Project Title: Prioritized HIV Prevention and Treatment Services for Key Populations in Bangladesh_MSM/Hijra Community

 

Detailed Narrative Description of Project:

Under the Funding Request (FR) stream, “Prioritized HIV Prevention and Treatment Services for Key Populations in Bangladesh” is awarded to DAM Consortium to be implemented for next nine (9) months starting from 1st April 2023 to 31st December 2023. icddr,b as Principal Recipient (PR) is here ensuring Technical and Financial support to implement HIV prevention and treatment services for men who have sex with men (MSM including MSW) and hijra, where DAM as one of the sub-recipients (SRs) and CMKS and AAS are SSR who are playing role in implementing and monitoring activities in some specified geographical areas of Bangladesh.

DAM Consortium has been operating and managing a total of 23 service centers (04 DICs, 10 SDICs and 09 Outlets) covering 19 districts of Rajshahi, Rangpur, Khulna, Barishal and Dhaka division and provide support to the 15,836 MSM and Hijra populations (MSM- 14,428 and Hijra 1,408) including Most at Risk Adolescents (MARA) project participants.

The project is implementing to achieve the national goal:

To prevent new HIV infections, reduce incidence and HIV related morbidity and mortality in Bangladesh by improving and further expanding targeted HIV interventions focusing on key populations and their partners.”

Objectives

The program has six main objectives, of which three are related to HIV service delivery, and three are related to creating an enabling environment. The program will:

  1. Prevent new HIV infections and reduce incidence by improving and expanding access to combination HIV prevention (including comprehensive harm reduction) services for KP;
  2. Increase case-finding among KP by improving and expanding access to differentiated HIV testing services (HTS);
  3. Improve access, adherence to and quality of ART services for KP in need, lowering HIV-related morbidity and mortality and reducing onward transmission of HIV;
  4. Strengthen community and government health systems, empower marginalized communities to claim their right to health in a stigma-free environment, and improve linkages and cross-referrals and build capacity to manage and deliver HIV services;
  5. Advocate for legal reform at the policy level and advocate and engage with local gatekeepers and law enforcement agencies to reduce stigma and enable implementation of HIV services for KP;
  6. Improve systems for M&E and strategic information (including updated IBBS data (ongoing under current grant), a revision of size-estimation data (using OP funds) and operations/implementation research).

The major activities of the service centers include HIV testing services (HTS) as well as STI treatment for MSM and Hijra population including MARA project participants and their regular partners (parikh and panthi), counselling, provide Behaviour change communication (BCC) messages, condom promotion and free distribution of condoms and lubricants, create awareness among project participants through one to one and group education sessions. In addition, the project is conducting sensitization meetings with relevant stakeholders to make service centers as a safe place for MSM and Hijra population. Besides the DIC-based activities, the project has included some referral linkage activities like- complicated STI cases, etiological management of STI cases, referral of female partners of married MSM and presumptive TB cases. The Peer Navigator has been providing patient navigation services to PLHIV by accompanied linkage with ART center, adherence counselling and follow up of treatment adherence.

Detailed Description of Services:

The project provided health care services for the poor section of sexual minority group of Bangladesh who are socially and economically marginalized including male sex workers and Hijra communities through set up and managing 23 Clinics and Service Centers by medical professional/counselor, Outreach and community worker and depot holders.

The project provided services with the following strategies;

  • General health care services including STI treatment, HTS services, PHC, counselling, condom distribution and SRHR services from static centre with free of cost consider marginalized and poor;
  • Satellite Clinic Services for General health, counselling and commodities distribution, STI treatment and management, HTS services with free of cost consider marginalized and poor;
  • Outreach services among the marginalized and poor sexual minority group through using health education session where different cadres of volunteers involved like peer educator, peer volunteer and depot holders etc.;
  • Creating enabling environment through social mobilization which includes advocacy and local level sensitization of stakeholders;
  • Skills development of Hijra and MSM by Life Skills Training and vocational trainings;
  • Referral services to meet the un-met needs (legal counselling) of Hijra and MSM;
  • Conduct TB screening and ensure DOTs through GOB and NGO service centres,
  • Referral of complicated health problems, care and support of PLHIV for ARV, family counselling;
  • Reduced Stigma and Discriminations and Prevention of gender-based violence among Hijra, ensure installation of complain boxes at the service centres;
  • quality assurance: The project used a standard quality assurance and improvement guideline / SOP, which confirmed the quality control of all aspects including health and pharmaceuticals, data verification, monitoring and supervision, use of proper documentation, etc;
  • Maintain Universal Precaution and Infection Prevention (UP/IP);
  • Develop, and distribution Behavior change communication (BCC) materials and conduct BCC session among the Hijra and MSM to enhance safer practices, health seeking behaviour and prevention of STIs, Hep-C, HIV and TB;
  • Provide Covid-19 response including awareness, food support, telemedicine, referral for testing, vaccination registration for the target people and their family members;

Duration: April 1, 2023 to December 31, 2023.

Name of Client/Donor : International Centre for Diarrhoeal Disease Research, Bangladesh / The Global Fund.

Total budget: BDT-30,644,950

Name of associate organizations, if any: 1. Chinnomul Manab Kalayan Society (CMKS)

  1. Ashar Alo Society (AAS)

Location: Tangail, Faridpur, Rajbari, Rajshahi, Natore, Chapainawabganj, Sirajganj, Pabna, Naogaon, Bogura, Rangpur, Dinajpur, Khulna, Bagerhat, Kushtia, Satkhira, Jashore, Barishal and Patuakhali.