Zoom Logo

Mitigating the Impact of COVID-19 on Key-Population-Focused HIV Programs - Shared screen with speaker view
Hally Mahler
19:08
Welcome everyone.
Hally Mahler
19:19
Please ask your questions and share your thoughts here in this space.
Hally Mahler
21:10
Please do introduce yourselves.
Kiran Bam
22:11
Hi all, Kiran Bam from LINKAGES Nepal
Rose Wilcher
22:13
And, please direct comments to all panelists and attendees (not to panelists only).
Godswill Agada
22:56
Hello all, Godswill Agada, STA,PCT and KP lead,FHI360 GF project,Nigeria
DR MAIMOONA Emmad
23:02
Salaam Dr Maimoona from Pakistan-Manager Surveillance-National AIDS CONTROL PROGRAM PAKISTAN
Purvi Shah
23:47
Hi All, Purvi Shah, Technical Specialist, FHI 360 HQ (Based in New Delhi, India)
Kathryn Rosecrans
23:47
Hello, Kathryn Rosecrans with Save the Children Myanmar, Global Fund PR
Sandar Aye
24:14
Hi all, Sandar Aye from Save the Children Myanmar, Global Fund PR
Clinton Trout
24:37
Good morning good afternoon good evening - Clint Trout, Heartland Alliance. Thank you for this much-needed webinar
ly
25:15
ly nguyen from CDC, Vietnam.
Anna Grimsrud
25:37
Hi all - Anna Grimsrud from the International AIDS Society in South Africa.
Elizabeth Amuli
25:50
Hello everyone, Elizabeth Amuli from Management and Development for Health, Tanzania.
SAMUEL ENGULU
26:04
Hi all, Samuel Engulu JSI USAID RHITES Lango project Uganda
Dorcas TOHON
26:05
hi All, Dorcas Tohon, technical officer EPIC-KPIF, FHI360 from Togo
Joe McMartin
26:18
Hello all, Joe McMartin from Frontline AIDS
Christopher Arineitwe
26:41
Hi, Christopher Arineitwe FHI 360 Uganda
Solange Baptiste
27:04
Hi everyone, Solange Baptiste - ITPC Global
Ugochi Ezenwelu
27:13
Hello all, Dr. Ugochi Ezenwelu STA - Lab FHI360/GF Nigeria
Ndoungou Salla Ba
27:30
good afternoon all, Ndoungou Salla Ba from WHO AFRO
HUMPHREY NDONDO
27:35
Hi everyone, Humphrey Ndondo- Snr. Technical Specialist- PSI, Zimbabwe
Gloria Gonese
28:12
Hello everyone, Gloria Gonese, Head of Program Zim-TTECH, Zimbabwe.
Nanna Gonji
28:13
Good Afternoon.. Nanna Gonji kP IHVN
Revati Chawla
28:21
Revati Chawla, Frontline AIDS, UK. Hello to the panellists and colleagues.
Helen Savva
28:43
Hi all - Helen Savva, CDC/South Africa
Mariette Slabbert
29:10
Hi all, Dr Mariette Slabbert from South Africa
Madani TALL
29:31
Salam, Tall Madani, LINKAGES/Mali
Dorica Boyee
29:35
Hello, Dorica Boyee, SI, Tanzania
Carey Johnson
30:04
Hi everyone - Carey Johnson, KP Sr Tech Advisor, PSI Zimbabwe and National AIDS Council - thanks for this!
Gaston Djomand
30:14
Gaston Djomand, KP Team, CDC Atlanta
Nelson Medeiros
30:53
Hi All
Phibion Manyanga
31:45
Are presentations going to be shared? Dr Phibion Manyanga from Zimbabwe
Meghan DiCarlo
32:00
Hi everyone. Meg DiCarlo, LINKAGES and EpiC, FHI 360
Dee Adams
32:21
Hello Dee Adams, LINKAGES Eswatini
Njambi Njuguna
32:40
Hello all. Njambi Njuguna, EpiC Kenya-
Curtis Mukumba
35:21
Since COVID-19 is not yet vulgarized to Community level in most of emerging countries, such as in DRC-my coutry, how can we ensure KP continue their activity without geopardizing their safety vis-à-vis to COVID-19??
