1. Supporting the Continuum
Prevention Services:
Supporting the Continuum
Prevention
Care
Treatment
All IP Meeting, June 20, 2013

2. Who gets which Services?
Activity:
Who gets which Services?

3. So…all populations receive a
Core Package
Here’s a reminder of that package and a bit more about the referral system.

4. Core Package of Services: Outreach
Behavior Change Communications (BBC) (messages change quarterly)
Condoms & Lubricant for MSM, TG (free and/or socially marketed)
Service referrals (for SW/MSM/TG/PWID and partner)
HIV
STI
RH/FP
Etc.

5. Referral System Promote 2 HIV tests and 4 STI screenings/year
Community
Facility
Referral System
Promote 2 HIV tests and 4 STI screenings/year
Promote condom/lubricant; promote condom + another contraceptive method for FSWs
Facilitate on-site testing/ screening
Provide referral card and service directory
Visit health facilities monthly to collect referral cards

6. Delivered by Outreach Workers in hotspots and DICs
Selected from their community
Transparent selection criteria and methods
Receive regular training
Provided with the necessary equipment
Provided an allowance of $60/month
Meet one-on-one and/or in small groups (6-8 individuals)

7. Ensure changing needs and issues are addressed
NO more PREACHING or BORING messages & materials
Ensure changing needs and issues are addressed
Materials and messages invigorated on a quarterly basis

8. Quarterly Training Model
Conduct Training Needs Assessment
Develop annual communication log frame/plan
Develop training curriculum
Training to master trainers
Training to outreach workers and field staff
Quarterly Training Model
HIV Flagship TA to IPs to develop and use Quarterly tool/topic
IP-led

9. Implementation: Staff ratio & targeted groups
Protocol Standards
Outreach Workers
(1 cover EW/MSM/TG;
1 cover 50 PWUD;
1 cover 30 PWID)
NGO Staff
(1 cover 4 OWs)
Depends on geography; # of contacts per client per year

10. All populations receive an
Expanded Core Package
of services, as needed
Needle and Syringe Program (NSP)
Methadone Maintenance Therapy (MMT)
Pre-ART and ART Services
Reproductive Health Services
Psychosocial support
Note: Pause between animation to ask the question.

11. Police Community Initiative Program Strategic Information
Service Delivery is Supported by…
Networks
Capacity Building/OD
Police Community Initiative Program
Strategic Information
Coordination

12. Services are delivered using a branded approach
Because branding works!
EW, it’s SMARTgirl
MSM, it’s MStyle
TG, it’s…?
PWID, it’s…?

13. means I am… SMARTgirl MStyle Beautiful/Handsome Talented / Creative
Modern
Strong – I know what I want and how to get it
I want to get the most out of life for myself and my family
I am Industrious – I work hard
I am Smart, of course, especially when it comes to my health!

14. Client Identification with the Brand
"I was working as a hostess when I first heard about SMARTgirl. It sounded very inspirational to me, because we are usually called “Karaoke girl or Beer garden girl…” …"Now I feel that I am a new person. I feel so proud whenever people call me SMARTgirl."
–Keo Kheng, SMARTgirl Peer Leader

15. Identification/ Community Building Information sheet Club signage
Stickers (I Love SMARTgirl, I love MStyle)
T-shirts, Bags, ID card for OWs and field staff
Membership card
Chip/Token (to identify "new" vs "repeat" reach)
SBC materials
Strength of the brand, helps

16. High Coverage Brand recognition = Reach and retention
Mobile SWs can find known, quality service across the country
Brand recognition =
Reach and retention
Brand name hides identity, as desired
Historically, SG and MS have had very high reach and coverage – approximately ½ of all EWs in the country and approximately ¾ of MSM.
For EWs, SG plays a key role. As EWs are moving, having a recognizable and consistent service in different provinces, even delivered through different organizations helps retain clients in the program.
For MSM, MS plays a key role by not calling the program an MSM program, MSM can maintain their identity a secret, if they wish to do so. In this way, also facilitates reach of discreet/hidden MSM.

17. HIV and Syphilis Testing
Lay counselors conduct testing in hotspots/DICs using Finger Prick testing

18. Social marketing of commodities (EC, implants)
“Condom Plus another Contraceptive Method”
Generate demand
Actively refer
Address barriers to service uptake
Ensure commodities/ supplies are available
Provide immediate follow-up/support
Social marketing of commodities (EC, implants)

19. Reaching the Hidden and Hard to Reach
MStyle Website and MStyle Facebook page
Strengthening the Community: Transitioning to local ownership/ management

20. Condom Social Marketing
Building capacity of IPs to forecast, sell and ensure supplies are available and visible where needed
Peer-to-peer selling
Promotion and sales through street-based vendors
'peer-to-peer selling' (outreach workers distribute to select EWs -- peer sales reps -- who sell on to others at their workplace) and 'promotion and sales through street-based vendors

21. Case Management Ensuring clients don’t drop out along the cascade
Outreach
Test +
Enroll in care
Start ART
Adherence
CD4 Testing
Ensuring clients don’t drop out along the cascade

22. Recognizing TG as a distinct population
Establishing a TG national and local network
Developing a branded program for Transgender individuals

23. Key Messages The B-CoPCT is a single SOP for all MARPs
Same core package of services for all
Expanded packages meet additional needs
EW and MSM programs are SMARTgirl and MStyle because branding works (and more branding is coming)
We have been effective, but more is needed to eliminate HIV in Cambodia (3.0 goal), so we have “Boosted” the CoPCT