Caribbean

The PEPFAR Caribbean regional HIV/AIDS program aims to increase the availability and use of quality, timely HIV/AIDS data to support evidence-based decision-making. Since 2010, our Global Strategic Information (GSI) group has supported the CDC Caribbean Regional Office (CRO) and its partners by working with regional institutions and individual Caribbean countries to develop and implement HIV epidemiologic surveillance methodologies that can monitor the burden of HIV among high-risk populations and associated risk behaviors. The result of this work is high-quality HIV/AIDS data that can be used to better plan HIV prevention programs, focus on specific subpopulations or geographic areas, and allocate resources.

Surveillance

Integrated Biological and Behavioral Surveillance Surveys (IBBSS) and Population Size Estimation

GSI provides technical assistance to Caribbean Ministries of Health (MOH) in planning and implementing formative assessments, integrated biological and behavioral surveillance surveys (IBBSS), and population size estimations, which are designed to improve understanding of the disease burden and unique service needs among high-risk populations. To date, GSI has supported implementation of IBBSS using respondent-driven sampling (RDS) and population size estimation among female sex workers in Antigua and Barbuda, and is currently providing technical assistance to IBBSS and population size estimation activities among men who have sex with men (MSM) and transgender persons (TGP) in Jamaica and Suriname. In these projects, GSI is incorporating novel use of technology-enabled solutions to facilitate recruitment and data management and is supporting the Ministries of Health to establish cohorts of both HIV-negative and HIV-positive key populations to provide HIV incidence and longitudinal cascade analyses.

Research & Evaluation

Jamaica Antiretroviral Therapy (ART) Outcomes Study

GSI is providing technical assistance to the Jamaican Ministry of Health (MOH) to design and implement the Jamaica Antiretroviral Therapy (ART) Outcomes Study. This project will provide information to Jamaica’s national HIV Treatment Program on how to improve service delivery, inform adherence support interventions and increase the proportion of ART patients that achieve viral suppression.

Data Driven Science

Development of HIV Epidemiologic Profiles

GSI led the development of country-level HIV Epidemiologic Profiles in Antigua and Barbuda, St. Kitts and Nevis, and Suriname. This activity provided information on socio-demographics of general and high-risk populations, indicators of risk, trends and characteristics among reported HIV and AIDS cases, patterns of service utilization, and gaps towards meeting 90-90-90 targets.

Training and Education

Training and Capacity-Building for Program Improvement

In collaboration with regional partners, GSI has led the development and execution of regional training workshops to build the capacities of Caribbean MOHs in areas related to HIV strategic information. Some of the major workshops include:

• Caribbean Regional Key Population Size Estimation workshop
• Data Analysis and Development of HIV Epidemiologic Factsheets Workshop for the Eastern Caribbean countries
• Strengthening HIV Case Surveillance Workshop in the Caribbean Region
• Development of HIV Epidemiologic Profiles for the Caribbean Region
• HIV Continuum of Care Data Analysis for Key Populations for the Caribbean Region

Establishment of Local Institutional Review Board (IRB)

GSI provided technical assistance to the Antigua and Barbuda MOH to design and establish an OHRP-registered Institutional Review Board (IRB) at the MOH. GSI provided training and mentoring in the ethical conduct of research, human subjects’ protections, and IRB administration and operations.

Tracking the 90-90-90 Cascade

Key Populations Cascades

GSI has also provided technical assistance to the St. Kitts and Nevis MOH to conduct secondary analysis of data generated from IBBSS among prisoners and MSM. The focus of the analysis was to calculate indicators for the HIV continuum of care cascade.

Health Informatics & Technology

Strengthening Health Information Systems

GSI provides technical assistance to the Jamaican MOH to link HIV treatment databases in DHIS2, laboratory information systems in Dissa, and other HIV program databases in Access. This allows clinicians to have more access to viral load and other laboratory data to improve patient management, and national level program managers to complete HIV cascade analyses by site level and identify areas for improvement.

GSI also provided technical assistance to the Antiguan and Barbudan Ministries of Health to phase out its paper-based HIV testing and counseling system in favor of an electronic database that can be used for data collection, management, and analysis.