CONSULTANTIVE MEETING BY GLOBAL FUND

ON FIRST QUARTER PERFORMANCE WITH 54

HIGH INCIDENCE WOREDA

ADAMA
JUNE 2022
 CONTENT OF THE PRESENTATION
• Definition of KPP’s in Ethiopian context
• Definition of KPP’s with minimum Package
• KPP’s at Health Facility
• KPP’s at Out reach
• Activities supported By Global Fund
• DIC’s Activities
• Roles and Responsibilities At all Level
• Selected Indicators for monitoring
 KPP’s in Ethiopian context
 Ethiopia has defined key and priority population groups by
taking local epidemiology in to consideration.
Who is key populations??
are Female sex workers (FSW) ,Prisoners and PWID-
high/substantial risk of acquiring HIV infection, have limited
access to services and some face stigma and discrimination.
While priority populations- are widowed, separated or
divorced; Distance Drivers; PLHIV and their partners; prisoners;
People working at hot spot areas (Mobile and resident).This
population groups have high risk of HIV infection, have limited
access to services and some encountered stigma and
discrimination.
 Conti…
• Key population
– FSW
– Prisoners
– PWID
• Priority population
– Distance drivers
– Sero Discordant
– Widowed and divorced urban women
– Mobile and resident workers/laborers in hot spot areas
Adolescent girls and young women
 Updates… (in 2020)
Percentage of women and men age 15-49 who are HIV
positive (2020)
 Female Sex Workers (FSWs)
• Availability of data on the size of FSW population is
limited and out dated.
• However, according to a recent extrapolation made
based on size estimates conducted by PSI and EPHI,
there are about 210,967 FSWs in Ethiopia.
• Review of few available programmatic sources indicate
a range of HIV test yield among FSWs from 2.8%
(MOH-DHIS-2) to 28% (ICT in PEPFAR supported sites).
• Assuming an average 23% prevalence reported in
2013, the total number of FSWs living with HIV
(LWHIV) could be 48,522.
6
 HIV Prevalence among FSWs 2013

Mekele - TI 33

Gambella - GA 32.8

Bahirdar-Am 31.6

Kombolcha -AM 30.4

Adama- Or 24.2

Semera Logia - Afar 23.9

Diredawa -DD 23.7

Shasheme-Oro 18.3

Metema-Ama 17.2

Hawassa-SNNPR 15.2

0 5 10 15 20 25 30 35

7
 Update - HIV Prevalence among FSWs 2020
Total 18.7
Shashemane 14
Hawassa 14.4
Mizan 15.3
Addis Ababa 15.4
Adama 16.1
Dilla 16.7
Logia/Semera 17.5
Arba Minch 18.3
Nekemte 19.8
Gonder 20
Kombolcha/Dese 20.3
Gamebella 21.6
Harar 23.1
Dire Dawa 23.7
Jimma 24.8
Bahir Dar 28.2
8
0 5 10 15 20 25 30
 HIV prevalence among KPPs
Population Est. no. Prevalence/Positivity n/SS/ Source

Male = 4.3% M=686 UNODC,2014

Female = 3.8% F=160
Prisoners 85,000 Total= 4.2% T=846

Total=2.2% 22,040 MOH, 2011EFY

PWID 4,448 Total=39.5% 177 OSSHD 2018

Widowed, W=1,522,7 • Widowed (Total) = • EDHS 2016

separated and 02 11.5% • EDHS 2016
divorced Sepa./ • Divo. or sep. (Total) =
women Divo.= 2.9%
555,907
• Widowed Women • EPHIA 2018
=15.1%
• Divo. or sep. Women =
8.6%

9
 HIV prevalence among KPPs…
Population Est. no. Prevalence/ n/SS/ Source
Positivity
Distance 30,000 Total = 4.9% 1609 EPHI 2014
Truck Drivers

Migrant, 1,000,0 Total = 1,6% 257,485 MOH,

Seasonal and 00 2011EFY
Daily Laborers
Adolescent >15 • Total = 0.8% EPHIA 2018
girls and million
young women • OSY=2.1% (AA) PEPFAR, AHRI,
• OSY=3.3% 2019, Venue-
(Gamb.) based study

10
 GUIDING PRINCIPLES

 Combination Prevention: the minimum service package needs to deliver

combination HIV prevention: behavioral, bio-medical and structural prevention
interventions to KPP

 Participation and inclusion, every effort has been made to ensure the
substantive and meaningful engagement of key and priority populations in
planning, implementation, monitoring and evaluation of HIV services.

