Pakistan HIV/AIDS Prevention and Care Project

OCTOBER 2008 — The USAID-funded Pakistan HIV/AIDS Prevention and Care Project (PHAPCP), launched in February 2006, is a three-year effort that runs through January 2009 and continues and expands HIV/AIDS prevention, care, and support activities initiated under the Implementing AIDS Prevention and Care (IMPACT) Project. FHI is a sub-contractor to Research Triangle Institute (RTI) for this project, whose many collaborators include national and provincial AIDS control programs, UNAIDS, and the World Bank.

PHAPCP is working toward achieving the USAID objective of improving the health of vulnerable populations in Pakistan by

• increasing the involvement of local NGOs and other institutions in providing targeted HIV prevention interventions among vulnerable populations, including youth considered to be at risk
• increasing the capacity of NGOs, the National AIDS Control Program, and provincial AIDS control programs to implement quality HIV/AIDS programming
• strengthening care and support activities for people living with HIV/AIDS (PLHA)
• developing effective and efficient models of behavior change interventions and counseling services

Project interventions aim to reduce risky behaviors and provide peer education, outreach, counseling and testing, and the early diagnosis and management of sexually transmitted infections. Drop-in centers have been established that provide HIV prevention education following the ABC approach, basic medical care, and referrals for early diagnosis and treatment of sexually transmitted infections (STIs) and to HIV counseling and testing.

The interventions began in four cities— Rawalpindi, Multan, Larkana, and Lahore—and have since been expanded to Karachi, Turbat, and Peshawar. So far, PHAPCP has reached about 40,500 individuals who are considered to be at high-risk of HIV infection with the ABC prevention approach. It has also provided diagnoses of sexually transmitted infections (STIs) and facilitated treatment for 1,800 individuals. As a result of the recent integration of voluntary counseling and testing services for HIV, about 10,000 more people have been reached.

To carry out these interventions, PHAPCP is working with and building the capacities of local NGOs and community-based organizations. FHI has granted sub-grants to:

• Awareness on Social, Economic, Education Rights Foundation (ASEER)
• Shah Abdul Lateef Bhittai Welfare Society (Youth Welfare Association, sub-recipient)
• Organization for Social Development
• Mehran Welfare Trust
• Support Agency for Rural and Human Association's Development  (Human Development and Relief Society, sub-recipient)

PHAPCP's Work in FATA/FR
PHAPCP was extended to Federally Administered Tribal Areas (FATA) and Frontier Regions (FR) after RTI received funding from USAID. The HIV/AIDS prevention, care, and support programming is implemented by RTI in partnership with FHI, in Khyber, Mohmand, and Aurakzai agencies of FATA and in the FR of Peshawar and Kohat.

PHAPCP is strengthening the capacity of the FATA Health Directorate to manage HIV prevention and STI management programs and is supporting the directorate and the National AIDS Control Program in its efforts to

• maintain low HIV prevalence in the FATA
• integrate HIV/AIDS awareness into life skills training and reproductive health services for youth
• increase the technical capacity of implementing agencies to provide consistent and high quality services, behavior change communication interventions, and supportive strategies and build their management, monitoring, and quality assurance skills

Though FHI, RTI has awarded four sub-grants to the following community-based organizations:

• Pakistan Village Development Program
• Community Appraisal and Motivation Programme
• All Women Advancement & Resource Development
• Support Agency for Rural & Human Association Development

PHAPCP's Work in Palliative Care
PHAPCP has been working with the New Lights AIDS Control Awareness Group, the leading organization working with people living with HIV/AIDS (PLHA) in Pakistan, to expand care and support for this group through a model continuum of care program. The program has established linkages with other agencies and with government hospitals to address the full range of care, treatment and support needs of PLWHA.

In addition, PHAPCP is providing home-based care for 200 HIV positive individuals and their 600 family members, helping them to meet physical, medical, and psychological needs. Community- and home-based care kits have been prepared for distribution.

In FATA/FR, PHAPCP has extended care and support for PLHA identified by the program, strengthening linkages with Hayat Abad Medical Complex in Peshawar to provide tertiary-level services in its out-patient department, as well as VCT services, social support, treatment of opportunistic infections, and referrals for antiretroviral treatment.