Revati Chawla
35:33
Thank you George for the comprehensive presentation on key issues experienced by the most marginalised. keen to hear some of the responses from networks. We have heard from INPUD on some of the responses for people who use drugs and will check the links you sent.
Andrew Lambert
35:49
Andrew Lambert, FHI 360, KP STA, Based in South Africa
Rushelle Hewitt
36:03
Hey good morning, good Afternoon every on HIV Private Sector Network
DR MAIMOONA Emmad
36:04
Thnakyou for the presentation
Hardwin Sithole
37:04
Hi everyone, Hardwin Sithole, PSI Zimbabwe
Joshua Gotom
37:31
Hello everyone, Joshua Gotom, IHVNigeria
Daniel Levitt
37:44
Good morning/afternoon/evening all - Daniel Levitt here :)
Ajit Joshi
37:46
George, thank you for the focus on discrimination, stigma, and access to services relative to KPs. Could you provide citations for the claims as well as whether those particular case studies are isolated or can they be aggregated rigorously, and then, can and should be generalized and then addressed or considered globally in a COVID1-19 response? What arguments might you marshal to counter-claims that a broad-based response is sufficient (no need for focused population specific programming)? What recommendations might you have for democracy, human rights and governance programming to include not only a KP focus, but also other populations at risk, e.g. TB and infectious diseases? Finally, from a rights holder lens, how might a KP approach build upon & mutually reinforce minority groups expressing concerns (migrants, as you point out, TIP survivors, people with disabilities, indigenous peoples, etc and overlap thereof, where appropriate?) Ajit Joshi - USAID/Washington, Senior Human Rights & Inclusion Advisor
Michael Cassell
38:06
Hi all! Michael Cassell from FHI 360 HQ, but based in Hanoi
Rachel Eersel
38:09
Hi all, Rachel Eersel, Suriname
halle chirisa
38:10
hello all, Halleluah , Key populations Officer , PSI, Zimbabwe
Rushelle Hewitt
38:26
Hey good morning good afternoon everyone, HIV Private Sector Network Jamaica
tania kambel
39:07
Hi all, Tania Kambel, Suriname
Lucia O'Connell
39:23
hello all, lucy OConnell , keypopulations focal point, MSF Southern Africa
Sandra Georges
41:04
Hi all, Sandra Georges, CARE CoP for CHAMP project in Cameroon
Wame Dikobe
41:59
Hi everyone, Wame Dikobe, FHI360, COP for KP, EpiC project Botswana
Hally Mahler
44:45
Don't forget to write your questions and comments here!
Liz Kariuki
46:26
Hi everyone, Liz Kariuki, Program Manager, FHI 360, South Africa
Caitlin Loehr
46:49
Hello, Caitlin Loehr from IntraHealth International
DR MAIMOONA Emmad
47:05
WHO has to take the lead in issuing strict vigilance and advisory on ART multi drug dispensing among adherent and virally suppressed clients registered with ART centers. Also Harm reduction outreach should be assured at spots
DR MAIMOONA Emmad
47:41
can WHO provide implementation examples how that is ensured
Ajit Joshi
52:45
Relative to harm reduction in Morocco (WHO), could you speak more to the yoga and related interventions provided as complementary/integrative tools? Did interventions also include breathwork (pranayama), systematic relaxation (including yoga nidra), and meditation? What was the monitoring done on that intervention? Was it based on evaluations of those tools used effectively with KPs? Are these effective psychosocial, non mental health tools that have been used in KPs and documented in the literature for improving KP outcomes? Ajit Joshi, USAID/Washington, Senior Human Rights and Inclusion Advisor
Benjamin Eveslage
52:59
I am am so thankful Lady Gaga on is on this slide
DR MAIMOONA Emmad
53:24
every country has a different beat and service delivery is getting a serious issue in Pakistan,
Jill Gay
54:55
What is impact on PEPFAR of Birx working on COVID 19?