 Equity and Non-discrimination- The necessary precautions should be taken to

ensure a right to have equitable health services and ensure equity and non-
discrimination against key and priority population in accessing HIV prevention
services.

 Fundamental human rights – HIV prevention services should be built on

 GUIDING PRINCIPLES

• Coordinated action: Ensure coordination among different actors and

avoid duplication of efforts to increase efficiency.
• Partnership: All partners including public, private, NGOs, CBOs and
civil societies should be involved in designing and implementing HIV
prevention programs targeting key and priority populations to
maximize the coverage, scale and intensity of prevention services.
• Sustainability: HIV prevention programs should be designed
capitalizing on tapping, mobilizing and building local capacity and
resources that foster and maintain sustainability.
• User friendly service: HIV prevention services should be friendly to KPP.
should be respectful, nonjudgmental, confidential, tailored and
responsive to needs of key and priority populations.
• Gender: HIV prevention services should be gender sensitive and there
should be gender and KPP disaggregated reporting
• Linkage: HIV prevention services should have strong referral linkage
with HIV treatment care and support program.
 Minimum HIV prevention Services: Female Sex Workers

Definition and size estimation:

• Female sex workers are defined in the Ethiopian
context as females who regularly or occasionally
trade sex for money in drinking establishments,
night clubs, local drink houses, chat and ‘’shisha’’
houses, “on the street”, around military and
refugee camps, construction sites, trade routes,
red light districts, and at their homes.
• In Ethiopia, the total population size of FSWs
estimated to be 160,000. (FHAPCO 2014)
 Minimum HIV prevention Services: Female Sex Workers

