To improve access to and support for uptake of HIV prevention, testing, treatment and care for gay men and other men who have sex with men and female sex workers, the LINKAGES project in Haiti integrated ART delivery within ten pre-existing key population-focused service delivery sites (Drop in Centres) as well as five hybrid sites in the period September 2015 – January 2020. Previously, those who tested positive for HIV at one of the centres or during mobile testing were referred to public and private ART facilities. At each key population-focused facility, the healthcare team includes medical doctors, nurses, lab technicians, a psychologist, pharmacist and social workers. Staff also undergo training on the provision of key population-friendly services to ensure that key populations are able to access existing services without fear of stigma and discrimination. Since 2019, PrEP service provision has also been included in three drop-in centres.
Since the start of the programme, dramatic improvements have been observed in linkage to care and rates of ART initiation. In the period September 2015-January 2020, 79% of individuals diagnosed were initiated on treatment.
Peer navigators are now an integral part, not just of psychosocial support, but also of ART delivery. Clients can request community or home-based ART refills from peer navigators if they have challenges in visiting the sites due to distance or busy schedules.
Eligibility
On 1st line ART for at least six months and virally suppressed
Building Blocks
ART refills
What
ART refill, peer support, safe space
When
Every 2-3 months
Where
KP focused service delivery site
Community/Home
Who
Multidisciplinary team including peers
Clinical consultations
What
ART rescripts, clinical consultation, comprehensive health check
When
Every month: During regular business hours for doctor led visits, additionally during evenings and/or weekends for KP- Community Health worker led visits
Where
KP focused service delivery site
Who
Multidisciplinary team
Psychosocial support
What
Psychosocial support, referral for additional counselling if needed, safe space.
When
Every 2 – 3 months, more frequently if required
Where
KP focused service delivery site
Community/Home
Who
Multidisciplinary team including peers
Further reading
Read more about DSD for key populations here. Also available in French and Portuguese.