Mariette Slabbert
55:55
Question to WHO: Please clarify 1 meter social distancing. Most other guidelines prescribe 6 feet or 2 metres
Hally Mahler
56:12
Jill Gay... Ambassador Birx remains in charge of PEPFAR. Her deputy is running the day-to-day, but I understand that Amb Birx still speaks with her every day. I don't know if there is someone else here from OGAC that would like to comment.
Kiran Bam
56:59
Can you please elaborate further on condom dispensing/distributions through pharmacies?
Linn Htet
57:59
WHO 2013 regarding Stopping NNRTI-based ART (use of a “tail”). Because of the prolonged half-life of EFV (and NVP), suddenly stopping an NNRTI-based regimen risks developing NNRTI resistance. Pharmacokinetic modelling reviewed for the guidelines suggests that, if the NRTI backbone included TDF, such a tail may not be needed, but if the NRTI backbone included AZT, a two-week tail is advisable (EFV has a longer half-life than NVP). Is that still applicable in case of inevitable interruption of ART. Just for contingency planning.
Nicolas Suarez
59:13
Do we know of any evidence of shortages of ARVs? At least here in the USA (in Georgia) I have been told of pharmacies declining to fill prescriptions for 3 month supplies though it is being widely recommended to have extra medications on hand. Wondering if this may be a concern and could be the underlying reason for not allowing people to access 3 month supplies?
Rose Wilcher
01:00:39
Yes, we will share all slides and a recording of the webinar for further distribution.
Njambi Njuguna
01:00:49
In Kenya, the government has reiterated that drugs are sufficient. Currently guidelines state dispensing for 3 months for all
Anna Grimsrud
01:01:12
Hi Nicolas - was on a webinar yesterday about multi-month dispensing and ARV supply chain. I can share some slides from this ( just email me at anna.grimsrud@iasociety.org) and there is some concern that there may be challenges because of the India lockdown. My understanding is that PEPFAR will be “tempering” their guidance on 3-6M refills later today.
DR MAIMOONA Emmad
01:01:35
thankyou!!
Nicolas Suarez
01:02:02
Thank you Anna!
HUMPHREY NDONDO
01:02:57
Is there any guidance that can be shared on engaging media reporting on individual cases of COVID 19 particularly where infection is traceable to index clients. we are concerned with the blatant public notification, disregard for privacy and confidentiality and forced contact tracing and Covid 19 status disclosure.
marie engel
01:05:10
From Marie (UNAIDS WCA Office ) to WHO: The shift to MMD does not necessarily modify the overall quantification of need, but it does have an impact with respect to whether or not sufficient stocks have been ordered and are “on hand” for massive/accelerated distribution while protecting buffer stocks . A question for WCA is how many countries actually have this stock-in-hand. If countries shift to MMD and deplete their buffer stocks in so doing, they need to be sure of timely new supplies to make up for that difference. That is where the second concern – that global ARV manufacturers may face disruption in supplies of basic ingredients and/or in production and delivery of new stocks due to COVID-19 – that adds a second complexity. Countries need to be “guaranteed” that if they liquidate their buffers the new supply can both be ordered and delivered in an accelerated manner.
marie engel
01:05:19
Could you pls share the latest update on efforts by WHO Global Fund, PEPFAR, and other key partners (such as RECs eg WAHO?) to guarantee adequate supply of drugs to countries.
Laurabeth Muzart
01:05:19
In Eswatini we are working to use Online demand creation to help decongest clinics and support MMD at our DIC.
Daniel Levitt
01:05:31
What has been the general thinking on community adherence group (CAG) distribution of ART?
