Hivos Latin America

Latin America

HIV and Human Rights in Latin America

 

In Latin America, Hivos is implementing projects funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria covering a range of activities from direct procurement of antiretroviral drugs (ARV), to prevention campaigns, capacity building and civic monitoring. Three of these are country programs in Guatemala, Costa Rica and Bolivia; one is a Latin America-wide program focusing on the rights of women who live with HIV.

COUNTRY GRANT: COSTA RICA

This is one of our three country grants in Latin America and the Caribbean. As a Principal Recipient of the Global Fund in Costa Rica, our efforts are aimed at:

  • Ensuring universal access for HIV prevention, treatment and health care to men who have sex with men (MSM) and female transgender persons (FTP).
  • Improving the legal, social and political environment, allowing MSM and FTP, including those living with HIV, to fully exercise their human rights.
  • Providing strategic information about HIV in key populations to help their country carry out effective planning and adequate decision-making.

While Costa Rica has a functioning public Social Security System - the Costa Rican Social Security Fund (CCSS) – the country faces challenges to provide LGBTI persons with quality sexual and reproductive health services. Stigma and discrimination are central issues that alienate populations from health facilities and services, including those related to HIV prevention and treatment.  Therefore, the main objective of the project is to extend access to testing and treatment to MSM and FTP.

Since the epidemic in the country is highly concentrated in these key populations, providing them with access to testing is fundamental to ensure wider coverage of early diagnosis and access to treatment. However, there remain many challenges to scaling-up HIV prevention efforts in Costa Rica because of restrictions on the use of rapid HIV tests (national legislation only allows tests in serum or plasma), which means the CCSS cannot offer such tests to the public.

While efforts are underway to lift those legal restrictions on the use of rapid HIV tests with capillary blood, Hivos and the Sub-recipients have hired a private laboratory to perform rapid testing outside the traditional business hours of the CCSS.

In cooperation with the CCSS, Hivos has contributed to developing HIV healthcare guidelines by asking service providers to accept the tests performed by private laboratories. This allows people living with HIV (PLWHIV) to receive adequate health services from civil society for follow-up and control.

Key achievements:

  • HIV prevention outreach to 2,044 citizens (1806 MSM; 238 FTP)
  • Voluntary Testing and Counselling (VTC) services accessed by 970 citizens (888 MSM, 82 FTP) and informed them on their HIV status in mobile units.

Implementation period: 1 July 2015 - 30 June 2018
Grant amount: US$ 4.8 million
Latest Performance Rating: A1 - exceeds expectations
Sub-recipients for this project:
SR 1: Transvida (with Hivos as manager); SR 2: a consortium with ADC, MANU and La Sala; SR 3: a consortium with ADC and Esperanza Viva;  SR 4: a consortium with ADC and MANU; SR 5: Frente por los Derechos Igualitarios (FDI).

COUNTRY GRANT: BOLIVIA

This is one of our three country grants in Latin America and the Caribbean. As a Principal Recipient of the Global Fund in Bolivia, our efforts are aimed at:

  • Promoting HIV prevention in a timely way amongst vulnerable groups with higher prevalence: men who have sex with men (MSM), female transgender people (FTP), and gay and bisexual men in the nine country departments.
  • Promoting HIV prevention in other vulnerable populations, e.g. sexual workers (SW), community-based organizations and prevention of vertical transmission in the three departments with the highest reported rate of HIV cases.
  • Ensuring universal access to comprehensive multidisciplinary care for people living with HIV/AIDS (PLWHA), with the active participation of their representative  organizations:
    • HIV screening and diagnosis
    • Stock management (drugs, reagents and supplies)
    • Training of health workers
    • Support in the development of Care Protocols STI HIV AIDS National Program
    • Support activities for PLWHA Mutual Aid Groups - monitoring adherence to ARV treatment
  • Strengthening the national HIV-related information system to carry out decision-making in the Bolivia’s nine departments.
  • Promoting the development of multi-sectoral public policies on HIV prevention and care in the context of the HIV/AIDS Law and the new political constitution of the state.
  • Strengthening the participation of PLWHA and civil society.

Thanks to the program, we have ensured: timely access to ARV treatment by purchasing ARVs at the lowest cost in the region; scoping of vulnerable populations through mobile units since 2011, with a potential absorption by the state to ensure sustainable results; and the development of a patient and public engagement (PPE) Strategy to monitor the adherence to ART, thus reducing dropouts and increasing primary prevention.

