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Programmatic Mapping and Size Estimation of Key Populations in Haiti

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Programmatic Mapping and Size Estimation of Key Populations in Haiti Programmatic Mapping and Size Estimation of Key Populations in Haiti FINAL REPORT APRIL 2017 APRIL 2017 This document was made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The contents are the responsibility of the LINKAGES project and do not necessarily reflect the views of USAID, PEPFAR, or the United States Government. LINKAGES, a five-year cooperative agreement (AID-OAA-A-14-00045), is the largest global project dedicated to key populations. LINKAGES is led by FHI 360 in partnership with IntraHealth International, Pact, and the University of North Carolina at Chapel Hill. Contents CONTRIBUTORS ............................................................................................................................................. 5 ACKNOWLEDGMENTS ................................................................................................................................... 5 EXECUTIVE SUMMARY .................................................................................................................................. 6 BACKGROUND ............................................................................................................................................... 8 HIV in Haiti ................................................................................................................................................ 8 Key Populations in Haiti ............................................................................................................................ 9 HIV Prevalence in Key Populations ......................................................................................................... 11 Introduction to PLACE ............................................................................................................................. 13 Study Objectives ..................................................................................................................................... 13 Study Timeline ........................................................................................................................................ 13 METHODS .................................................................................................................................................... 14 Preparation ............................................................................................................................................. 14 Data Collection ........................................................................................................................................ 15 Personnel and Training ....................................................................................................................... 15 Study Procedures ................................................................................................................................ 16 Ethical Considerations ......................................................................................................................... 19 Data Management and Analysis ......................................................................................................... 19 Data Use .................................................................................................................................................. 24 NATIONAL RESULTS ..................................................................................................................................... 25 Selection of Study Areas ......................................................................................................................... 25 Phase I: Community Informant Interviews ............................................................................................. 27 Phase II: Hot Spot Mapping .................................................................................................................... 30 Phase III: Individual Interviews and Testing ............................................................................................ 36 HIV Treatment Cascade....................................................................................................................... 43 Coinfection with Syphilis and HIV ....................................................................................................... 44 Risk Factors for HIV ............................................................................................................................. 45 Key Population Size Estimates ................................................................................................................ 50 SUBNATIONAL RESULTS .............................................................................................................................. 54 Artibonite ................................................................................................................................................ 55 Centre...................................................................................................................................................... 57 Grande-Anse ........................................................................................................................................... 59 Nippes ..................................................................................................................................................... 61 Nord ........................................................................................................................................................ 63 Nord-Est .................................................................................................................................................. 65 Nord-Ouest ............................................................................................................................................. 67 Ouest ....................................................................................................................................................... 69 Sud .......................................................................................................................................................... 71 Sud-Est .................................................................................................................................................... 73 DISCUSSION ................................................................................................................................................. 75 Strengths and Limitations ....................................................................................................................... 78 RECOMMENDATIONS…………………………………………………………………………………………………………………………….81 REFERENCES ................................................................................................................................................ 83 APPENDIX A: FORM A.................................................................................................................................. 86 APPENDIX B: FORM B .................................................................................................................................. 87 APPENDIX C: FORM C .................................................................................................................................. 93 CONTRIBUTORS The University of North Carolina at Chapel Hill (UNC) conducted this study with support from FHI 360, the U.S. Agency for International Development (USAID), and the Programme National de Lutte contre les IST/VIH/Sida (PNLS). The study was conducted as part of Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES), a five-year cooperative agreement funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). This global project is implemented by FHI 360 in partnership with Pact, IntraHealth International, and the University of North Carolina at Chapel Hill. Investigators • Jess Edwards, PhD • Michael Herce, MD • Jacob Michel, MS • Sharon Weir, PhD • Lauren Zalla, MS ACKNOWLEDGMENTS Many individuals made this study possible. First and foremost, we acknowledge Yardley Estiverne and all the members of the field team including Dulène Alexis, Jamessie Boucher, Rony Brignolle, Daphney Cadet, Marie Génite Daniel, Socaina Desarmes, Betshaida Henscherley Desormes, Marie Yvelène Eliacin, Nadine Estelly, Suzette Etienne, Jackson Fleuranvil, Johnson Francois, Pierre-Paul Jacques, Dudley Jasmin, Jean Max Jean, Steeven Jean-Gilles, Samson Joseph Hervil, Samuel Jean-Lys, Sophonie Jeanty, Ralph Steevens Jeudy, Louis André Joseph, Kingson Ladouceur, Guirlene Laurent, Farah Longchamps, Duval F. Chevalier Mathias, Valéry Michel, Mackenson Michel, Linetcheli Michel, Stéphanie Mondésir, Régine Noël, Lucianne Picard, Marlange Pierre, Manès Pierre, Lovely Raphael, Junior Ruben, Nadia St. Fort Laurent, and Célestin Val-Ciis. We thank the staff of the PNLS for accompanying the study team from the very beginning, especially Gracia Desforges and Nirva Duval. LINKAGES staff members contributed to the success of this study in many ways, especially Steeve Laguerre, Max Bond Saint-Val, Johanne Etienne, Rashid Dorsainvil, Philippe Jean, Danielle Jadotte, Sarahdjaine Cadet, and Michel Millien. Several organizations assisted the study team in the field, especially SEROvie and Union de Personnes Luttant contre
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