​IntraHealth International will expand its HIV prevention, care, and treatment efforts in Central America with a new $15 million award from the U.S. Agency for International Development. The Strengthening Care and Treatment Cascade Project will help El Salvador, Guatemala, Honduras, Nicaragua, and Panama improve the quality and reach of their HIV services and allocate more resources where they are most needed.

While the overall HIV prevalence is low in these countries, the epidemic is concentrated among key groups, including men who have sex with men, transgender women, and female sex workers. Despite these realities, health policy and practice have continued to prioritize testing and treatment for the general population and pregnant women over these groups.

IntraHealth and our partners will focus on reaching these clients with high-quality, stigma-free services and work together to enroll and retain as many people living with HIV as possible on treatment. The project will also prioritize identifying and treating common HIV comorbidities, including tuberculosis.

Every client—regardless of background, gender, or status—must be able to expect and receive respectful, high-quality health services, without bias. 

All five countries support the UNAIDS 90-90-90 goals (90% of HIV-positive people knowing their status, 90% of people diagnosed with HIV on antiretroviral therapy (ART), and 90% of clients on ART achieving viral load suppression by 2020). Among the project countries, 64% of people estimated to be living with HIV have been diagnosed. However, only an estimated 37% who know their status are on ART (22%-53%), and less than 25% of those on treatment have achieved viral suppression.

“We need sustainable approaches to truly end the HIV epidemic in Central America, including improving quality and reducing stigma and discrimination,” says Yadira Villasenor, IntraHealth’s chief of party and regional director. “Every client—regardless of background, gender, or status—must be able to expect and receive respectful, high-quality health services, without bias. We must work at all levels of the health sector and in our communities to achieve this.”

The project will:

• Help health facilities, partners, and community-level organizations that work with key populations to set, prioritize, and reach their objectives, and sustain interventions
• Address stigma, gender discrimination, and other forms of discrimination, as well as gender-based violence
• Retain people living with HIV in care by addressing barriers to treatment adherence
• Promote evidence-based decision-making by ensuring that complete, timely, and useful information is available to people living with HIV and health workers.

IntraHealth will collaborate with the ministries of health, social security institutes, and National AIDS Programs in each country to address HIV-related policies, set priorities, and provide services. IntraHealth’s local partners include Asociación de Salud Integral, Colectivo Amigos Contra El Sida, and Entre Amigos. This work extends and builds on the successes of IntraHealth’s USAID Central America Capacity Plus (CAMPLUS) Project.