HIV Services and System Strengthening Project – HS3 Quarterly Progress Report January 1 to March 31, 2020

The project aims to strengthen the health system and improve HIV services in the Dominican Republic. HS3 works closely with local partners, including Gestión e Innovación en Salud (GIS), the National Health Service (SNS), the National HIV/AIDS Commission (CONAVIHSIDA), and the General Directorate for the Control of Sexually Transmitted Infections and AIDS (DIGECITSS). The project focuses on four priority pillars: expanding access to HIV services for focus clients, strengthening community approaches to linkages, institutional reform to eliminate policy constraints, and an OVC program to serve focus client families. Key Population Incentive Fund's (KPIF) goals align closely with HS3's objectives, aiming to improve programs for key populations, including female sex workers, men who have sex with men, and transgender individuals. HS3 has been implementing its activities in the Dominican Republic since April 2019, with a period of performance until April 2024. The project has been working to expand access to HIV services, including HIV testing, treatment, and prevention services. In the first quarter of 2020, HS3 supported 13 health facilities, with a total of 24,083 individuals receiving HIV testing, including 13,031 focus clients. Among those tested, 470 were found to be HIV positive, representing a 4% positivity rate. The project has also been working to strengthen community approaches to linkages, including the Enhanced Peer Outreach Approach (EPOA). In the second quarter of 2020, HS3 rolled out EPOA with greater fidelity, resulting in a higher yield of HIV positive individuals. The project has also been working to improve index testing, with 11 health facilities and 4 community-based organizations offering this service. In terms of treatment, HS3 has been working to increase the number of individuals on antiretroviral therapy (ART). In the second quarter of 2020, the project reported 13,155 clients currently on ART, with 80% having a documented viral load test within the last 12 months and 84% being virally suppressed. The project has also been working to improve TB screening and treatment, with 266 ART clients receiving a TB screening and 77 diagnosed with TB and started treatment. In relation to KPIF, HS3 has been working to improve testing and treatment services for key populations. In the second quarter of 2020, the project surpassed its target for testing, non-index, female sex workers, and men who have sex with men, reaching 57% and 52% of the annual target respectively. However, the project has identified areas for improvement, including a low case detection rate for female sex workers and insufficient index testing. Overall, HS3 has made significant progress in improving HIV services and strengthening the health system in the Dominican Republic. However, the project continues to face challenges, including the COVID-19 pandemic, which has impacted the delivery of services. The project will continue to work to address these challenges and improve HIV services for focus clients and key populations.