Vulnerability, Risks and HIV Prevalence

• In Ethiopia, the national survey done in all capital

of 11 regions in 2013, the overall HIV prevalence
among FSWs is 23%. The highest prevalence
observed among SMS/ phone based FSW (23.6%)
followed by hotel/bar based FSW (22%) and red-
light (20.6%). The prevalence varies from 32% in
Mekelle, to 14% in Hawassa.
 Minimum HIV prevention Services: Female Sex Workers
 Risk and vulnerability factor:
• Exposed for partner violence (Gender Based Violence)
• Sex without condom or inconsistent and incorrect use of condom
• High rate of condom breakage (27% average prevalence)
• Alcohol, Khat and other drugs use
• Multiple concurrent sexual partners
• Low health seeking behaviour
• High prevalence of STI
• Lack of comprehensive knowledge on HIV
• Illiteracy and low level of education
• Limited access for prevention, care and treatment of HIV
• Peer pressure by experienced sex workers gatekeepers, pimps etc
• Low risk perception with regular partner ‘Baluka’, resulting inconsistent condom
use
• Lack of legal protection and justice (for example not having ID cards and
unavailability of GBV timely response)
• Stigma and discrimination (for self-identified)
 Minimum HIV prevention Services: Female Sex Workers
 MINIMUM PREVENTION INTERVENTIONS FOR FSWS:
Behavioral
• Peer education session (small group and one to one)
• Communication and Promotion through community wide events
• Information through print and mass media (leaflets, flyers, booklets, radio and TV)
Bio-Medical
• Condom
• Pre-Exposure Prophylaxis
• Post Exposure Prophylaxis
• HIV testing services including self-test
• STI screening and treatment
• Referral and linkage to care and treatment/PMTCT
Structural Intervention
• Economic Empowerment: Vocational skills training and income generating schemes
• Prevention and management of Gender based violence and promote male engagement (Social
protection services and violence prevention).
• Legal framework/protection for minors (<18yrs) not to engage in sex work
• Reducing stigma and discrimination against PLHIV and marginalized groups
• Community empowerment and enforcement of laws to protect basic human rights
• Life skills training and basic informal education.
 Minimum HIV prevention Services: Female Sex Workers
 LIST OF RECOMMENDED TOOLS:
Behavioral:
• Peer educators training manual and Peer learning guide
• Information kits and IEC/BCC materials (HIV general, Condom use, HIV testing-self test, STIs
prevention and management, PrEP, risk self-screening, GBV prevention, Contraceptive
methods)
• Standard operating procedures for community wide events
Biomedical:
• KPP friendly service training manual
• PEP/PrEP training manual and wall charts
• STIS training manual and STI wall chart
• Self-test and HIV test algorithm
• GBV Response services flow chart
• Partner invitation card
• Linkage referral forms
• Recording and reporting forms,
Structural:
• GBV prevention and management stakeholders training manual, Service directory and
information kit
 MINIMUM HIV PREVENTION SERVICES: LONG
DISTANCE DRIVERS
• Definition/ description: Long distance drivers are drivers
who are obliged to travel for more than 24 hours and
more on the road that involves overnight stay out of their
home.
• This group includes heavy truck drivers, bus drivers, Isuzu
drivers, and tour-car drivers. Most of them are men
between 18 and 39 years of age. Almost all are literate
with the majority of the group having had completed
eighth grade (primary school). About half of this group has
never married or is divorced.
• According to recent data from ministry of transport in
Ethiopia, there are about 30,000 Long Distance Drivers.
 MINIMUM PREVENTION INTERVENTIONS FOR LONG
DISTANCE DRIVERS:
Behavioral
Outreach one to one or group education sessions
·Information through print, electronic and mass media (Billboards,
leaflets, flyers, booklets, Information CD and radio)
Bio-Medical
Condom
·HIV testing services including HIV self-test
·STI screening and treatment
·Referral and linkage to treatment
Structural Intervention
Address policy, strategy and organizational barriers to HIV prevention
service access for long distance drivers
 MINIMUM PREVENTION INTERVENTIONS FOR LONG
DISTANCE DRIVERS:
LIST RECOMMENDED TOOLS:
• Behavioral:
• Outreach SBCC SOP
• Information kits and IEC/BCC materials (HIV general, Condom use, HIV testing-self
test, STIs prevention and management, PrEP, risk self-screening, GBV prevention,
Contraceptive methods)
• CD with information on HIV prevention and risk behaviors, Condom use, HIV
testing including self-test, STIs symptoms and signs, prevention and management
• Billboards with information on HIV prevention and risk behaviors, Condom use, HIV
testing including self-test, STIs symptoms and signs, prevention and management
Biomedical:
• STI wall chart
• Self-test and HIV test algorithm
• Referral forms and directory
• Recording and reporting forms,
Structural:
• Work place policy and manuals
 MINIMUM HIV PREVENTION SERVICES: PRISONERS

Definition: The term “prisons” refers to all places of

detention within a country, and the terms “prisoners”
and “detainees” refer to all those detained in criminal
justice and prison facilities, including adult and juvenile
males and females, during the investigation of a crime,
while awaiting trial, after conviction, before sentencing
and after sentencing.
 In most countries including Ethiopia, most of the
prisoners come from poor, uneducated and
disadvantaged communities and are therefore more
likely to be at risk of infectious diseases, including HIV.
 Their HIV prevalence of 4.2%, and it varies among the
regions.
MINIMUM HIV PREVENTION SERVICES: PRISONERS
Behavioral
Peer education (group and one to one)
·Life Skills training
·Mini-media
·Information through print (information kits, leaflets, flyers, booklets, magazines
and newsletter )
·Communication and promotion through edutainment events
Bio-Medical
HIV testing services including linkage and referral services for ART and PMTCT
·STI screening and treatment
·Provide safe shaving and tattooing services
·Condom for prisoners who are released or allowed to leave the prison
·PEP, in the event of potential exposure to HIV
Structural Intervention
Address policy, strategy and organizational barriers
·Prevention of sexual violence
MINIMUM HIV PREVENTION SERVICES: PRISONERS
RECOMMENDED TOOLS
• Peer educators training manual and peer learning
guide
• Life-skills training manual
• Information kits and IEC/BCC materials (HIV general,
Condom use, HIV testing-self test, STIs prevention and
management, PrEP, risk self-screening, GBV
prevention, Contraceptive methods)
• Mini-media staff training manual
• Mini-media and Edutainment events SOP
• Registration formats
• Report formats
 MINIMUM HIV PREVENTION SERVICES: WIDOWED AND
DIVORCED WOMEN

