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Background: Guyana''s 2014 Biological and Behavioural Surveillance Survey reports significantly higher HIV prevalence among KPs compared to 1.6% in general population. Transgender persons prevalence rate at 8.4%, sex workers at 5.5%, and men who have sex with men at 4.9%. There are persistent programmatic challenges to reaching and testing most at-risk KPs due to high levels of stigma and discrimination. Consequential, is low uptake of HIV testing services (HTS) and treatment services among KPs. This threatens Guyana''s ability to help its people and achieve UNAIDS 90/90/90 targets.
Description: To address challenges, Advancing Partners and Communities (APC) Project in Guyana, a USAID funded programme led by JSI, introduced a personalized KP social network strategy. APC-supported peer educators, themselves KPs, belonging to social networks of most at-risk KPs reach them individually to encourage testing and linkage to treatment. KP peer educators provide HIV education in high risk communities for the most at-risk from their social networks and refer for HTS provided by KP-led NGOs. Efforts to improve HIV testing yield include personalized HTS and those testing HIV-positive are referred to a treatment site and accompanied if they choose.
Lessons learned: Identification of most at risk KPs, testing them and their partners, and linking positives to HIV care and treatment services yields the best outcomes. HTS quarter one results between 2017 and 2018 show a decrease of testing by 18% but an increase in HIV positive diagnosis by 14.2%. The results directly correlates to APC''s strategy. In quarter one of 2017, 14.3% of newly diagnosed KPs linked to HIV treatment - 7% female sex workers (FSW), 7% men who have sex with men (MSM). In quarter one 2018, 43.8% KPs linked (12.5% FSW, 25% MSM & 6.3% transgender).
Conclusions/Next steps: The concept of a personalized approach for peer-led HTS and linkage is labour intensive but effective. Working in conjunction with KPs to develop tailored and flexible approaches that nimbly respond to challenges can lead to innovative strategies which achieve the best results to locate, diagnose and link most at-risk KPs.