Colleen Oakes
01:05:47
How can we support distribution of products/services (i.e. HIVST, ART, etc) while protecting the confidentiality of KP clients?
Desy Natalia Sagala
01:06:56
Is there any guidance or strategic and systematic recommendations to do the VL testing in this physical distancing situation?
Laurabeth Muzart
01:06:59
We distribute HIV ST, Condoms and Lubricants in locations that are still accessible during lockdowns. We leave them with security guards, and are looking to expand to Bottle Stores. We provide contact information if assistance is needed for the HIV ST confirmations or HIV ST overall, including WhatsApp support
Caroline Francis
01:07:02
@AnnaGrimsrud - with insecure ARV supplies in Indonesia, it will not be possible to offer even 2-month MMD. Focus now is being placed on provision of broad home-based ARV delivery
Njambi Njuguna
01:07:19
Daniel - this has been working very well in Kenya. Also distribution through the peer navigators to their peers
Laurabeth Muzart
01:07:46
We also now do ePSS consultations. there has been a big demand, and allows social distancing but still addressing the increase in mental health needs during COVID
Daniel Levitt
01:07:50
Thank you, Njambi.
Hally Mahler
01:08:32
There are many options for decentralized drug distribution... including CAGs, home delivery, greater use of private pharmacies and lockers.
halle chirisa
01:08:38
I have realised that the moment outreach workers reach out for community refills wearing the PPE during this COVID period neighbours tend to suspect that the clients are covid suspects - how do we maintain confidentiality and protect our communities?
Hally Mahler
01:08:49
All are valid approaches - and depends on what structures already exist.
Ajit Joshi
01:09:27
Chris, regarding your point on ARTs and the supply chain, are you raising this concern with those looking at the supply chain from economic stability perspectives, or others that advocate for standards, accountability, and governance on supply chain -- trafficking, labor standards, environmental standards? Ajit Joshi, Senior Human Rights and Inclusion Advisor, USAID/Washington
DR MAIMOONA Emmad
01:11:52
rising FP/RH needs among key population ,,, we continuously talk about KP , but neglected vulnerable populations like spouses of PWID. inclusion of PHC with outreach??
David Olusegun Oyedeji
01:11:53
KP CARE 2 project as part of covid-19 mitigation plan is using community care service points like PPMVs, Pharmacy and Laboratory for HIV testing, enrollment in care with MMD 3months and community refill. Peer navigators who live less than 10 meters from the service delivery points are monitoring and supporting the KPs
Joe McMartin
01:13:18
Thank you Chris - great presentation
Lucia O'Connell
01:13:40
i would like to hear how do we increase the resources to ensure increase in staff to support the adaptations through covid,
Lucia O'Connell
01:13:56
more nurses fast
Lucia O'Connell
01:14:11
and more training for comunity health workers
Hally Mahler
01:14:13
You will get all slides
Laurabeth Muzart
01:16:40
We have seen that a small added amount of data to our outreach workers they are able to easily reach out to clients to check in on KPs, including helping to link to clinics or COVID-19 related services. Also the Going Online platform has really helped as well
DR MAIMOONA Emmad
01:17:20
Pakistan has spots where outreach service delivery is ensured and those spots have not even clean safe drinking water, I am confused for online virtual and airtime hotline communication
DR MAIMOONA Emmad
01:18:56
We must not forget countries with lowest education and inabililty to access online
Daniel Levitt
01:19:06
Would be great to get ahold of the strategies for living at home safely for LGBT youth, especially if you have in multiple languages (e.g. French)
Laurabeth Muzart
01:20:48
The FSW led CBO here has been working to get some hot spots that are still active, and lack water to make Tippy Tap options (a small barrel with water) and depending on where access to soap. But they are providing during that time
Ajit Joshi
01:21:12
Robyn, on outcome one relative to isolation and mental health, how might lesbians, trans men, bi women who may not be an immediate KP focus or within the definition be included from a safety perspective? I see on concern two a switch in terminology to LGBT youth, for example; hence, I'm trying to better understand population focus and how to ensure safety. Also, from an intersectional approach, for both concerns one and two, how might more specific outreach be done for those who are also indigenous, not speaking a major language, and have a disability, and if so, in what ways? And, on concern three, what language might you recommend to decision makers so that GBV approaches do not default to focusing primarily on cisgender, heterosexual women from prevention and support approaches to the detriment of the KPs we have been speaking about? Ajit Joshi, Senior Human Rights and Inclusion Advisor, USAID/Washington
Revati Chawla
01:22:18
I think the COVID pandemic has forced us to adopt a more humanitarian approach - if people don't have water to drink (like in Pakistan), HIV is not the first ting on their minds. it is an opportunity - and need - to work more closely with the Humanitarian sectors.