• Definition and size estimation:

• Widowed woman is a woman whose spouse has
died and not remarried.
• A Separated woman is a woman who lives apart
from her spouse and not remarried
• Divorced woman is a woman who has legally
dissolved or terminated a marriage under the rule
of law of the country and not remarried.
• HIV prevalence Widowed 11.5% and Divorced
2.9%
 MINIMUM HIV PREVENTION SERVICES: WIDOWED AND
DIVORCED WOMEN
Behavioral
Outreach one to one sessions
·Peer education (group and one to one)
·Information through print and (leaflets, flyers, booklets )
Bio-Medical
Condom
·HIV testing services including self-test
·STI screening and treatment
Structural Intervention
Economic strengthening including support through community care
coalition(3C)
·Comprehensive Gender Based Violence response
 MINIMUM HIV PREVENTION SERVICES: WIDOWED AND
DIVORCED WOMEN
LIST RECOMMENDED TOOLS:
Behavioral:
• Peer educators training manual and Peer learning guide
• Outreach one to one education manual for divorced, separated and widowed women
• Information kits and IEC/BCC materials (HIV general, Condom use, HIV testing-self test, STIs
prevention and management, risk self-screening, GBV prevention, Contraceptive methods)
Biomedical:
• STIS training manual and STI wall chart
• Self-test and HIV test algorithm
• GBV Response services flow chart
• Referral forms/slip
• Recording and reporting forms,
Structural:
• GBV prevention and management stakeholders training manual, service directory and
information kit
• SOP for selection and support of women for economic empowerment
MINIMUM HIV PREVENTION SERVICES: WORKERS IN HOT SPOT AREAS

Definition and size estimation:

