Project Title: EpiC – Maintaining Targets and Maintaining Epidemic Control

Donor: U.S. President’s Emergency Plan for AIDS Relief (PEFAR) and the U.S. Agency for International Development (USAID)

Partners: The project is led by FHI 360 and WAAF is implementing EpiC with two community-based organizations namely, Hope Alliance Foundation (HAF) and Worldwide International Youth Organization (WIYO)

Project Timeframe: 5 years (2019 – 2024). The official start date of the project for the WAAF team: August 1st, 2020

Geographical Scope: The geographical scope is the Greater Accra Region of Ghana

  • HAF is focusing on men who have sex with men (MSM) and transgender (TG) people
  • WIYO is focusing on FSW (female sex worker)

Project Goal/Objective: WAAF will target two key activities that will challenge the remaining barriers to epidemic control: HIV self-testing and the administering of Pre-exposure Prophylaxis (PrEP). The four primary objectives of the project focus on developing existing HIV prevention measures, case finding, treatment gaps, and building long-term sustainability to attain and maintain epidemic control.

  • Attain and maintain control of the HIV epidemic among at-risk men, women, and priority population (PP)
  • Attain and maintain control of the HIV epidemic among the key population (KP)
  • Improve program management (including health information systems (HIS), human resources for health (HRH), and financial systems) to ensure attainment and maintenance of control of the epidemic
  • Support the transition of prime funding and implementation to capable local partners to meet the PEPFAR goal of 70% of funding to local partners by 2020

Rationale: Key population groups continue to be at a higher risk of contracting HIV despite various interventions that have been used to reach out to them. With the goal of reaching the UNAIDS 90-90-90 targets and achieving HIV epidemic control by 2030, which ultimately will result in an overall reduction of the spread of HIV, there is the need to ensure all evidence-based approaches that successfully reduce HIV transmission are utilized.

Pre-Exposure Prophylaxis (PrEP) is one intervention that, to date, has not been implemented in Ghana. However, in other parts of the world, there is evidence that PrEP can ensure the virus is blocked from establishing a permanent infection for people who are at very high risk of contracting HIV and take the pill every day. Data has further shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily.

Therefore, to ensure that Ghana does not fall behind in reaching targets and maintaining epidemic control, PrEP must certainly be one of the interventions in HIV programming.

Evidence to support the need for the project: Even with the great strides the Ghana HIV program has made in abating the HIV epidemic, more work is still needed. FSW, with a 6.9% HIV prevalence, and MSM, with an 18% HIV prevalence, are higher-risk populations for contracting the disease. There is a staggering amount of people, approximately 43%, who do not know their status. UNAIDS data collected in 2019 estimates that only 34% of people living with HIV (PLHIV) are on antiretroviral therapy (ART). This is evidence that there is a need for a continual and more aggressive national response to help stop the spread of HIV.

  • Progress so far:
  • 172 KP reached with PrEP information and screened
  • 72 FSW
  • 93 MSM
  • 7 TG
  • 130 KP initiated on PrEP at International Health Care Center (IHCC)
    PrEP has been highly accepted by the KP, both MSM, FSW, and TG.
    There has been positive feedback from many of the clients introduced to PrEP. Education is ongoing and innovative strategies to ensure more enroll and more remain in care.