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Getting the architecture right:

Getting the architecture right: working out how best to deliver the comprehensive package of HIV prevention and care programs and services among key affected populations Lou McCallum Director, APMG. Where are we up to in the development of Comprehensive Packages for key populations?.

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Getting the architecture right:

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  1. Getting the architecture right: working out how best to deliver the comprehensive package of HIV prevention and care programs and services among key affected populations Lou McCallum Director, APMG

  2. Where are we up to in the development of Comprehensive Packages for key populations?

  3. MSM and TG

  4. MSM

  5. Sex workers

  6. Drug users

  7. Prisoners

  8. y HIV – Current Model and Challenges General Health System • Challenges • Health system is isolated • Not an active partner • Not involved in outreach • Depends on donors to bring key populations in • Creates long-term problems: • Hard to scale-up a sustainable system • Few links between different key population groups • Focused on numbers • Angry advocates • Like finds like • People aren’t empowered Donor Intervention Outreach IDU CSW MSM Prisoners Migrants PLHIV

  9. Create demand – ensure supply NGO • Strategy • Quality improvement enhances outreach, and opens entry points • Create demand, ensure supply • Focus on long-term engagement CBO CBO NGO CBO NGO Entry Point Entry Point Care Environment

  10. Models • Humsafar Trust, Mumbai • Mature MSM NGO • Has its own STI/HIV clinic as primary care and a feeder to mainstream services • Sub-population segmentation • Not duplicating government services – advocating and feeding in • Outreach to create demand • Mentor for emerging CBOs • Research arm

  11. Models • PT Foundation, Malaysia • Serves MSM, TG, DU and SW • Good links with VCT and PLHIV services, government and private • Has its staff placed in these services to strengthen links, improve quality and acceptance

  12. Balance

  13. Key point It is only by working out the most appropriate and sustainable connection between demand and supply The key is in the balance

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