• Workers in Hot Spot areas are those people who
seek jobs and move from their place of residence
to another temporarily, seasonally, or longer
period of time. It also include workers who live in
their permanent residence but work in a place
where there is high HIV transmission.
• Work areas where the HIV prevalence is above the
average for the population (1.5%) is considered
hot spot.
MINIMUM HIV PREVENTION SERVICES: WORKERS IN HOT SPOT AREAS
Vulnerability, risks and HIV prevalence:
 The HIV prevalence of mobile and stable workers is estimated
1.5% (FHAPCO, CUI 2017). The hot spot areas are associated with
high vulnerability to HIV. A combination of social, physical and
emotional factors can make mobile populations highly vulnerable
to HIV infection that may include
 Separation from socio-cultural norms that regulate behavior in
stable communities and peer pressure to engage in high risk sex
 Multiple and concurrent sexual partnership or transactional sex
 Alcohol and substance abuse (‘Khat’, cigarette, shisha)
 Gender based violence
 Lack of competent corporate culture for HIV/AIDS mainstreaming
and limited access to HIV service at workplace
 Poor quality and non-user friendly health and HIV services .
MINIMUM HIV PREVENTION SERVICES: WORKERS IN HOT SPOT AREAS
Behavioral
Peer education (group and one to one)
·Life skills training for young workers
·Information through print and mass media (leaflets, flyers, booklets and radio)
·Mini-media and community wide events edutainment
·Social Media
Bio-Medical
Male and female Condom
·STI screening, diagnosis and treatment
·Provide HIV testing services including linkage and referral for ART and PMTCT services
·PEP, in the event of potential exposure to HIV, if applicable
Structural Intervention
Avail organizational workplace HIV prevention policy and strategy to ensure HIV
mainstreaming
·Strengthen linkage between workplace health system into wider community health system
as well as partnership among different stakeholders
·Enhance the capacity of management and staffs of workplace to plan, implement and
monitor HIV prevention at the workplace
·Set mechanisms for GBV Prevention and response
MINIMUM HIV PREVENTION SERVICES: WORKERS IN HOT SPOT AREAS
LIST OF RECOMMENDED TOOLS:
Behavioral:
• Peer educators training manual and Peer learning guide
• Information kits and IEC/BCC materials (HIV general, Condom use, HIV testing-self
test, STIs prevention and management, risk self-screening, GBV prevention,
Contraceptive methods)
• Standard operating procedures for community wide events and Mini-media
Biomedical:
• PEP training manual and wall charts
• STIS training manual and STI wall chart
• HIV test algorithm
• GBV Response services flow chart
• Linkage referral forms
• Recording and reporting forms.
Structural:
• Work place HIV policy development guidance and HIV Mainstreaming manual
• Life skills training manual.
 Minimum HIV prevention Services: Youth adolescents
 Risk and vulnerability factor:
• Sex exercise without condom or inconsistent and incorrect
use of condom
• Alcohol, Khat and other drugs use
• Multiple concurrent sexual partners
• Low health seeking behaviour
• High prevalence of STI
• Lack of comprehensive knowledge on HIV
• Peer pressure
• Impact of Social media
• Low risk perception with regular partner resulting
inconsistent condom use
 Minimum HIV prevention Services: Youth adolescents
 MINIMUM PREVENTION INTERVENTIONS FOR FSWS:
Behavioral
• Peer education session (small group )
• Communication and Promotion through community wide events
• Information through print and mass media (leaflets, flyers, booklets, mini-media)
Bio-Medical
• Condom
• Post Exposure Prophylaxis
• HIV testing services
• SRH services and family planning
• STI screening and treatment
• Referral and linkage to care and treatment
Structural Intervention
• Life skills training
• Economic Empowerment: Vocational skills training and income generating schemes
• Prevention and management of Gender based violence
• Legal framework/protection for minors (<18yrs) not to engage in sex work
• Community empowerment and enforcement of laws to protect basic human rights
 Minimum HIV prevention Services: Youth adolescents
 LIST OF RECOMMENDED TOOLS:
Behavioral:
• Peer educators training manual and Peer learning guide
• IEC/BCC materials (HIV general, Condom use, STIs prevention and management,
GBV prevention, Contraceptive methods).
• HIV and STI prevention messages through anti AIDS club and mini-media
Biomedical:
• KPP friendly service training manual
• PEP training manual and wall charts
• STIS training manual and STI wall chart
• GBV Response services flow chart
• Partner invitation card
• Linkage referral forms
• Recording and reporting forms,
Structural:
• GBV prevention and management stakeholders training manual, Service directory
and information kit
 The Response

Youths and Adolescent :

• Implementation of evidence-based and
comprehensive HIV/SRH intervention packages;
• Scaling up of implementation of school health
program,
• Improving scope and quality of HIV/SRH services of
youth development centers,
• Implementing interventions that address structural
barriers through community structures.
• Enhanced use of media to reach adolescent girls,
young women and their partners. 34
 KPP FRIENDLY SERVICES
Making the HIV service user friendly is of
paramount importance to increase access for
KPPs.
It minimizes barriers to service use, makes the
providers understand and respect clients’
different values and characteristics.
provides tailored service to clients.
Helps providers to have positive attitude
and friendly approach towards them.
 KPP FRIENDLY SERVICES
Principles in friendly service delivery are:
 Accessibility: KPPs are able to obtain the health services that are
available
 Acceptable: KPPs are willing to take the health services that are
available
 Effectiveness: The right health services are provided to the right
client, in the right way, and make a positive contribution to his/her
health, ensuring the interventions do no harm.
 Appropriateness: Respecting client’s human rights and accord them
basic dignity (e.g. services are voluntary, consented, respect privacy
and confidentiality and are right health services).
 Respectful: Respecting clients views, knowledge and life
experiences (non-judgmental & adjusted).
 Client involvement: Recognize that clients are part of the solution
(engaging them in making decisions).
 KPP’S MINIMUM PACKAGE
• Post-exposure prophylaxis
• Pre-exposure prophylaxis
• Self-testing
• ART for HIV positives
• Viral load
• Referral linkages between services
• Life skills education
• Participation of sex workers in HIV prevention
programs
 Conti…..