Key achievements:

  • HIV prevention outreach to 29,946 citizens (20,305 sex workers; 9,034 MSM; and 607 transgender groups)
  • Voluntary Testing and Counselling (VTC) services accessed by 7,338 citizens (3,165 MSM, 4,173 SW) and informed them on their HIV status in mobile units.
  • 7,064 persons living with HIV accessed to ARV treatment.

Implementation period: September 2010 – December 2018
Grant Amount: US$ 23.2 million + 8.8 million extension
Latest Performance Rating: A1 - Exceeds expectations
Sub-recipients: Bolivian Ministry of Health, Vivo en Positivo, ASUNCAMI, Fundación Igualdad and Redvihda

COUNTRY GRANT: GUATEMALA

This one of our three country grants in Latin America and the Caribbean. As a Principal Recipient of the Global Fund in Guatemala, our efforts are aimed at:

  • Strengthening the HIV prevention efforts among key populations: mapping their sizes and profiles; design Information, Education and Communication (IEC/CBC) interventions; ensuring access to condoms and lubricants; conducting voluntary testing and counseling; and supporting the diagnosis and treatment of other sexually transmitted diseases
  • Strengthening civil society with:
    • Strategic information – Stigma and discrimination index
    • A human rights approach (KAP) to build a more inclusive / open society
    • Skill-building for advocacy
    • Monitoring the quality of service provision
    • Six civil organizations that will be better able to contribute to the national HIV response
    • Small grants in support of more than 10 community-based organizations
  • Access to Treatment, Care and Support

Target groups:

Men who have sex with men (MSM), female Sex Workers (FSW), people deprived of liberty (PDL), transgender women, people living with HIV/AIDS (PLWHA) and their families.

Key achievements:

  • HIV prevention outreach to 29817 citizens, 1700 Sex workers; 20509 MSM; 3713 transgender women, 3895 imprisoned persons)
  • Voluntary Testing and Counselling (VTC) services accessed by 25922 citizens (20509 MSM, 1700 Sex Workers, 3713 transgender women) and informed them on their HIV status in mobile units.
  • Official Health Ministry figures indicate there are 13,684 adults (15 years and older) and 704 children in Guatemala.living with HIV who are given access to ARV treatment.

Implementation period: October 2011- September 2018
Grant amount: US$ 42 million + 7.9 million extension
Latest Performance Rating: A2 - Meets expectations
Sub-recipients:

  1. Colectivo Amigos Contra el SIDA (CAS)
  2. Asociación Gente Positiva
  3. Asociación IDEI
  4. Fundación Marco Antonio
  5. Proyecto Vida
  6. Red Sur Occidente REDSO
  7. Fundación Sida y Sociedad
  8. APROFAM/SOMOS
  9. ITPC/Lideres Profesionales
  10. Red Legal
  11. Fundación Fernando Iturbide
  12. Clínica de enfermedades infecciosas Hospital Roosevelt.

 

REGIONAL GRANT: HIV AND WOMEN RIGHTS

The International Community of Women with HIV (ICW) is the only international network established and coordinated by HIV+ women, girls and adolescents from around the world. Today, it counts over 19 million members, and its Latin American chapter currently has representation in 18 countries across Latin America and the Caribbean.

The project is being implemented with member organizations from 11 countries: Bolivia, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Peru, and the Dominican Republic.

This project, in cooperation between Hivos and ICW Latina, has two main objectives. Firstly, to position women living with HIV in 11 target countries as a key population in the effort to contain and reverse the epidemic. Secondly, to establish women as HIV actors and strengthen their capacities to become more active and effective human rights advocates as part of their struggle against gender-based violence in their local communities. The project is supported by the Global Fund to Fight Aids, Tuberculosis and Malaria.

Key achievements:

  • Development of a baseline study on advocacy skills of ICW Latina (Secretariat and National Chapters).
  • Evidence generated by conducting a mapping of gender equality, HIV, sexual and reproductive health, and violence against women with HIV in the legal frameworks and policies of the region.
  • Draft of the regional advocacy strategy.
  • Draft of 5 of the 11 national strategy plans.

Implementation period: 01 January 2016 – 31 December 2018
Grant Amount: US$ 4.3 million
Sub-recipients: Secretaría Regional de ICW Latina, and the 11 prioritized chapters of the ICW: Bolivia, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Peru, Dominican Republic.