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

APC Resources

Reaching Key Populations and Improving HIV Services: Country Program in Review- Dominican Republic
December 2019 | Report

From 2014 through 2019, APC worked in the Dominican Republic to improve access, delivery, and quality of HIV prevention, care, and treatment services for key populations and priority populations.

Final Report: Botswana
December 2019 | Report

From October 2015 to April 2019, the USAID mission in Botswana funded the APC project. The aim of the project was to ensure that communities measurably contribute to achieving the UNAIDS 90-90-90 targets. Read more about what the project accomplished over the last four years.

Final Report: APC Guyana HIV/AIDS Reduction and Prevention Project
September 2019 | Report

From September 2013 to September 2019, JSI Research & Training Institute, Inc. implemented the USAID-funded APC Guyana HIV/AIDS Reduction and Prevention Project. The project design included innovative, evidence-based, and cost-effective solutions, tailored to meet the needs of populations at risk of HIV in Guyana, in the contexts where programs are implemented, and where individuals reside.

Where Gender-Based Violence Meets HIV
March 2019 | Project Highlight

APC’s GBV project in Guyana multiplies the effects of PEPFAR investments by integrating GBV prevention and response into existing HIV prevention, care, and treatment programs in community-based organizations and health services. This includes supporting and developing national guidelines, strengthening coordination across sectors, and building the capacity of and linkages between clinics and community-based services in GBV prevention.

Workshop Curriculum: Developing Policy Advocacy Strategies
March 2019 | Training Curriculum

A learning package focused on developing an advocacy strategy, specifically to advocate for policy change to address barriers to HIV prevention, care, and treatment services.

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.

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.

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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

Final Report: APC Guyana HIV/AIDS Reduction and Prevention Project
September 2019 | Report

From September 2013 to September 2019, JSI Research & Training Institute, Inc. implemented the USAID-funded APC Guyana HIV/AIDS Reduction and Prevention Project. The project design included innovative, evidence-based, and cost-effective solutions, tailored to meet the needs of populations at risk of HIV in Guyana, in the contexts where programs are implemented, and where individuals reside.

Developing Policy Advocacy Strategies: Session 15 - Closing
March 2019 | Manual

This manual is part of a learning package focused on developing an advocacy strategy, specifically to advocate for policy change to address barriers to HIV prevention, care, and treatment services. The five-day curriculum is broken into 15 modules. Session 15 ensures that expectations were met; evaluations, and closing remarks.

Developing Policy Advocacy Strategies: Session 15 Manual (PDF, 1.3 MB)

Workshop Curriculum: Developing Policy Advocacy Strategies
March 2019 | Training Curriculum
Workshop participants hold string creating a web.

A learning package focused on developing an advocacy strategy, specifically to advocate for policy change to address barriers to HIV prevention, care, and treatment services.

This five-day curriculum is broken into 15 modules; a facilitator’s manual provides overall guidance on how to use the module components including, session plans, PowerPoint slides, and participant handouts for use during the sessions and as job aids after the workshop concludes.

APC created this curriculum as part of the PEPFAR-funded Local Capacity Initiative, which strengthened sustainability of national HIV and AIDS responses in 14 countries and regions. As part of the program, APC provided technical assistance to increase the advocacy capacity of local nongovernmental organizations (NGOs).

Facilitator’s Manual - Provides background on the workshop, tips for preparation, and sample agendas, as well as the pre-work assignment and pre-/post-test.

Session 1: Opening Session - Welcomes participants to the workshop; reviews expectations, the agenda, and ground rules; and sets the tone of the workshop.

Session 2. Key Concepts and Definitions - Introduces basic elements of policy advocacy, provides definitions of key concepts, differentiates advocacy from similar concepts, and identifies types of policy change.

Session 3. The Policy Development Process - Reviews policy development frameworks, the basic steps of the policy development process, and which advocacy activities to use when advocating for change.

Session 4. Overview of Steps in Advocacy Strategy Development - Introduces the steps to develop and implement an advocacy strategy.

Session 5. Define the Issue and Identify a Policy Solution - Introduces methods to define a policy issue, including criteria to assess whether an issue is well suited for advocacy and the most appropriate policy solution.

Session 6. Set Goals and Objectives - Introduces goals and objectives of policy advocacy strategies and allows participants to develop goals and objectives for advocacy strategies they are creating.

