Support SongES and MVS in the development of PrEP and HIV self-testing pilot projects and strengthen their capacity to implement, monitor, evaluate and capitalize on these pilot projects (phase 1)

Background

The main objective of the Global Fund’s HIV-HSR (2021-2023) grant is to contribute to a 75% reduction in new HIV infections and a 75% reduction in HIV-related deaths by 2022 and to strengthen the demand for and delivery of quality health care and services to the general population. The HIV-HSSR grant (2021-2023) plans to offer testing to 90% of MSM, 60% of sex workers (SW), 54% of prisoners, and 92% of pregnant women by 2023.

In Niger, despite concentrated type prevalence among key populations, HIV testing coverage remains low among these key populations (SW 6.46%; MSM 11.22%). In 2019, the Global Fund’s HIV grant implementation report indicates that only 33% of MSM have been tested and know the result, compared to 13% of SW. This is due to the priority use of conventional testing (voluntary testing, provider-initiated testing), as the differentiated testing strategy (community-based testing) has only recently been adopted (National HIV Testing Standards and Guidelines, CDIS, 2021). In addition, Niger does not have national guidelines for the administration of pre-exposure prophylaxis (PrEP) in key populations, including MSM, even though PrEP is widely recommended by WHO to prevent HIV transmission in key populations.

In order to contribute to Niger’s HIV prevention objectives, two pilot projects have been proposed to test HIV self-testing (HIVST) and PrEP among key populations (SW, MSM) within the framework of the Global Fund’s C19RM additional financing (2022-2023):

PrEP pilot project in key populations (100 SW and 100 MSM) in Niamey in Year 1 and in Zinder (50 SW and 50 MSM) in Year 2.
HIV self-testing pilot project among key populations (100 SW and 100 MSM) in Niamey in Year 1 and in Zinder (50 SW and 50 MSM) in Year 2.

Duration	April 2022 – July 2022
Source of funding	Initiative Chanel 1
Beneficiary	Mieux vivres sans le SIDA (MVS) et SongES
Total amount of the project	60 750 €
Country	Niger

General objective of the mission: To support SongES and MVS in the development of PrEP and ADVIH pilot projects and to strengthen their implementation, monitoring and evaluation, and capitalization capacities

Specific objectives of the mission

Specific Objective 1: To co-develop the PrEP and HIV self-testing pilot projects
Specific objective 2: Strengthen the implementation, monitoring and evaluation capacities and capitalize on the PrEP and HIV self-testing pilot projects

Activities and Deliverables:

Step 1 – Kick-off meeting:

Presentation of the methodology, scoping and planning of the technical assistance

Step 2: Conduct a situational analysis and feasibility assessment of the pilot projects

Literature review and analysis: National normative documents, legislative documents, literature (evidence and similar experiences), mapping of key populations, partners activity reports and more broadly reports on national HIV prevention and testing for key populations, funding elements (including GF)
Participatory diagnosis (mission): On-site observations (patient circuit, organization of services…), interviews with stakeholders including key populations, analysis of barriers and facilitators to access to prevention and testing services, analysis of feasibility and integration of HIVST and PrEP in the existing offer
Quantification of inputs needed for HIV treatment and PrEP and comparison with availability/supply plan/existing resources

Step 3: Development of operational and capacity building plans

Based on the situational analysis/diagnosis and exchanges with partners, confirmation of the feasibility of deployment, two operational plans for HIVST and PrEP integrating the preparation and deployment stages, a timetable and budgetary elements
The operational plans will be accompanied by a capacity building plan for SongES and MVS, particularly for those involved in the dispensing of HIV treatment and the prescription and monitoring of PrEP

Step 4: Development of a brief note on the strategy for deployment, potential scaling up, sustainability and capitalization of PrEP and HIVST pilot projects

A brief note on the strategies for deployment, potential scaling up, sustainability and capitalization of the PrEP and HIVST pilot projects will be proposed, highlighting in particular the strategic axes/choices, identified risks and opportunities for a potential phase 2