Benjamin Eveslage
01:22:26
Dan here are some related resources:1. Frontline Defenders (27 March 2020) Physical, emotional and digital protection while using home as office in times of COVID-19. https://www.frontlinedefenders.org/en/statement-report/physical-emotional-and-digital-protection-while-using-home-office-times-covid-19
DR MAIMOONA Emmad
01:22:41
we received 7 calls from FSW network for SRH needs and just confirmed two expired using traditional methods, Mortality will rise if access isn't ensured in person, how we can achieve that
DR MAIMOONA Emmad
01:23:58
Covid will force many to understand that diseases know no borders and we must make guidelines taking everyone on board
Daniel Levitt
01:25:18
Thanks, Ben!
Jill Gay
01:25:58
which organizations are tracking globally access to contraception and safe abortion services globally by country?
Ajit Joshi
01:27:11
Robyn, on concern three, actions suggested (just before the opportunities section) what suggestions might you have for those managing grants and contracts so that workers become more aware of their rights and implementing partners prioritize mental health and psychosocial services of their staff? Does there need to be a broad based policy? If so, what should it look like? Ajit Joshi, Senior Human Rights and Inclusion Advisor, USAID/Washington
Michael Cassell
01:32:07
Dan: some CDC resources here: https://www.cdc.gov/lgbthealth/youth-resources.htm
Hally Mahler
01:32:29
There have been a lot of questions here regarding how countries can provide MMD when there are issues with stock. In the case of PEPFAR, I know there is a whole team that is working on this issue, working with suppliers in India and elsewhere to ensure that stocks can get to where they need to be. We do not have someone who can address this question directly on this webinar, but we will share your questions with the supply chain team at USAID and try to get back to you.
Daniel Levitt
01:32:41
Fantastic, thanks, Michael.
Hally Mahler
01:32:43
I don't know if there is someone who can answer these same questions from Global Fund?
Annette Verster
01:33:21
GF has advised countries to use 5% of their current or future grants towards COVID19
marie engel
01:33:42
Noted and thanks Hally for your response.
DR MAIMOONA Emmad
01:34:08
Thnaks Hally
Annette Verster
01:34:50
countries advise larger measures for physical distancing but the WHO recommendation remains at a minimum of at least 1 m.
Njambi Njuguna
01:35:33
Thanks Ben. In Kenya for some of our CSOs, we realized that a sizeable proportion of sex workers do not have smart phones thus cannot be reached by WhatsApp or going online approach. We are now exploring use of bulk sms service for health chats, information on GBV and tips for mitigation. It would also help them feel connected to the CSOs. We are also going to use this venue to widely distribute the hotline numbers for the CSOS
Sandar Aye
01:35:38
can anyone please share the experience of maintaining the life-saving prevention activities like condom distribution and HIV testing where online outreach is not feasible?
Hally Mahler
01:35:53
Robyn and George... there have been several questions regarding tracking criminalization examples (do we have anyone formally tracking).
Anna Grimsrud
01:36:06
Hot of the press Global Fund COVID_19 Information Note: Considerations for Global Fund HIV Support - https://www.theglobalfund.org/media/9512/covid19_hiv_infonote_en.pdf?u=637218468240000000
Hally Mahler
01:36:29
Also... there was a question about how we are ensuring that GBV prevention doesn't just focus on cis-gender women.
