Overview

The Joint United Nations Team on AIDS (Joint Team) was instrumental in providing HIV prevention, testing and treatment services in Haiti and in advocating for national and local commitments to fast track the HIV response despite other pressing health and humanitarian issues.

HIV testing and treatment

Following the 2016 High Level Meeting, the “Test and Treat” strategy was adopted as national policy by Haitian authorities. The ensuing months saw a marked increase in the number of persons getting tested for HIV, as well as patients on antiretroviral therapy (ART). Hence, on 24 June 2016, 4130 people were tested for HIV during National HIV Testing Day, an initiative conducted by the Joint Team, the Ministry of Health and civil society organizations. As a result, some 87 101 individuals are currently on ARV, which represents 57.7% of PLHIV in the country. Under the leadership of ILO, the Joint Team - in collaboration with the Ministry of Health and the Ministry of Labour and Social Affairs - provided support to employers and workers, to strengthen workplace HIV-related programmes in the Ouest and Nord-Ouest regions. These programmes aim to ensure HIV- related services are delivered in the workplace with a target population of more than 8000 workers (65% female) from the private sector. Using workplace health services as a platform, 2050 workers were given access to HIV and STI related services, including testing and counselling. In addition, 729 workers benefited from training and information from peer educators during working hours.

Innovative mechanisms to guarantee access to combination prevention services have been put in place with ILO’s collaboration. For example, HIV services were included in the collective bargaining agreement negotiations at company level. Finally, due to increased interest of the private sector and workers’ organizations in the HIV response, the ILO has supported the development of a sectoral policy for the textile sector (one of the most important private employers of the country), to be adopted in 2017. 

Elimination of mother-to-child transmission (eMTCT)

In 2016, the Joint Team contributed to the development of a road map for eMTCT, and participated in the joint United Nations and Canada programme to strengthen neo-natal and child health services after Hurricane Matthew. UNICEF also developed a training manual on the prevention of mother-to-child transmission, highlighting the need for a partnership strategy to be developed among relevant actors in order to maximize eMTCT results.

UNFPA maintained the quality of Emergency Obstetric and Neonatal Care services in four centres that also served as a model for the midwifery model of care and as training centres for students from the National Midwives Institute. In 2016, 4732 deliveries, 25 144 prenatal visits and 4355 post-partum consultations were thus assured.

HIV prevention among young people and key populations

In 2016, the Joint Team conducted awareness campaigns on HIV testing and Sexual and Reproductive Health (SRH) programmes. For example, the Joint Team supported the Ministry of Education in creating health clubs in 100 schools in 10 departments. Around 4,000 young people aged 12 to 18 were reached by awareness raising activities on HIV testing. In addition, innovative school materials on health were developed for educators, including on topics such as discrimination and violence at school.

Prevention activities were conducted in 7 of the 10 departments of the country (Artibonite, Grande-Anse, Nord, Nord-Est, Nord-Ouest, Sud and Ouest), and included:

• awareness and information on HIV/AIDS and security behaviours (153,508 adolescents sensitized);
• training of educators, peers providing testing, peer educators, health care workers (566 were trained);
• supply of condoms (1,033,073 condoms provided);
• HIV testing (7,358 sexually active adolescents and young people tested, among whom 61 (0.8%) were positive);
• referral of those HIV positive (83.6%) to healthcare settings;
• opening “Stay negative” clubs where the population can seek information on how to stay HIV negative.

As part of the ALL IN Initiative, UNICEF supported the training of 80 young people (44 girls and 36 boys) on media techniques. Following the training, the adolescents/young people made 12 programmes, eight reportages, four street interviews and three testimonies on young people, adolescents and HIV, peer influence, sexual minorities and HIV, young people and HIV prevention. They also created a page on Facebook which has garnered more than 30 000 views to date, mainly from individuals aged 15-35 who live in metropolitan areas.

Gender inequality and gender-based violence (GBV)

In 2016, the Joint Team provided support to the Ministry of Women’s Affairs and Women’s Rights to improve medical care and referrals for legal and psychosocial assistance that included conducting trainings on the Minimum Integrated Services Package (MISP) to ensure reproductive health and rights are respected during emergencies. In addition, UNFPA distributed 6,000 dignity kits and continued help the Ministry strengthen its gender-based violence (GBV) services in the Grande-Anse and Ouest departments, the areas most affected by Hurricane Matthew, and to enable access to those services to affected populations.

The Joint Team mobilised resources to enable young women and men in accessing SRH services and addressing early pregnancy as well as GBV issues (including intimate partner violence). For instance, as a result of a partnership with the TOYA Foundation, 90 adolescent and youth representatives from three departments (Artibonite, Ouest and Sud-Est) attended a series of workshops aimed at youth empowerment through skills-building in advocacy, communication, and leadership in addressing HIV, sexual violence, and unplanned pregnancies among young girls. 

Investment and efficiency

The Joint Team supported the National Statistics Office (Institut Haïtien de Statistiques et d’Informatique - IHSI) in implementing the 2017/2018 census by mobilizing US$ 30.5 million. Support was also provided to the National AIDS Commission to gather information on the departments most affected by Hurricane Matthew, with findings fed into the Post Disaster National Assessment plan. In addition, poll studies are being conducted to generate more evidence on stigma and discrimination faced by PLHIV and key populations in partnership with the Center for Disease Control (CDC).

Finally, the capacity of PLHIV networks to access Global Fund resources has been strengthened so they may better advocate for a greater number of patients to be included in ART retention and PMTCT programmes.

Secretariat functions

Using evidence-based data, and in agreement with national authorities, six cities in Haiti with the highest HIV burden were identified. The mayor of one of these cities was invited to participate in the Cities event during the High-Level Meeting held in June 2016 in New York. As an outcome of his participation, the mayor committed to provide all needed support to mobilise the mayors of the metropolitan area. Creating a dialogue on the involvement of municipalities in the national response to HIV, the mayors and deputy-mayors of nine cities (Carrefour, Cité Soleil, Croix des Bouquets, Delmas, Gressier, Kenskoff, Port au Prince, Pétion-Ville and Tabarre) actively engaged in the implementation of the Paris Declaration. The UNAIDS Secretariat also supported them in the development of a road map for their respective city in the context of the Fast-Track strategy

In 2017, the Joint Team will endeavour to:

• mobilize 12 mayors of Fast-Track cities, organizing orientation workshops on the Fast-Track cities' initiative in five cities and capacity building sessions of cities’ focal points, and developing of cities' plans;                    
• establish a partnership with the Haiti National Federation of Mayors for the implementation of the Paris Declaration;           
• conduct a series of  workshops on key strategies to fast-track prevention activities as well as voluntary counselling and testing services among youth and adolescent;
• mobilize community-based organizations for HIV prevention and testing (Carnaval HIV Campaign, Caribbean Testing Day Campaign, World AIDS Day);
• develop and conduct workshops on key strategies to fast-track eMTCT;
• brief the incoming governmental  authorities on the High-Level Meeting, and the engagements needed for the implementation of the 2016 Political Declaration;
• develop a plan to address stigma and discrimination and promote the human rights of key populations and PLHIV.