In Central America, closures and shutdowns related to COVID-19 have left many people—including those who live with HIV—unsure about where to pick up medications or how to get the health services they need.

Yadira Villaseñor leads IntraHealth International’s work in Central America. She sat down with us to talk about how the region and its frontline health workers are tackling the pandemic and what the future of HIV care in Central America might look like.

How are you responding to COVID-19 in the region?

Here in Central America, we are adapting as much as we can during this challenging situation. Because frontline health workers face greater risk of COVID-19 infection, we are training them on how to respond to the disease, especially in how it relates to HIV treatment and prevention.

We are also providing HIV treatment outside of the health facilities we support and dispensing medications that will last clients for multiple months, so they don’t have to go pick up their antiretroviral treatment (ART) at the pharmacy as often.

And we are working with ministries of health to adapt and be flexible during this situation. People living with HIV must be able to continue with their treatment, despite the pandemic.

How are you seeing people who live with HIV affected by the pandemic? Do you think it could threaten HIV progress in Central America?

COVID-19 is certainly affecting HIV progress in Central America.

We work in five Central American countries and one of the most permanent priorities in all of them during this pandemic is to sustain the gains we’ve already made toward HIV epidemic control and to support ART delivery.

Our work promotes health equity, gender equity, and human rights.

The government has restricted transportation and social distancing is necessary, which has led to challenges in delivering medical care. We are trying to minimize patient contact with health facilities and limit it to essential needs while ensuring that people who live with HIV get the best possible outcomes.

We track clients’ needs and have developed methods for being in contact with them, but I think access to ART will be interrupted. We know that some people living with HIV will not access the treatment they need because they cannot go to the facilities. So we are focusing on delivering treatment to clients outside of the facilities.

Also read: mHealth Tool Is Keeping Central American Clients Connected to HIV Care amid COVID-19 Shutdowns

IntraHealth has been helping communities in Central America since 1993. What about this work most excites you?

We offer people who live with HIV the promise to be healthy and increase their viral suppression.

Our work promotes health equity, gender equity, and human rights. People who live with HIV face a lot of stigma and discrimination, but if they are adhering to treatment, they reduce their viral load and become healthier people—this helps many to recover their self-esteem. It’s important to me for people who live with HIV to have what they need to lead healthy lives.

And we’re also creating new models and approaches to adapt to the constant changes in the region. Each country we work in has different challenges, so we anticipate the different situations and risks, and we build trust with all stakeholders. We are always thinking strategically and with our mission in mind. That makes me proud.

As we all grapple with COVID-19, how important is universal health coverage?

Universal health coverage should be based on strong, people-centered primary health care.

Right now, during the pandemic, a lot of attention is given to the hospitals. But if we focus on primary health coverage, people could receive all their services—including services that prevent COVID-19 or other infections—in their communities.

But we also need to focus on quality of health care, which is a challenge here in Central America. At IntraHealth, we support health workers to perform their best. We must continue working at all levels of care, but focus our efforts on primary health care and strengthen it.

What will the future look like for HIV care and treatment in Central America?

The future of health care in Central America starts with strong alliances with all stakeholders.

The strain of the COVID-19 pandemic will make it very challenging to achieve the 95-95-95 goals. But these challenges will become opportunities for us to be more creative and to propose new models to achieve our goals.

I am so proud to be part of IntraHealth because I think this is an organization that really cares for people. Not just the health workers, but the clients and all staff. We are part of a very great team here.

IntraHealth’s work in Central America is funded by the US Agency for International Development.