• Peer education
• Condom promotion and distribution
• STI screening, diagnosis and treatment
• HIV testing and counseling
• Outreach programs
• Sex worker friendly services
• Sex worker support groups
Comprehensive package of HIV service for
KPP’s
• Peer education and outreach
• Sexual and drug use assessment and risk reduction
• Condoms and condom-compatible lubricants
• HIV Testing and Counseling
• Retesting for FSWs who tested HIV Negative
• ART for all KP living with HIV
• Post Exposure Prophylaxis (PEP)
• Pre Exposure Prophylaxis (PrEP) for FSWs and uninfected partners in Sero-
discordant couples
• Prevention and management of co-morbidities including STIs, TB, Hepatitis B & C,
and mental health disorders
• Reproductive health services including PMTCT for women of child-bearing age and
pregnant women
• Provision of FP
• Provision of SGBV management
 KPP’S At Health Facility
• KPP service will be provided in KPP’s friendly clinics. (standalone)

• KPP service will be provided for 24 hours of a day.

• KPP service will be provided by trained health professional.

• KPP Service provider should screen all FSWs for HIV.

• All FSWs screened should be tested for HIV.

• All FSWs Partner’s reached should be tested for HIV including HIVST.

• All FSWs who doesn’t wish to came HFs should offer directly assisted HIVST

using PNs and Unassisted HIVST for those who doesn’t want to be assisted.

