Lifesaving Care Delivered in the Community
For almost 20 years, we have worked to reduce the global burden of HIV by testing people for HIV, supporting people on treatment, circumcising males to reduce their chance of getting HIV and offering oral pre-exposure prophylaxis to people at risk.
With more than 38 million people living with HIV worldwide, this work is more essential than it has ever been. We place the community at the center of a continuum of care, with an emphasis on services that respond to the needs of the people.
Our HIV projects deliver a core package of prevention services that are vulnerability-tailored, high-quality, and client- and community-centered. These services combine biomedical, behavioral and structural programs with linkages to treatment, care, support and other referral services.
From 2009 to 2021, more than 5.3 million men and boys were circumcised through Jhpiego programs, significantly reducing their chances of HIV infection.
Test and Treat for HIV
With Jhpiego Gateway project volunteer Mervis Chapotoka’s help, Jane Edward was able to convince her reluctant husband Harry to be tested for HIV. Today, husband and wife are on treatment and their family is looking forward to a healthy future!
How We Make an Impact
Testing is key to epidemic control. It is the only way a person can know if they have HIV. Without early testing, people often are diagnosed late in the course of their illness when it is harder to treat and often lack the knowledge they need to prevent transmission of the virus. HIV testing is the critical entry point to life-saving HIV care and treatment for people who test positive. For those who test negative, testing services are an important link to prevention services, such as pre-exposure prophylaxis (PrEP), voluntary medical male circumcision (VMMC), condoms and risk reduction counseling.
Since 2001, Jhpiego has supported HIV testing service programs in 34 countries, providing almost 15 million people with testing services, and linking nearly 525,000 people living with HIV to care and treatment services. We have achieved this by:
- Supporting UNAIDS 90-90-90 goals through partnerships with local governments and communities, and delivery of high-quality HIV testing services with active linkage to HIV care and treatment for people living with HIV.
- Designing targeted programs that expand access to HIV testing services and uptake among hard-to-reach populations, including key populations, men, adolescent girls and young women, children and partners of people living with HIV, through health facility- and community-based testing services.
- Using evidence-based and innovative approaches for reaching target populations, including integrated and provider-initiated testing services, mobile testing, workplace testing, partner notification, couples testing and HIV self-testing.
- Pursuing emerging testing approaches, including:
- HIV self-testing—Jhpiego provides advocacy and technical assistance for HIV self-testing and supports ministries of health on policy and implementation planning in multiple countries.
- Partner notification services—Reaching partners and children of people living with HIV is a priority for all our testing programs. Strategies employed include enhanced support for index clients to disclose to partners, home- and community-based testing, referral of partners to a health facility, integration of partner notification and self-testing, and couples HIV testing and counseling.
If a person tests HIV positive, we can link them to care and treatment. Our support for these essential services includes clinical care, diagnosis and management of opportunistic infections, viral load testing and community-based psychosocial support. Currently, more than 156,000 people are receiving antiretroviral treatment through Jhpiego-supported programs. Our work in this area includes:
- Support adoption of World Health Organization’s policy to promote “Treat All” patients who test HIV-positive, regardless of their viral load, to keep people healthier and to reduce the risk of transmission
- Promote patient-centered treatment solutions—community treatment and multi-month dispensing for stable clients on treatment
- Support adherence and retention of patients on treatment through peer support groups and intensive support for clients with high viral loads (> 1,000 copies/mL)
- Switch patients with confirmed treatment or virological failure to second-line therapy
While there are a growing number of tools that can be used to prevent HIV transmission (including condoms and changing behaviors), Jhpiego has championed biomedical prevention interventions and works to bring them to more people. These interventions, which are for those who do not have HIV, include voluntary medical male circumcision (VMMC)—a safe, minor procedure that reduces the risk of female-to-male HIV transmission by 70% —and PrEP—pre-exposure prophylaxis, which is a daily pill that, if taken properly, can be more than 90% effective in preventing HIV.
Since 2003, Jhpiego has emerged as one of the few international organizations with the knowledge and experience to support, strengthen, and scale up VMMC services while ensuring safety and quality. Since 2009, more than 5.3 million men and boys have accessed VMMC through Jhpiego-supported services across 12 of the 15 VMMC focus countries. We are now using our expertise from VMMC to bring PrEP to more people by:
- Reaching individuals in greatest need with high-impact HIV prevention interventions
- Offering service delivery models that maximize accessibility, safety and acceptability, especially for hard-to-reach populations
Prevention of mother-to-child transmission
HIV can be transmitted to babies of women who are HIV positive, before birth, during birth and when they are breastfeeding. However, with effective interventions, fewer than 5% babies of HIV-positive women will contract the virus.
- Integrating care for mother and baby—early infant diagnosis and prevention of mother-to-child transmission/antiretroviral therapy services in a single appointment
- Using effective tracking systems—early infant diagnosis for up to 8 weeks
- Increasing male involvement/engagement—for example, using antenatal care as an entry point to attract men to health services
We were one of the first international organizations to introduce and scale up oral PrEP services for HIV prevention, rigorously ensuring safety and quality. Jhpiego has led the way in elevating PrEP as a high-impact intervention, taking it from research to practice at scale. As part of this process, we build systems from the ground up—creating policy and training manuals at the global/national level, supply chains, and safety surveillance systems. A key component of PrEP introduction has also included awareness building and demand creation.
In the last 5 years, nearly 330,000 individuals were newly enrolled on antiretroviral therapy and 87,000 people started on PrEP at Jhpiego-supported sites.