The goal of ending the HIV epidemic as a public health threat by 2030 depends on transformed health systems that include significantly scaled-up community responses. Community-based HIV programmes are key enablers to broadening the reach and uptake of services, supporting retention in care, monitoring the quality of services, advancing human rights and combatting stigma and discrimination. For example, community HIV testing may reach more men, young adults, and key populations compared to facility-based testing. Community-based strategies also require minimal infrastructure allowing for easier scale up.
The aim of this course is to provide participants with practical guidance on how to design, implement and evaluate community-based HIV service delivery for key and priority populations such as men who have sex with men (MSM), people who inject drugs (PWID), female sex workers (FSW), people in prisons, adolescents, migrant men and others.
The course focuses on community-based HIV testing (including self-testing, partner notification, social network testing, testing within networks of recently infected persons), facilitated linkage to care, and differentiated ART delivery and evaluation of these interventions.
The presentations will address various models of differentiated ART delivery, highlighting their advantages and challenges. A growing body of evidence supports the use of differentiated ART services (DARTS) for HIV-positive individuals from key and priority populations. The implementation of such novel approaches requires fundamental changes to delivery systems but also to programme monitoring, requiring new approaches to ensure that data are available to inform the care of individuals and enable programmatic evaluation of diverse DARTS models.
- Approaches to improve HIV testing efficiency (coverage and quality of services) and yield (proportion of all tests performed that identify a new case of HIV).
- The effectiveness of social‐network based HIV interventions targeting key and priority populations
- Best practices for linkage from HIV testing to prevention and treatment services, such as HIV pre-exposure prophylaxis, harm reduction and HIV treatment, which may be facility- or community-based.
- Using routine programmatic data and other evaluation designs (observational and experimental studies) to evaluate community-based interventions
- Decentralizing ART delivery to the community
- Non-facility-based service locations for ART initiation and maintenance, and ARV distribution
- Case management and peer navigation approaches for improving KP retention in ART programmes and viral suppression
Objectives of the course:
- To illustrate innovative and effective approaches for HIV testing, including social network testing, extended risk network testing and testing within networks of recently infected persons
- To outline how the use of national and sub-national data can assist in optimizing uptake of testing and testing yield
- To provide an overview of effective linkage to ART strategies and interventions to optimize retention, such as case management, patient navigators and the use of social media
- To illustrate a range of modalities for differentiated ART delivery for key populations, such as multi-month prescriptions, fast-track drug refills, community ART groups and adherence clubs
- To describe patient-level and programme-level monitoring and evaluation of differentiated ART delivery
The course consists of lectures, exercises and case studies. It is designed to provide participants with practical skills and knowledge in development, implementation and evaluation of community-based HIV interventions.
Participants will have opportunities to share their own country-specific experiences in the implementation and evaluation of HIV community-based programmes among populations at higher risk of HIV, and challenges that have been encountered.
The key part of the course is individual/ group work, which consists of the development of a proposal for a community-based HIV intervention or evaluation of such intervention. Participants are encouraged to work on proposals which they can later on use in their countries.
Professionals working on planning, implementation and evaluation of HIV prevention and treatment programmes
Professor George W. Rutherford, MD, Institute for Global Health Sciences, University of California, San Francisco, USA
Associate professor Ivana Bozicevic, MD, DrPH, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia
Zoran Dominkovic, WHO Collaborating Centre for HIV Strategic Information, School of Medicine, University of Zagreb, Croatia
Jelena Mihaljević, WHO Collaborating Centre for HIV Strategic Information
Duration and site: The course takes place in Zagreb, Croatia, at Andrija Stampar School of Public H
ealth, from 25-29 March 2019.
The course fee is 1000 USD and includes lunches and coffee breaks during the course and course materials.
Please apply before 22 February 2019, at http://www.whohub-zagreb.org/apply/registration