LINKAGES Quarterly Report (October 1 to December 31, 2018) – Thailand

The LINKAGES Thailand project collaborated with local implementing partners and expanded its support to other healthcare facilities to strengthen combination HIV prevention, care, and treatment interventions among key populations, including men who have sex with men (MSM), male sex workers (MSWs), transgender women (TGs), transgender sex workers (TGSWs), and female sex workers (FSWs). A total of 18,006 key populations were reached with HIV prevention education and commodities during this reporting period. The combined number of clients counted under KP_PREV this quarter includes 10,919 reached as the result of community-based interactions, while an additional 7,087 key populations were walk-in clients. This represents 35% of the annual KP_PREV target. Additionally, 428 MSM, 11 MSW, 16 TG, 7 TGSW, and 14 FSW initiated PrEP for the first time, accounting for 22% of the annual PrEP_NEW target. HIV testing and treatment services were also expanded during this period. A total of 9,748 MSM, 643 MSW, 1,096 TG, 251 TGSW, 236 PWID, 1,823 FSW, 8,468 non-key population males, and 7,753 non-key population females received HIV testing and learned their test results. This reflects 72% of the annual HTS_TST target. Of the above, 612 MSM, 32 MSW, 52 TG, 17 TGSW, 17 FSW, 7 PWID, 307 non-key population males, and 208 non-key population females tested HIV positive. The overall case-finding rate for FY19 Q1 was 4%, and the total of 1,252 newly diagnosed HIV-positive clients account for 43% of the HTS_TST_POS target for FY19. ART initiation and viral suppression rates were also monitored during this period. A total of 571 MSM, 2 MSW, 44 TG, 7 TGSW, 4 PWID, and 7 FSW, as well as 246 non-key population males and 157 non-key population females started ART during this reporting period. In total, LINKAGES Thailand supported 1,038 HIV-positive individuals to initiate ART, reflecting 35% of the TX_NEW target for FY19. Additionally, 5,668 ART clients received a viral load test in FY19 Q1, and 98% (5,539/5,668) had achieved viral suppression (TX_PLVS). The project also explored activities to improve coverage of key populations who prefer less of a face-to-face outreach strategy. Partners reported a total of 2.6 million online engagements under the ON_CLICK indicator. Most of these engagements (55%) came as the result of posts (organic and boosted) on the official page(s) owned by LINKAGES Thailand's implementing partners. An additional 33% were the result of online paid advertising, including Facebook and Google ad campaigns and advertising materials promoted via dating apps. Same-day ART (SDART) has now been scaled up in 6 provinces in Thailand, including Bangkok, and is now being implemented in 9 hospitals. During this reporting period, 126 clients tested HIV positive in these hospitals, and 97% initiated SDART. National Health Security Office (NHSO) investments with community-based organizations (CBOs) continued to increase, totaling $1.44 million in contracted commitments to LINKAGES-supported organizations. This contributes to the PEPFAR Incentive Fund (PIF) goal of strengthened country ownership and domestic financing of Thailand's leading and highest-performing Key Population-led Health Services (KP-LHS) organizations. However, challenges were also encountered during this reporting period. While a few community partners saw HIV testing increases, most community-based partners saw decreases during this period due to staffing disruptions or shifts in clinic operating hours. Additionally, the number of new PrEP acceptors this reporting period represents a 13% decrease from the previous quarter, partly due to a supply issue with the manufacturer of generic tenofovir-emtricitabine.