EpiC Kazakhstan Semi-Annual Report (FY21 Q1-Q2 October 2020 to March 2021)

The EpiC team supported these community partners in several major areas, including adaptation of the case management program to ensure service continuity during the COVID-19 pandemic and lockdown. During the reporting period, an increased number of COVID-19 cases were registered and quarantine restrictions by local authorities were re-introduced in both project sub-national units (SNUs). However, EpiC CBOs continued to provide online counselling, delivery of HIV self-tests (HIVST) to partners of PLHIV, and support to AIDS centers in antiretroviral therapy (ART) delivery for PLHIV. The program team provided daily technical support to ensure CBOs are meeting their targets and data quality assurance standards. The EpiC team addressed the gaps identified by the RedCap survey, strengthening provision of first-line support (LIVES) for survivors of intimate partner violence (IPV), adverse events monitoring and response, and supportive supervision. CBOs were equipped with and trained in standard operation procedures (SOP) on adverse events monitoring and response adapted to local context, supportive supervision, and informational materials on PLHIV's rights. CBOs were also trained on the peer navigation approach to enhance client-centered treatment and care support to PLHIV. Major accomplishments for the reporting period include the following: 452 partners of PLHIV received community-based rapid testing services and learned their results. Of these, 88 people received their first reactive rapid test (RT) results, with a reactivity rate of 19.5%. All 88 clients were referred to AIDS Centers for confirmatory testing, and 82 clients received positive confirmatory results, including 80 Q1 clients (91% out of those with reactive results and 17.7% of all people tested). Out of 82 newly diagnosed PLHIV in the reporting period, 60 people initiated ART (73%). Overall, 171 PLHIV initiated ART with the help of peer navigators (PNs) during the reporting period, including 60 newly identified clients and 111 known positives who were not on ART and were referred to the project by the AIDS Centers. PNs distributed 304 HIVST kits among PLHIV partners, and 291 (96%) people reported their results. A total of 18 partners who reported positive results were confirmed positive at AIDS Centers (6% yield). The national HIV testing algorithm in Kazakhstan includes two Elisa tests and a Western blot, which is done in the Republican AIDS Center (RAC) in Almaty. According to the protocol, it is supposed to take an average of five days to receive confirmatory results; however, for clients in the project sites, it can take from one to three weeks as the local AIDS Center needs to collect a certain amount of test samples before sending to the RAC laboratory for Western blot. Quarterly trends show that COVID-19 had a major negative effect on program activities during the reporting period. Both project sites were in the government-qualified "red zone" with lockdowns applied during FY21Q1. In FY21Q2, when the lockdown restrictions were lifted, other mobility restrictions were in place due to bad road conditions between sites during the winter period (January – February). Despite these challenges, PNs made efforts to ensure that project clients continued to receive treatment and testing services. The program team conducted site visits to both sites in January and February to provide technical support for PNs to increase case finding.