XVIII International AIDS Conference

Abstract

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Health systems strengthening in Peru: NGO-supported, health center-designed strategies to increase HIV testing among men who have sex with men

S. Santos1, A. Buffardi2, M. Blas1, R. Cabello1

1Via Libre, Lima, Peru, 2University of Washigton, Washington, United States

Issues: Men who have sex with men (MSM) represent the population at highest risk for HIV in Peru. Government health centers offer HIV testing for MSM but estimates suggest that less than 10% of MSM access these services.
Description: From October 2008 - September 2009 the Peruvian NGO Via Libre launched the SOMOS project, designed to strengthen health services for MSM in 9 government health centers in the three regions with the highest prevalence of HIV. Each center received $4,000 to implement strategies that they themselves designed to increase rates of HIV testing among MSM. The primary strategy employed by the centers was a mobile screening service, used by 90% of the centers. Half allocated funds to supplement their insufficient supply of rapid tests and condoms provided by the government; to create information, education and communication materials targeted to this population; and to improve infrastructure. Only one third chose to use the funds to train and sensitize clinicians or to develop new management systems (extended clinic hours, revised patient flowcharts).
Lessons learned: These strategies, desgined to meet the needs and realities of each center and their MSM patient population, contributed to a doubling of the number of HIV tests administered to MSM (6448/3060), compared to baseline rates the previous year. Health personnel expressed gratification in being part of the decision-making process regarding the use of funds. Centers who achieved the greatest increases in testing rates did not report communication or coordination challenges with regional health departments, unlike centers with lower uptake.
Next steps: Future interventions should actively involve government health care personnel in the design as well as the implementation of activities, and coordinate strategies with regional health authorities. In order to reach vulnerable populations not attending health centers, traditional center-based screening may need to be supplemented by mobile health services.


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