Hally Mahler
01:37:33
Annette... there was an earlier question asking what statements WHO will be making regarding pushing governments to take on MMD and other decentralized harm reduction approaches.
Carey Johnson
01:37:44
Is there a way to save this chat content? It is also very useful. I am trying to Ctrl+C but it isn't picking.
Hally Mahler
01:38:41
Emily... is there a link to information about that?
Laurabeth Muzart
01:38:55
@sandar We asked each out reach worker to find a location within their community (as most normal hotspots are closed or paroled by police) that is walkable and doesn't encourage large groups. We have then linked with a person there (often security guard) have shifted to HIV ST, Condom and Lubricants pick ups. We then tell people to go there for pick up. Or one on one distribution occurs where people just drop what is needed (in a normal bag) so people can pick it up and there is no close contact.
Robyn Dayton
01:39:38
In terms of making sure that GBV screening is not only for cisgender women, we encourage that all members of key populations be screened for violence. Full guidance on violence prevention and response in KP programs can be found here - https://www.fhi360.org/resource/linkages-violence-prevention-and-response-series
Hally Mahler
01:40:42
Chris and anyone else... there were questions on how community-based testing can continue during this time
Hally Mahler
01:40:53
Thanks Kent
Tiffany Lillie
01:41:46
unassisted HIVST is the priority HIV testing modality at this time
Hally Mahler
01:41:48
There were also questions about whether PEPFAR programs can purchase PPE. Please see the documents Kent just posted links to regarding that question.
Emily Christie
01:41:50
Hi, there was a question on tracking criminal laws. ICNL has a tracker on laws affecting rights and freedoms including some criminal laws https://www.icnl.org/covid19tracker/
Annita Mondo
01:42:07
What incentives have you used for participation for your digital/ online solutions
Emily Christie
01:42:17
Fair Trials also has a tracker
Ajit Joshi
01:42:24
Benjamin, how are you supporting KP needs that are beyond HIV through these platforms? Are outreach workers trained to speak to and addressoOther health needs, food security, economic livelihood, access to rights and reporting experiences of discrimination, violence, blackmail, and scapegoating that George and Robyn referenced? Can they point users to the right resources? Does the user interface in your platforms allow for users to input these other issues? Ajit Joshi, Senior Human Rights and Inclusion Advisor, USAID/Washington
Tiffany Lillie
01:42:38
If community testing is still allowable, ensure that PPE are available for staff/beneficiaries
Chris Akolo
01:42:48
Orasure Technologies has a webinar titled “Innovative Strategies for HIV screening during COVID” scheduled for Thursday, April 9, 2020, at 1:00 pm EST. You can register here: orasure.zoom.us/webinar/register/...
Daniel Levitt
01:42:59
Fantastic session - well organized and absolutely relevant. Thanks to the EpiC team for organizing, and very much looking forward to the next webinar.
Emily Christie
01:43:04
Fair trials looking at laws and access to justice https://www.fairtrials.org/covid19justice?field_tags_tid%5B0%5D=1165
George Ayala
01:43:11
Can we publish the questions and answers and circulated all slides?
Clinton Trout
01:43:50
Second Georg. Can't copy/paste the chat. Thanks all for a great webinar.
Ibeabuchi Uruakpa
01:43:55
Great presentations
Chioma O
01:44:00
Really wonderful webinar, so much useful information. Look forward to receiving the additional documents. Thank you
Annette Verster
01:44:02
as I mentioned, WHO recommends multi dose take home for OST
Nicolas Suarez
01:44:05
Thank you everyone, great presentations and appreciate everyone's questions and comments in the chat!
Daniel Levitt
01:44:22
Chris - the link you sent did not come through fully.
George Ayala
01:44:37
THANK YOU!!!
Joe McMartin
01:44:57
Thank you