• All FSWs tested HIV positive should be linked to care and treatment.
 Continue…..
• All GBV/SV survivors will receive package of services including
PEP, HTC, EC, STI screening/management, psychosocial & legal
support, Other medical services, including trauma care for victims
of violence.
• All FSWs should be screened for STI, provided STI diagnosis and
treatment.
• KP friendly service providers should screen all FSWs for TB.
• All FSWs should be counseled for family planning services.
• KP friendly clinic should be provided with prevention
commodities and supplies for (Condoms, Gloves,).
• All KP friendly clinics shall be equipped with gynecological
equipment, FP commodities, STI Kit and supplies.
• All HIV negative FSWs should screened for PrEP eligibility
• Provide PrEP to HIV-negative FSWs as they are at high risk of
acquiring HIV.
• KP friendly clinic should coordinate, supervise and support the
 KPP’S Service at out reach
• Providing peer education (home based) on HIV, benefits of HIV
Counseling and Testing.
• Giving Health Education On HIV/AIDS
• Distributing of male condoms.
• Distributing IEC / BCC Materials.
• Organizing and forming - up support groups (Positive and negative
FSWs).
• Providing support in Out Reach activities / campaigns
• All FSWs who doesn’t wish to came HFs should offer directly
assisted HIVST using PNs and Unassisted HIVST for those who
doesn’t want to be assisted.
• Conducting LTFU tracing (For HIV Positive FSWs who declined to
be enrolled).
• Conduct mapping of venues, FSWs hotspot sites bi-annually.
• Conducting an update on FSWs distribution.
• Following – up of the migration / movement of FSWs.
2014 EFY GLOBAL FUND NFM3 GRANT
ACTIVITIES
 For KPP’s ( FSW)
• Conduct Education Session with KPP’S
• Recruit 756 Peer Facilitators
• Conduct out reach To KPP’S
• Transport communication cost for 216 MSG
• Supporting Implementation of Adolescent
friendly clinics in HF once a week
 Conti…..
• Procure medical & other supplies to establish
10 FSW DIC
• Procure Medical & other supplies to establish
10 FSW DIC
• Salary for 5 staff to provide who works at DIC
• Hose rent & utility for FSW 10 DIC
 Activities……….
 In the Development Scheme
• Providing stationary materials for 3373 peer
facilitators at workplaces in hotspot areas
• Provide incentive for 3373 peer education who
facilitate peer education at work place
• Provide Mini media equipment for equipment To
hotspot area
• Conduct 5 days training for 3373 Peer educator
who facilitate Peer education at work place
 Conti…..
 Rehabilitation Center for PWID for Adama
Medical collage
• Procurement of medical equipment for the
center
• Procure furniture and computers fore the
centers
• Provide 21 days training for 10 rehabilitation
center service providers for PWID
• Giving Different training on HIV/AIDS clinical
and social activities
 DIC (Drop in center)
• Sustainable and low cost DICs will provide comprehensive behavioral, bio-
medical and structural interventions to key and priority populations especially
FSWs at selected hot spot towns.
• At regional level 10 Town was selected for Establishment of DIC
• The DICs will be implemented with government ownership and in partnership
with Global Fund.
• DICs will be established in government owned houses or House rent covered
by Global fund.
• Salary for 5 staff who will work in DIC was allocated By Global Fund
2 Nurses
2 guards
1 cleaners
• The center will provide free service For FSW.
• Woreda/Town Health Office will play a leadership and coordination role.
 10 Towns selected for DIC
1.Shakkiso
2.Ambo
3.Agaro
4.Mettu
5.Sululta
6.Asella
7.Burayyu
8.Jimma
9.Sebbeta
10.Modjo
 Activities done in DIC
• DICs will provide comprehensive HIV/SRH services SBCC,
• Risk Reduction Counseling
• HIV testing and counseling
• PrEP, (pre exposure prophylaxis)
• STIs screening and treatment
• Family planning and provision of or referral linkage for treatment and
PMTCT).
• provide or link to social services of community and development
partners.
• when appropriate, referral and linkages to KPP friendly health facilities
• Condom Provision
• Provision of post exposure prophylaxis
ROLES AND RESPONSIBILITIES OF PEER FACILITATORS

1. Organizing and conducting discussions with peers on

different areas
 One – to – one
 In groups
One Peer Facilitator should reach 40 FSW
&expected to establish 4 groups

2. Condom promotion, demonstration and distribution

3. Distribution of IEC / BCC materials (client support tools)

 CONT…
4. Conducting mobilization related activities.

 Conducting mapping services for hotels and bars

(updating the data) at least twice a year

 Conducting mapping services for FSWs (Data on new

arrivals and those leaving towns should have to be
updated)

 Conducting community wide events (social gathering,

coffee ceremonies)
 CONT…
5. Facilitating referrals and linkages (To either
public or private health facilities or to police
stations)
 To HFs to access various clinical services and ensure
linkages
 To CBOs / FBOs for support services
 To Police Stations to deal no – clinical services like
GBVs
6. Follow – up and update the migration and
movement of FSWs regularly
 CONT…
7. Attending on catchment area meetings
8. Organizing and forming support groups (for
both HIV positives and negatives in order to
disseminate messages on prevention)
Facilitation and arrangement for the formation of
FSWs Support Groups;
The total number of FSWs per each support group
should comprise a total of 10 FSWs.
The Peer Facilitators should develop a schedule to
address the peer education activities at least twice
per week
 CONT…..
 Tracing of LTFU from Pre ep and ART(Integrated with KPP providers)
 Distribution of HST kits For KPP’s
 Detecting HIV positive Clients(by counseling on HTS)
 Counseling on Risk Reduction
 educate on how to generate income
 Life skill education
 Monthly and weakly reporting of Activities done
• The PFs will be under the HF and will be managed by the HCPs in
charge of offering KP Friendly services in public Health Facilities
• The PNs will be provided with transportation allowances
 Roles and Responsibilities

At Facilitity Level KPP’s Providers

• KPP Service provider should screen all FSWs for HIV.

