EpiC Quarterly Report (April to June 2020) - Barbados

The national curfew imposed at the end of Quarter 2 (Q2) resulted in all implementing partners transitioning to online engagement in Q3. Technical support was provided to all partners to enhance their online systems, and a number of tools were developed to complement existing efforts. The national stock-out of HIV rapid test kits (RTKs) and testing reagents halted testing activities from February 20th, 2020. The Ministry of Health and Wellness (MHW) procured the RTKs and reagents in Q3, and limited testing activities resumed on May 7th, 2020. The EpiC Barbados program will officially close on July 31st, 2020, with the completion of service delivery by July 21st, 2020. Key results in Q3 included reaching 163 men who have sex with men (MSM) with HIV prevention interventions, testing 46 MSM and receiving their results, and linking 1 MSM to care. Additionally, 5 peer educators were trained on Motivational Communication, and 48 MSM were screened for sexually transmitted infections (STIs) and received their results. Seven MSM were referred and received online psychosocial services. The program continued to be affected by the COVID-19 pandemic, with Barbados recording two cases in March and a national curfew implemented on March 28th. By the end of March, all outreach workers had transitioned to online reach and engagement, and this continued into Q3. By June 30th, a total of 97 cases had been confirmed, with 7 deaths recorded. The national curfew was lifted on July 1st, with the resumption of all services island-wide. In Q3, the project reached clients mainly through online engagement, with 163 MSM reached with HIV prevention interventions, surpassing the annual target of 514 (112%). Of the 163 MSM reached online, 46 were tested for HIV and received their results, representing a testing uptake of 39% (46/118) via online outreach. Both CEED and Equals have systems in place to prevent de-duplication of online engagement clients and clients reached through face-to-face interactions. During Q3, 46 MSM were tested for HIV and received their results, representing a cumulative achievement of 61% of the annual target (215 of 351) and a cumulative testing uptake of 37% (215/574). In addition, 18 women were tested for a cumulative total of 82 tested. No CEED facilitated health fairs or community clinics were conducted during Q3. Technical support was provided to both CEED and Equals to enhance virtual outreach and service delivery. Equals received support in the development of a self-guided risk assessment tool, which utilizes inputs from clients about their HIV risks to provide an auto-generated list of recommended actions and services. Upon completion of the assessment, users are navigated to an online booking tool where they can make reservations for recommended services at Equals. A draft close-out brief was prepared by the Barbados Program Manager, highlighting the program achievements over a four-year period (2017-2020). The brief recognized the performance of the LINKAGES/EpiC implementing partners and stakeholders and the cumulative impact of the project on the Barbados HIV/AIDS landscape. A draft Guidance Document of Using Mobile Devices for Online HIV Outreach was also drafted for the Barbados partners, providing specific considerations for outreach workers who engage with key populations online and programs that support routine data collection for quality and service improvement. A south-to-south exchange was led by Equals, providing technical assistance and sharing their 'going online experience' with two EpiC-supported CSOs in Guyana, GTU and Artistes in Direct Support. This exchange culminated in a series of webinars over a 3-week period, with Equals sharing lessons related to generating service demand through online content and observing ethics and privacy during online engagement. Equals has pledged to provide continued support and guidance in the future. Motivational Communication sessions were held with both IPs during the month of June, revisiting the core principles of Motivational Communications and its application to online outreach. Two cohorts of outreach workers were trained on Motivational Communication, with a focus on online engagement.