Quarterly Report (Year 2 – Q1)

To help the DOH address these challenges in HIV programming, the United States Agency for International Development (USAID) provided assistance to develop and test comprehensive package of services (CPS) models for MSM and PWID that the national AIDS program could adopt and recommend to other local government units (LGUs) for implementation. The ROMP Project developed CPS model frameworks for MSM and PWID following the prevention and education, diagnosis, treatment, and care and support continuum espoused by the DOH. To support CPS model implementation, FHI 360 developed training designs and modules for basic peer education and advanced motivational interviewing, stigma reduction and desensitization, and process documentation, as well as operational guides for peer-driven recruitment (PDR) and terms of reference (TOR) for CPS model implementers. The project also formulated an integrated strategic behavioral communication (SBC) strategy and identified key messages for MSM and PWID that are integral to CPS model implementation. Sixty local government staff coming from four project sites were trained to supervise the implementation of PDR targeting highest-risk MSM and PWID through their sexual and social networks, conduct facility-based motivational interviewing to encourage HIV counseling and testing (HCT), results notification, follow-up testing, and the use of prevention commodities, and implement a case management approach for HIV-positive MSM and PWID to increase treatment initiation, retention, and adherence. To ensure the supply of needed HIV testing kits and prevention commodities, the project negotiated with the DOH to provide sufficient quantities of these commodities to the project sites. The ROMP project shifted gears to Phase III (CPS Model Pilot Testing) in Q1 of Year 2, operationalizing the project's innovations/key interventions, including peer-driven recruitment using a "snowball" scheme and incentives to recruit highest-risk MSM and PWID to a health facility, facility-based peer educators trained on Motiv8, a second-level training for PEs to develop skills and techniques for harnessing a client's intrinsic motivations for behavior change, a case management approach to track cohorts of enrolled clients for treatment, care, and support outcomes, and a Case Management Coordinator to provide individual referral and follow-up, and the Service Delivery Network (SDN) for PLHIV, which serves as the platform for delivery of the comprehensive package of services by formally binding together various service delivery agencies, strengthening their referral process and coordination mechanisms, and ensuring smooth provision of needed services. The SDN for PLHIV in Quezon City was launched in December 12, 2013. While numerous key innovations were launched as planned during this implementation period, ROMP also met unexpected challenges when the Visayan region was struck by natural calamities, including an earthquake in Bohol and Cebu and super typhoon Yolanda, which disrupted planned ROMP meetings in the Cebu tri-city area and delayed implementation. The long holiday season also slowed client recruitment, especially for the MSM component. The confluence of these events contributed to the project not meeting its service delivery targets for the 1st quarter of Y2. The ROMP project intends to further strengthen implementation and expand coverage in the next quarter (Y2Q2) with more intensive monitoring, mentoring, and coaching activities for site implementers, the operationalization of the text messaging service (TXTBro and TXTBai) including collaboration with the CHANGE project to enhance/expand communication activities, and the establishment of the SDN for PLHIV in the Cebu tri-city area, which will include an HIV+ PWID support group. ROMP will further continue to coordinate and leverage support from the GF-TFM project and Big Cities Initiative Project funded by ADB in the convergence cities (Cebu and Mandaue).