• All FSWs screened should be tested for HIV.

• All FSWs Partner’s reached should be tested for HIV including

HIVST.

• All FSWs who doesn’t wish to came HFs should offer directly assisted

HIVST using PNs and Unassisted HIVST for those who doesn’t want

to be assisted.
 Conti….
• All GBV/SV survivors will receive package of services including PEP,
HTC, EC, STI screening/management, psychosocial & legal support,
Other medical services, including trauma care for victims of violence.
• All FSWs should be screened for STI, provided STI diagnosis and
treatment.
• KP friendly service providers should screen all FSWs for TB.
• All FSWs should be counseled for family planning services.
• KP friendly clinic should be provided with prevention commodities and
supplies for (Condoms, Gloves,).
• All KP friendly clinics shall be equipped with gynecological
equipment, FP commodities, STI Kit and supplies.
• All HIV negative FSWs should screened for PrEP eligibility
• Provide PrEP to HIV-negative FSWs as they are at high risk of acquiring
HIV.
• KP friendly clinic should coordinate, supervise and support the activities
of peer facilitators
 Roles and Responsibilities
At Facility Level( Facility Head)
 Separate KPP’s clinic with in the facility
 Assign KPP’s Provider(Focal Person)
 Lead development of planning by KPP’s provider and
implementation
 Coordinate KPP’s activities in a facility
 Improve case detection to meet site level target for HIV+
 Monitor the implementation of risk based HIV testing and
mitigate missed opportunity at high yield entry points
Provide timely feedback to the HTS providers, KPP-FCs
focal person & management on their performance
 Identify & monitor family members HIV testing status for
FSWs index case.
 Conti…..
– Identify & monitor KPP’s partner for HIV testing
– Strengthen posttest counseling and support sites to track
referrals and provide feedback to other KPP’s facilities and
community sites.
– Lead the site level KPP’s activities to institutionalized and
monitor rapid ART initiation for all identified HIV positives
KPP’s.
– Collaborate with site level partners to strengthen linkage of
clients identified through KPP services.
– Monitor RTK utilization at sites and report to facility
management
– Review & analyze facility performance KPP’s data for decision
making
 Conti….

At Woreda/Town Level
• Coordinate all KPP’s activities In the town HF
• Mobilize resource allocated for Town
• Follow the implementation of KPP’s HF
• Facilitating Transportation cost for PF& MSG
• Strength Task force at town level
• Facilitate out reach service for KPP’S
• Facilitate and monitor DIC activities
• Organize the report and send for Responsible
Bodies
 Conti…
Zonal Level
• Coordinate all over activities related to KPP’s in zones
• Establish technical Working Group (members)
HIV/AIDS program clinical and social focal persons
PMTCT focal person
Pharmacy Focal person
Laboratory Focal person
partners representative at local level
• Conducting Supportive supervision in the Zone
• Conducting CAM in the zones with KPP’s HF
 Selected indicators For monitoring
• Number of training manuals, SOPs, job aid adopted & distributed
• Number of peer Facilitator trained
• Number of Sex workers support groups established
• Number of weekly sessions conducted
• Number of outreach programs conducted
• Number of FSWs reached Peer facilitators
• Number of KPP’s access to full package at KPP’s clinic
• Number of KPP’s received STI diagnosis and Treatment
• Number of KPP’s received HCT Service
• Number of FSW started Pre ep
• Number of FSW totally on Pre ep
• Number of FSW on pre ep Transfer Out to other HF
• Number of FSW on Pre ep out of risk
 Selected Indicators…
• Number of HIV+ KPP’ss linked to ART
• Number of HIV+ KPP’s received ART Service
• Number of HIV+ KPP’s received VL testing
• Number of KPP’s with suppressed VL
• Number of KPP’s who received GBV services
• Number of KPP’s with GBVs referred to the policy and
legal support
• Number of KPP’s counseled for khat, alcohol & other
substance abuses
• Number of FSWs Referred for HIV services
• Number of MSG selected
• Total Number of Women counselled by MSG
GALATOOMAA!