Session 7. Identify Target Audiences: Decision-makers and Influencers - Defines target audience, decision-maker, and influencer; reinforces the importance of knowing your primary and secondary target audiences and capturing information about stakeholders in a power map.

Session 8. Engage in Partnerships - Reviews the various types of partnerships, the characteristics of successful teams, and creating and maintaining effective partnerships.

Session 9. Create Effective Advocacy Communication - Introduces the components of, and the process for developing and delivering, an effective advocacy message; allows participants to design and deliver a message for their advocacy strategy.

Session 10. Plan Advocacy Activities - Reviews the types of activities that can be used to support advocacy objectives and identify specific activities to support an objective in the advocacy strategy.

Session 11. Assess Resources - Identifies the resources needed to implement an advocacy strategy and plan how to obtain them.

Session 12. Monitor and Evaluate Policy Advocacy - Reviews basic principles of monitoring and evaluation (M&E) and the use of M&E to demonstrate progress toward accomplishing advocacy goals and objectives.

Session 13. Draft the Advocacy Strategy - Provides participants the opportunity to compile the work completed during the workshop into a draft advocacy strategy.

Session 14. Present Advocacy Strategies - Presents opportunities for small groups to receive constructive feedback on their draft strategies from facilitators and other participants.

Session 15. Closing - Ensures that expectations were met; evaluations and closing remarks.

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.

Family Planning/HIV Integration Quality Assurance Tool [printable paper-based version] (PDF, 4 MB)

Family Planning/HIV Integration Quality Assurance Tool [interactive Excel-based version] (XLSX, 6.7 MB)

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.

Agape Network began their work to combat the spread of HIV/AIDS in the community of Sophia in Georgetown, Guyana. Agape Network takes a family centered approach, offering care and support services to people living with HIV (PLHIV) and their families. Separate services are available for orphans and other vulnerable children (OVC) such as home-based care, after school program support, and counseling. Adults receive psychological and nutritional counseling services, social support, and referrals.

ASA is an informal group of friends, non-profit, funded by private companies, made up of people with or without disabilities, that promotes the social integration of young people and adults with physical or sensory disabilities, through socialization spaces that allow know and transmit experiences of life and disability, strengthen self-concept and self-esteem, generate solid links for an exchange of mutual support, to make their relationship with the environment more positive.

Artistes in Direct Support is a non-profit, community-based organization focused on HIV/AIDS and sexually transmitted infection (STI) education. Volunteers and staff educate at-risk populations through the performing arts, media, and peer education. With the additional funding from USAID, Artistes in Direct Support has expanded their scope of work to include community mobilization, capacity building, voluntary counseling and testing (VCT), and outreach services for men having sex with men (MSM) and female sex workers (FSW).

The Asociación Dominicana de Planificación Familiar (ADOPLAFAM) is a non-governmental organization (NGO) focused on improving family planning and HIV/AIDS services in Provinces throughout the Dominican Republic. ADOPLAFAM aims to build HIV service delivery capacity in the Dominican Republic, ensuring universal access to care and support, prevention, and treatment services for key populations. They partner with other local organizations including Clínica de Familia la Romana, Grupo Este Amor, and Clínica Esperanza y Caridad.

The Centro de Promoción y Solidaridad Humana (CEPROSH) is an HIV/AIDS awareness and prevention organization based in the northern region of the Dominican Republic that works to improve regional capacity to deliver quality HIV services to key populations.

La Clinica de Familia, Inc. (LCDF) is a private, not-for-profit federally qualified health center (FQHC) that was established in Doña Ana County, New Mexico in 1978. LCDF provides quality health care for the entire family through a system of medical clinics, dental clinics, school based clinics, behavioral health services, mental health services, Early Head Start programs, Healthy Start programs and a Promotora program. LCDF health and social services programs are funded by grants, contracts, and fee-for-service.

Comforting Hearts is an NGO focused on supporting families affected by HIV/AIDS through physical, social, spiritual, and psychological care and support services and education. The organization offers services for people living with HIV (PLHIV) and orphans and other vulnerable children (OVC). The OVC component provides nutrition, health, education, and shelter services in addition to the general care and support services. The program addresses socioeconomic empowerment and illiteracy among key populations as an avenue to increase clients’ personal and fiscal autonomy.

