Getting the architecture right: working out how best to deliver the comprehensive package of HIV prevention and care programs and services among key affected populations
Mar 26, 2015
Getting the architecture right:working out how best to deliver the comprehensive package of HIV prevention and care programs and services among key affected populations
Lou McCallumDirector, APMG
Where are we up to in the development of Comprehensive Packages for key populations?
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MSM and TGMSM and TG
MSMMSM
Sex workersSex workers
5
Drug usersDrug users
6
PrisonersPrisoners
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yy
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Challenges
Health system is isolatedo Not an active partnero Not involved in
outreacho Depends on donors
to bring key populations in
Creates long-term problems:
o Hard to scale-up a sustainable system
o Few links between different key population groups
o Focused on numberso Angry advocateso Like finds like
People aren’t empowered
HIV – Current Model and Challenges
General Health System
Donor Intervention
IDU CSW MSM Prisoners Migrants PLHIV
Outreach
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Strategy
Quality improvement enhances outreach, and opens entry points
Create demand, ensure supply
Focus on long-term engagement
Create demand – ensure supply
CBOCBO CBO
NGO
NGO
NGO
Care Environment
Entry Point
Entry Point
ModelsModels
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• Humsafar Trust, Mumbai– Mature MSM NGO– Has its own STI/HIV clinic as primary care and a
feeder to mainstream services– Sub-population segmentation– Not duplicating government services – advocating
and feeding in– Outreach to create demand– Mentor for emerging CBOs– Research arm
ModelsModels
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• PT Foundation, Malaysia– Serves MSM, TG, DU and SW– Good links with VCT and PLHIV services,
government and private– Has its staff placed in these services to
strengthen links, improve quality and acceptance
BalanceBalance
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Key pointKey point
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• It is only by working out the most appropriate and sustainable connection between demand and supply
• The key is in the balance