that 1088 patients, initiated treatment, of which 804 people (73.8%) initiated within seven days from their diagnosis. The project has collaborated with HIV clinics, so that 11 437 people receive treatment, 77% are on a regimen with an integrase inhibitor (8,768 people) and 88% of the cohort receive multi-month dispensing (10 015 people).
• Recovery of people in treatment interruption: the strategy is activated through a telephone call the same day that the person does not attend their scheduled appointment at the clinic. If the person does not attend after the phone calls, we proceed to verify if the user has been transferred to another clinic or has passed away. If the person does not appear on the official transfer or deceased lists, a home visit is activated. Contact is attempted by other means such as WhatsApp, social networks and/or email. The NGOs with which there are sub-agreements have an important role in the recovery of users since they support home visits. Likewise, the implementation of differentiated service models, multi-month delivery and the implementation of the VUELVE strategy.
• Viral load coverage: Viral load coverage of people in treatment is 93% (10 363), with 94% (9715) with viral suppression.
• Continuous Quality Improvement: In Guatemala, coordination, and collaboration with the recently created Quality Unit in the Ministry of Public Health and Social Assistance was completed.