The Centro de Orientación e Investigación Integral (COIN) is a private organization conceived as a result of the emergence of HIV/AIDS and human trafficking in the Dominican Republic. COIN implements HIV prevention programs and health care services for key populations throughout the region. COIN works with surrounding communities in the process of identifying their needs and problems to address key issues and reduce stigma.

Family Awareness Consciousness Togetherness (FACT), an NGO based in Corriverton, Guyana, focuses their efforts on the effects of HIV on family units. FACT seeks to bridge gaps in HIV service delivery by collaborating with other service providers, government agencies, faith-based organizations, NGOs, community leaders, and all stakeholders.

Este Amor was one of three Caribbean civil society organizations given CVC/COIN Mini-Grants of US$20,000 to pilot and help refine CVC/COIN’s Sex Positive approach to peer education. In October 2011, it chose 20 MSM from 15 to 19 years old to take four days of training guided by an early draft of the new CVC/COIN facilitator’s manual. At the end of this training, it chose eight to apply lessons as they conducted individual and group interventions in towns, villages and bateys (ethnic Haitian settlements) across the Province of San Pedro de Macorís, in the country’s Eastern Region.

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December 19, 2019 | Webinar

Watch the recording from APCs farewell webinar highlighting the project's critical work and legacy in community health in more than 40 countries over the past seven years (2012–2019).

September 30, 2019 | Event

Since 2012, the USAID-funded Advancing Partners & Communities (APC) project has worked in over 40 countries to improve community health systems and build the capacity of local nongovernmental organizations (NGOs) to provide basic health services, expand access to voluntary family planning, and connect people to health facilities.

April 12, 2019 | Newsletter

This issue of the Quality Improvement Collaborative Newsletter tracks the timeline from the conceptualization, launch, and implementation of the QIC model at the PEPFAR-supported clinical sites. This model supports the Government of the Dominican Republic (GODR) expansion of the “Treatment for All” strategy to meet the country’s 90-90-90 treatment target established by the Joint United Nations Programme on HIV/AIDS (UNAIDS) to achieve control of the HIV epidemic by 2020.

July 20, 2018 | Announcement

Representatives from the APC project to attend and present at the 22nd International AIDS Conference (AIDS 2018) from July 23-27 in the Netherlands.

February 20, 2018 | Announcement

JSI Research & Training Institute’s Advancing Partners & Communities (APC) project organized a Quality Improvement (QI) Collaboratives Launch Workshop in Santo Domingo, Dominican Republic (DR) from January 31 to February 2, 2018.

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

November 30, 2017 | General News

In Botswana, APC initiated data collection of HIV testing services using mobile phones to help identify risk factors associated with HIV, and to enable better screening.

November 30, 2017 | Blog

Given mounting global evidence highlighting the correlation between experiencing violence and increased vulnerability to HIV infection, Guyana must tackle the causes of gender-based violence head-on.

November 22, 2017 | General News

In October 2017, Advancing Partners & Communities, in conjunction with PEPFAR and other partners convened a meeting with Ministry of Health officials, donors, and civil society members in Santo Domingo, Dominican Republic to discuss sustainable responses to the national health system.

June 27, 2017 | General News

Advancing Partners & Communities hosted a luncheon and health discussion session for transgender pageant participants in Guyana. 

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May 2014 | Video

This video highlights Advancing Partners & Communities (APC) and the Guyana Business Coalition against HIV and AIDS (GBCHA) campaign intended to help cultivate partnerships between local businesses and NGOs in Guyana to fight HIV. The campaign aims to encourage a broader range of partnerships by increasing the visibility of NGOs responding to HIV/AIDS while keeping the business sector informed of successes.

November 2014 | Video

This media blast aims to increase the Business Sector’s awareness of gender-based violence (GBV) in Guyana and what businesses can do to end GBV. 

Through partnership with local government and lower health centers, WellShare International is offering community-based HIV counseling and testing services through outreaches and is integrating family planning alongside other services.

CEPROSH staff

Since October 2016, Advancing with Partners and Communities has been supporting implementation of Test and START in three provinces of the Dominican Republic. The Centro de Promoción y Solidaridad Humana (CEPROSH) HIV comprehensive care clinic in Puerto Plata is one of the clinics making a difference.

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.

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.

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.

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