In Central America, key populations (KPs) – especially men who have sex with men, transgender women, and female sex workers – are at increased risk of HIV infection and face significant stigma and discrimination, making it challenging to reach them for effective HIV prevention.
Overview and Objectives
USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) recognized the need for enhanced efforts to reach KPs as part of the regional strategy to achieve HIV epidemic control in Central America. One strategy for doing this is leveraging the growing network of civil society organizations that have emerged to support KPs.
PrevenSida – the USAID Project to Prevent the Transmission of HIV/AIDS – was a 10-year cooperative agreement (2010-2020) funded by PEPFAR through USAID. The project worked in Nicaragua for its first five years and expanded to Honduras, Guatemala, El Salvador, and Panama in 2016.
USAID expanded PrevenSida’s scope of work in 2017 to include the generation, dissemination, and use of HIV strategic information. This led the project to support and build the capacity of CSOs and academic institutions in Nicaragua, El Salvador, Guatemala, Honduras, and Panama to analyze and use HIV information and to improve their capacity to generate new knowledge about how to reduce gaps in the continuum of care for KPs.
PrevenSida encompassed five programmatic areas:
- Strengthening the management and technical capacity of non-governmental organizations (NGOs) serving KPs and people living with HIV (PLHIV);
- Improving access to and quality of HIV preventive services;
- Reducing stigma and discrimination towards KPs and PLHIV;
- Improving the participation of NGOs representing KPs and PLHIV in the national HIV/AIDS response; and
- Improving the generation, dissemination, and use of HIV strategic information with KPs in Central America.
PrevenSida achieved or exceeded most of its goals – particularly those related to capacity building and strengthening the continuum of care for KPs – providing technical support that helped 74 CSOs in the five countries meet standards for management, planning, financial control, and provision of HIV care and support services. This allowed the CSOs to implement HIV prevention activities more widely and effectively.
A primary PrevenSida institutional strengthening strategy was the $2.5 million in grants to CSOs to provide HIV care and prevention services at the community level. Through 111 small grants, URC built the capacity of 37 Nicaraguan NGOs serving KPs to provide HIV care and prevention services at the community level. These NGOs performed 60,718 HIV tests, of which 34,894 (57%) were performed on KPs, and reached 3,623 PLHIV with community support services. This testing served to identify and link to care 248 HIV-positive individuals, of whom 205 were members of KPs.
And the project partnered with the Center for Health Research and Studies (CIES) at the National Autonomous University of Nicaragua to develop a two-year management course with academic credits, aimed at CSO leaders. The project designed an interactive HIV prevention teaching package and trained facilitators in the NGOs to sustain cascaded trainings on these topics.
With the development of the PEPFAR 3.0 strategy to improve the use of strategic information for KPs, USAID added to the project’s scope of work in 2017, the generation, dissemination, and use of HIV strategic information across Central America. URC supported and built the capacity of NGOs and academic institutions in Nicaragua, El Salvador, Guatemala, Honduras, and Panama to analyze and use HIV information and generate new knowledge specific to KPs.
The project developed a Virtual Knowledge Management Platform – still in use – that consolidated HIV information and training materials to support vulnerable populations in Guatemala, El Salvador, Honduras, Nicaragua, and Panama in a user-friendly, online system.
In the project’s final extension period of 2018-2020, URC provided technical assistance to Ministries of Health in El Salvador, Guatemala, Honduras, and Panama to strengthen their HIV information systems to the Test-and-Start strategy and achievement of the UNAIDS 95-95-95 targets.