Integration of HIV-related Services for Sustainability under PEPFAR

Enhances the integration of HIV-related services and primary healthcare in select countries that are at or near HIV epidemic control to sustain gains made by PEPFAR and contribute to resilient public health systems. The United States President's Emergency Plan for AIDS Relief (PEPFAR) is a US governmental initiative to address the global HIV/AIDS epidemic. To ensure longevity and sustainability in areas with low HIV prevalence, HIV treatment can be incorporated into existing successful primary health care models with decentralised service delivery to promote adherence to long-term treatment.18 With support from the United States Agency for International Development (USAID) and other international partners, Haiti has had integrated HIV and primary health-care services for over 20 years.19, 20 The PEPFAR programme in Haiti integrates HIV, maternal and child health care, and family planning services in primary health-care settings to reduce HIV stigma. At the site level, Haitians who receive maternal and child health care and family planning services also obtain HIV education and screening, as well as STI education and treatment. At the community level, Haiti provides integrated HIV self-testing, postnatal visits, immunisations, referral services, adherence counselling, and tracking of treatment interruptions. HIV services are also being integrated into the scope of work for community health workers.21 Efforts to make HIV treatment more sustainable include gradual transition of donor-paid health worker salaries to the national budget.