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

FHI 360 worked with the USAID Mission to finalize a workplan, targets, and project organogram, hire key project staff, and identify and develop sub-agreements with key implementing partners (IPs). The project emphasized harmonization of planned EpiC activities with other key stakeholders, including the Global Fund (GF-PROTECTS), to maximize available resources in the country. EpiC completed an agreement with the Philippines' Department of Health - Epidemiology Bureau (DOH-EB) to facilitate data collection and sharing across EpiC sites. This agreement allowed reporting of service delivery indicators toward PEPFAR targets using the country's national HIV data collection system. During this period, EpiC Philippines began to rapidly roll out targeted technical assistance, including providing technical support to update the country's national guidelines on testing services, pre-exposure prophylaxis (PrEP), and treatment services. Implementation challenges related to the COVID-19 pandemic limited the project's ability to provide on-site support to implementing partners. Despite this, by the end of the reporting period, EpiC Philippines had finalized its FY21 implementation plan, filled almost all major staffing positions, developed sub-agreements with two key implementing partners, rolled out technical assistance for testing, treatment support, and PrEP, and begun reporting service delivery data in collaboration with the DOH-EB. EpiC direct implementation, technical assistance, and data collection started in March 2021. The project focused on finalizing sub-agreements with community-based implementing partners who will be supported to conduct outreach and HIV education activities that will begin in FY21 Q3. In preparation for the beginning of support for prevention activities, the EpiC team began roll out of technical assistance on a primarily virtual basis. The EpiC team introduced the concept of the Enhanced Peer Outreach Approach (EPOA) to 142 implementers from 28 facilities during the DOH-Central Luzon Regional AIDS STI Viral Hepatitis Prevention and Control Program (RASVPCP) monthly partners coordination activity. EpiC Philippines partners collected HIV testing service delivery during the FY21 Q1-2 period through paper-based forms. However, EpiC accesses service delivery data for reporting purposes through the DOH-EB database and the current national system is not collecting data on negative tests, thus, limiting reporting for the HTS_TST indicator. EpiC is supporting the DOH-EB with the scale-up of OHASIS that will require collection of HTS_TST_NEG and ensure reporting by Q3, to be able to report on HTS_TST performance and calculate program and site-level case-finding rates to better inform program targeting. One community partner (HASH) was able to report initial results from community-based screening. HASH tested 234 clients in the month of March with an overall reactivity rate of 13.2% across two sites. Case-finding was notably higher in Trece Martirez (17%) in comparison to Makati (13%), though the Makati site tested far more clients (204 versus 30). To achieve these high case-finding rates, HASH mainly engaged different community-based "motivators" who accessed different known KP "orgy" networks. These results were not included in HTS_TST_POS reporting (below) as they are pending confirmatory reports for the 31 reactive clients. Based on previous performance, about 90% (28) of these clients are expected to be added to the HTS_TST_POS numbers. During Q1-2, EpiC Philippines partners reported 106 individuals confirmed HIV-positive test results (HTS_TST_POS). Sixty-seven (63%) of which were from Region 3 facilities, 21 (20%) were from National Capital Region (NCR) facilities, and 18 (17%) were from Region 4A facilities. Of all confirmed positive cases, 78 (74%) were reported by tertiary hospitals. The Philippines' national testing algorithm introduces significant delays to the process of confirmatory testing, which can lead to wait times up to one month. The Philippines has introduced a Rapid HIV Diagnostic Algorithm (rHIVda) which reduces the turn-around time to 1-2 days, and all confirmed positive results reported during this semi-annual period were confirmed through rHIVda, including 19 clients who were referred from non-rHIVda sites to sites accredited to perform rapid confirmation.