Linkages Across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) Project Cooperative Agreement No. AID-OAA-A-14-00045

This model includes a peer-driven strategy, managed by community-based supporters (CBS), to recruit key populations (KPs), including men who have sex with men (MSM), transgender women (TG), male sex workers (MSW), and transgender sex workers (TGSW). The CBS also offer HIV screening under a test-for-triage strategy using HIV oral fluid testing kits (OraQuick) to screen volunteer peers. During the second semester of FY16 (Q3 and Q4), 1,612 unique individuals were reached with prevention activities at the three sites: 747 in Vientiane Capital, 458 in Savannakhet, and 407 in Champasak. Compared to the first semester (FY16-Q1 and Q2), CBSs reached a slightly greater number of KP individuals during the second semester. The EPM model reached a significant number of KP individuals through the implementation of the EPM model, with a total of 3,119 unique KP individuals reached during the entire FY16. The majority of KP individuals reached through the EPM model were MSM and MSW, representing more than three fourths (79 percent) of the total population reached during FY16. Out of 3,119 individuals reached during FY16, 1,285 (41 percent) were MSM, 1,187 (38 percent) were MSW, 344 (11 percent) were TG, and 303 (10 percent) were TGSW. The CBS team is diverse, including 10 TG and 9 MSM, and the recruitment of peers operates mainly in the MSM and MSW networks. Under the EPM model, 631 new KP individuals were screened during FY16-Q4, with 616 negative and 15 reactive, resulting in an HIV screening yield of 2 percent during FY16-Q4. The HIV screening yield decreased from 4 percent in FY16-Q3 to 2 percent in FY16-Q4, reaching the same level as FY16-Q1. The test-for-triage strategy was paused during almost two months in FY16-Q2 to develop quality-improvement activities to increase successful referral to HTC services for those screened reactive. The screening ratio of the key populations that were reached during FY16-Q4 remained relatively stable compared to FY16-Q3, at 72 and 71 percent, respectively. The data suggest that the EPM model is effective in reaching KP individuals and increasing HIV screening yield. However, the HIV screening yield decreased in FY16-Q4, which may be due to the pause in the test-for-triage strategy during FY16-Q2. A total of 19 CBSs were still active at the end of this reporting period, reaching their peers through the EPM model, which includes peer-driven and outreach strategies, HIV oral fluid screening (test for triage), and community-based care and support activities. The CBSs provided care and support services to a total of 14 MSM and transgender women during the whole FY16. During FY16-Q4, at CST services in the LINKAGES referral network, a total of 35 MSM/TG were newly enrolled in clinical care, and 32 were initiated on ART. The achievements against annual targets at the end of Q4 FY16 were greatly exceeded for all indicators except for care and support services. The results for KP_PREV (DSD) achieved 174 percent of the annual target for this indicator. The EPM model reached 27 percent of the estimated number of MSM and transgender women in VTE, 50 percent in SVK, and 69 percent in CPS. The EPM model was effective in reaching KP individuals and increasing HIV screening yield, but the HIV screening yield decreased in FY16-Q4.